Abstract:

Objective To explore the application of cognitive interview in the development of patient experience with nursing care scale. Methods According to the conceptual framework of patient experience with nursing care,the scale was developed by interviewing and expert consultations. By purposive sampling method,23 inpatients were selected as interviewees from June to July of 2020 in a tertiary hospital in Shanghai. 3 rounds of cognitive interviews were conducted to explore the respondents’ understanding of each item and their suggestions. The items of the scale were revised according to the results of the interviews and the expert group discussions. After the revision,we used convenient sampling to select 427 inpatients who were admitted to Zhongshan Hospital of Fudan University from May to June 2021 for testing psychometric properties,and the best potential structure of the scale was formed through program analysis and exploratory factor analysis. Results The first round of results showed that 8 items were revised due to "vague and unclear sentence"; the second round of results showed that an item was revised due to "incomprehensible keywords";the third round of results showed that the respondents were able to understand all the items. The final version of the scale includes 7 dimensions,namely,admission and discharge management,information and education,emotional support,observation and treatment,safety and privacy,response needs,communication and coordination,and the cumulative variance contribution rate is 70.785%. The Cronbach’s α coefficient of the scale is 0.945,and the average content validity index is 0.959 with good reliability and validity. Conclusion Cognitive interviews are helpful to the development of patient experience with nursing care scale,which effectively guides the revision of items,and can efficiently solve the problems of understanding differences and measurement errors in the process of scale development,so as to improve the scientificity,accuracy and applicability of the scale.

Key words: Patient Experience, Scale Development, Cognitive Interview, Nursing Administration Research

摘要：

目的 探讨认知性访谈在患者护理服务体验量表编制中的应用。 方法 在患者护理服务体验概念框架的指导下,通过患者访谈、专家函询形成初测量表。采用目的抽样选取2021年2月—4月就诊于上海市某三级甲等综合医院的23例住院患者作为访谈对象,共进行3轮认知性访谈,了解使用人群对量表各条目的理解情况及建议,并结合访谈结果,通过专家小组讨论,在不改变句意的基础上对条目进行修订。修订后通过方便抽样法选取427例于2021年5月—6月在复旦大学附属中山医院就诊的住院患者进行测量学检验,通过项目分析和探索性因子分析,找出量表潜在结构。 结果 第1轮访谈结果显示,8个条目句意模糊、表达不清,进行修订;第2轮访谈结果显示,1个条目关键词难以理解,进行修订;第3轮访谈结果显示,受访者能够正确理解条目。最终正式量表包括7个维度,分别为出入院管理、信息与教育、情感支持、病情观察与处理、安全与隐私、应答需求、沟通与协调,累计方差贡献率为70.785%。量表的Cronbach’s α系数为0.945,平均内容效度指数为0.959,具有良好的信效度。 结论 通过采用认知性访谈,了解目标人群对患者护理服务体验量表各条目的理解情况,有效解决了量表编制过程中的理解差异及测量误差问题,提高了患者护理服务体验测评量表的科学性、准确性与适用性。

关键词: 患者体验, 量表编制, 认知性访谈, 护理管理研究