Development and psychometric tests of the Palliative Care Quality Assessment Scale in the neonatal intensive care setting
王草源 1任义梅 1陈方圆1
扫码查看
点击上方二维码区域，可以放大扫码查看
作者信息
1. 210029 南京市 南京医科大学第一附属医院(江苏省人民医院)新生儿科
折叠
摘要
目的 编制NICU终末期患儿安宁疗护质量评价量表(Neonatal Intensive Care Unit-Palliative Care Quality Assessment Scale,NICU-PCQAS),并检验其信效度,为测评 NICU 患儿安宁疗护质量提供适用工具.方法 在新生儿"优逝"理论框架指导下,借鉴成人死亡质量量表,通过文献回顾和半结构式访谈构建量表条目池;通过德尔菲专家函询、预调查形成量表初稿.采用方便抽样法,对2021年7月-2023年7月江苏省、浙江省、四川省等3所综合医院、9所妇幼保健院、6所儿童医院的344例NICU患儿的安宁疗护质量进行调查,并进行项目分析和信效度检验.结果 量表包括5个维度,20个条目.探索性因子分析共提取5个公因子,可解释总变异的76.35％;验证性因子分析结果显示,量表结构模型的拟合指标良好(x2/df=1.25、残差均方根=0.03、增值拟合指数=0.99、拟合优度指数=0.99、近似误差均方根=0.03).量表条目水平的内容效度指数为0.78～1.00,量表水平的内容效度指数为0.97.总量表的Cronbach's α系数为0.92,折半系数为0.75,各维度的Cronbach's α系数为0.86～0.93,折半系数为0.87～0.92.结论 NICU-PCQAS信效度良好,可用于测评NICU患儿的安宁疗护质量,为NICU新生儿安宁疗护的开展提供依据.
Abstract
Objective To develop the Neonatal Intensive Care Unit-Palliative Care Quality Assessment Scale(NICU-PCQAS)and evaluate its reliability and validity,with the aim of providing an appropriate tool for assessing the quality of palliative care in NICU infants.Methods Guided by the conceptual model of a good death in the NICU,and referring to the Adult Quality of Dying and Death Questionnaire,the initial item pool was constructed through literature review and semi-structured interviews.The draft of the NICU-PCQAS was developed using a Delphi methodology and pre-investigation.Convenient sampling was used to investigate and evaluate the quality of palliative care of 344 neonates in 3 general hospitals,9 maternal and child health hospitals,and 6 children's hospitals in Jiangsu Province,Zhejiang Province,and Sichuan Province from July 2021 to July 2023.The data were then analyzed for item analysis,testing of reliability and validity.Results A 5-domain,20-item NICU-PCQAS was developed.Exploratory factor analysis identified five factors accounting for 76.35％of the variance.Confirmatory factor analysis showed a good fit(x2/df=1.25,RMR=0.03,IFI=0.99,CFI=0.99,RMSEA=0.03).The I-CVI ranged from 0.78 to 1.00,and the S-CVI was 0.97.The Cronbach's α was 0.92,and the Spearman-Brown coefficient was 0.75.Domain-specific Cronbach's α ranged from 0.86 to 0.93,and Spearman-Brown coefficients ranged from 0.87 to 0.92.Conclusion The NICU-PCQAS is reliable and valid,suitable for assessing the quality of palliative care in NICU infants,and supports the development of palliative care in NICUs.
关键词
安宁疗护/死亡质量/新生儿重症监护病房/量表编制/信度/效度
Key words
Palliative Care/Quality of Dying and Death/Intensive Care Units,Neonatal/Scale Development/Reliability/Validity
维普
万方数据