【摘要】：目的:構(gòu)建腸造口患者出院后護理需求量表,并檢驗其信效度。為護理工作者進行支持性照護提供有效評估工具,為護理工作者實施有針對性的護理干預(yù)提供理論參考依據(jù)。方法:(1)條目池形成:通過調(diào)研國內(nèi)外的相關(guān)文獻,以馬斯洛需要理論為框架,結(jié)合小組討論,運用質(zhì)性研究,對吉林省3家三級甲等醫(yī)院出院后的12名腸造口患者進行半結(jié)構(gòu)式訪談?wù){(diào)研,深入了解造口患者出院后的護理需求內(nèi)容(訪談時間為:2015年9月-10月),對訪談錄音資料進行整理分析后,形成腸造口患者出院后護理需求量表條目池。(2)預(yù)試量表形成:選取國內(nèi)6家三級甲等醫(yī)院的9位腸造口醫(yī)療、護理專家,運用德爾菲法,通過兩輪專家函詢對條目進行篩選及內(nèi)容效度評定,刪除內(nèi)容表達不清的條目,增加認為應(yīng)補充的條目,形成6個維度的預(yù)試量表。采用目的抽樣法對吉林省3家三級甲等醫(yī)院20名出院后的腸造口患者進行小樣本測試(2015年11月-2016年1月)。(3)量表形成及檢驗:2016年2月-10月,通過便利抽樣法,選取吉林省3家三級甲等醫(yī)院結(jié)直腸科行腸造口術(shù)后已出院患者200名,進行量表臨床施測后,收集該量表的相關(guān)數(shù)據(jù),并利用決斷值法、相關(guān)系數(shù)法和內(nèi)部一致性系數(shù)法,再進一步判斷該量表條目有無增減,并采用內(nèi)部一致性信度、分半信度、重測信度、內(nèi)容效度和結(jié)構(gòu)效度對量表各條目進行信效度分析。結(jié)果:(1)量表形成情況本研究通過文獻回顧、患者質(zhì)性訪談結(jié)合對專家進行德爾菲法函詢后,經(jīng)過小樣本預(yù)調(diào)查,再對條目進行統(tǒng)計學(xué)篩選后形成6個維度、24個條目的正式測試量表。(2)量表的信度本研究量表的總Cronbach’a系數(shù)為0.751,各維度Cronbach’a系數(shù)為在0.968-0.974,均在0.7以上,說明內(nèi)部一致性較好。量表的折半信度為0.794;重測信度為0.827。(3)量表的效度量表總體的內(nèi)容效度S-CVI為0.968,24個條目的I-CVI值在0.78-1.00。量表總體適當(dāng)性量數(shù)KMO值為0.913,指標(biāo)值大于0.900,表示變量間有共同因素存在;Bartlett球形檢驗的近似卡方分布為4653.818,自由度為276,顯著性概率值P≤0.01,達到顯著水平,說明量表項目適合進行因素分析。提取主成分6個,6個主成分累積解釋變異程度為91.753%,說明該量表具有較好的效度。結(jié)論:(1)本研究完成了腸造口患者出院后護理需求量表的編制。量表內(nèi)容包括6個維度、24個條目。(2)量表信效度較為理想,能夠科學(xué)、準(zhǔn)確、全面的反映腸造口患者出院后的護理需求,可以利用本量表對其進行護理需求的評估。
[Abstract]:Objective: to construct a nursing demand table for patients with enterostomy after discharge and to test its reliability and validity. To provide an effective evaluation tool for nursing workers to carry out supportive care, and to provide theoretical reference for nursing workers to carry out targeted nursing intervention. Methods: (1) the formation of item pool: by investigating the relevant literature at home and abroad, taking Maslow's needs theory as the frame, combining with group discussion, using qualitative research, Twelve patients with enterostomy after discharge from 3 Grade 3A hospitals in Jilin Province were investigated with semi-structural interviews. After deeply understanding the nursing needs of the patients who were discharged from the hospital (interview time: September-October 2015), after sorting out and analyzing the recorded interview materials, (2) formation of pre-test scale: select 9 enterostomy medical experts from 6 Grade 3A hospitals in China, and use Delphi method. The items were screened and evaluated by two rounds of expert letter, the items which were not clearly expressed were deleted, the items that should be supplemented were added, and the pre-test scale of six dimensions was formed. Objective to test the formation and test of small sample (). (3) scale in 20 patients with enterostomy after discharge from 3 Grade 3A hospitals in Jilin province from November 2015 to January 2016. Two hundred patients who had been discharged from hospital after colorectostomy were selected from 3 Grade 3A hospitals in Jilin province. The data of the scale were collected after clinical test, and the determination value method, correlation coefficient method and internal consistency coefficient method were used to collect the relevant data of the scale. Furthermore, the internal consistency reliability, split-half reliability, test-retest reliability, content validity and structural validity were used to analyze the reliability and validity of each item of the scale. Results: (1) the form of the scale was studied by literature review, qualitative interviews with experts were conducted by Delphi method, and a small sample was pre-investigated. After statistical screening, 6 dimensions and 24 items of formal test scale were formed. (2) the total Cronbach'a coefficient of reliability of the scale was 0.751, and the Cronbach'a coefficient of each dimension was 0.968-0.974, all above 0.7, indicating that the internal consistency was better. The compromise reliability of the scale was 0.794, and the test-retest reliability was 0.827. (3) the overall content validity of the scale was 0.368, and the I-CVI of 24 items was 0.78-1.00. The KMO value of the total fitness of the scale was 0.913, and the index value was greater than 0.900. The approximate chi-square distribution of Bartlett spherical test was 4653.818, and the degree of freedom was 276.The significant probability value P 鈮，

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