衡量关怀科学：一种以患者为中心的关怀互动预测模型。
Measuring the Science of Caring: A Patient-Centred Predictive Model for the Caring Interaction.
作者信息
Allande-Cussó Regina, Pinero-De Plaza María Alejandra, Gómez-Salgado Juan, Porcel-Gálvez Ana María
机构信息
Department of Nursing, University of Seville, Seville, Spain.
Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Bedford Park, South Australia, Australia.
出版信息
Scand J Caring Sci. 2025 Sep;39(3):e70110. doi: 10.1111/scs.70110.
BACKGROUND
The nurse-patient relationship is central to quality nursing care, yet its impact remains difficult to quantify. While existing models assess caring competencies from the perspective of nursing students and professionals, there is a lack of validated instruments incorporating direct patient feedback.
OBJECTIVE
This study aimed to develop and validate the Nursing Interaction in Caring_Competence Assessment-Patient (NIC_CA-Patient) tool, a patient-centred instrument designed to measure caring interaction in nursing practice and establish a predictive model of its development from the patient's perspective.
METHODS
A cross-sectional study was conducted in eight hospitals within the Andalusian Health Care System, involving 1060 patients admitted to internal medicine units. The NIC_CA-Patient tool was adapted from the Caring Nurse-Patient Interactions (CNPI) scale and validated through exploratory factor analysis (EFA) and partial least squares structural equation modelling (PLS-SEM).
RESULTS
The final model identified three key dimensions-therapeutic relationship, problem management and adaptation-explaining 79% of the variance in patient-reported experiences. The predictive model demonstrated strong reliability (Cronbach's α = 0.97) and excellent model fit indices (SRMR = 0.03, AVE > 0.7).
CONCLUSION
The NIC_CA-Patient tool provides a quantifiable and predictive measure of caring interaction from the patient's perspective. Its implementation in clinical practice and research can enhance patient-centred care by identifying relational factors that improve health outcomes and patient experience.
背景
护患关系是优质护理的核心，但它的影响仍难以量化。虽然现有模型从护理专业学生和专业人员的角度评估关怀能力，但缺乏纳入患者直接反馈的经过验证的工具。
目的
本研究旨在开发并验证以患者为中心的“护理关怀能力评估-患者版”（NIC_CA-Patient）工具，该工具旨在衡量护理实践中的关怀互动，并从患者角度建立其发展的预测模型。
方法
在安达卢西亚医疗保健系统的八家医院进行了一项横断面研究，涉及1060名入住内科病房的患者。NIC_CA-Patient工具改编自“关怀护患互动”（CNPI）量表，并通过探索性因子分析（EFA）和偏最小二乘结构方程模型（PLS-SEM）进行验证。
结果
最终模型确定了三个关键维度——治疗关系、问题管理和适应——解释了患者报告体验中79%的方差。预测模型显示出很强的可靠性（Cronbach's α = 0.97）和出色的模型拟合指数（SRMR = 0.03，AVE > 0.7）。
结论
NIC_CA-Patient工具从患者角度提供了一种可量化和预测性的关怀互动测量方法。在临床实践和研究中实施该工具可以通过识别改善健康结果和患者体验的关系因素来加强以患者为中心的护理。
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