| Objective: The purpose of this study is to revise the existing scoring standards for the skill operation of medical assistants in Shanxi Province through scientific methods,so as to increase their scientificity and practicability,improve their reliability and validity,and provide theoretical basis for the training and assessment of nursing assistants.Methods: A preliminary study was conducted by using literature analysis method and semistructured interview method,and a preliminary item pool was constructed based on the existing skill operation scoring standards of medical nursing assistants in Shanxi Province.Delphi expert consultation method was applied to select the index items.Yaahp software was used to calculate the weight of each level of indicators.Item analysis method,variation coefficient method,consistency coefficient method and collinearity coefficient method were used to test and re-screen the items and finally determine the items.The evaluation of 352 nursing assistants trained in a third-class a hospital was carried out by using the formed skill operation scoring standard for medical nursing assistants.SPSS23.0 was used to analyze the data.Internal consistency reliability,fractional half-reliability,Person correlation coefficient,content validity index and exploratory factor analysis were used for reliability and validity analysis.Experts were invited to use the Angoff method,a standard reference examination qualification line,to delimit the skill operation examination qualification line.Results:1.Construct a standard entry pool for skill operation scoring of medical nursing assistants Through qualitative interviews with 12 medical nursing assistants,this study obtained four themes: organizational environment of training and assessment,assessment system,acculturation and income return of training.A total of 20 experts completed three rounds of Delphi expert consultation,and the three rounds of questionnaire recovery rates were 100%,91% and 100%,the feedback rates were 82%,65% and 10%,the expert's authority coefficient was 0.85,and the kendall's W was 0.317(P<0.001).It indicates that the enthusiasm and authority of experts are high,and the opinions of experts tend to be consistent.2.Set the weight of indicators at all levels With reference to experts' importance scoring of indicators at all levels(Likert fivelevel scoring method),Analytic hierarchy process(AHP)method and Yaahp software were used to determine the weights and combined weights of indicators at all levels.The results are shown in the appendix.3.Screening of index items In this study,202 medical nurses were tested by four methods: item analysis method,coefficient of variation method,coefficient of consistency method and collinearity coefficient method.The results of the project analysis method showed that there was no significant difference between the three high and low groups(P > 0.01),namely,"ask the patient whether the operation can be carried out and obtain the informed consent of the patient or family member";"dictate the temperature and humidity of the ward to make the environment suitable for operation";"close the doors and Windows as appropriate to cover the patient";The results of the coefficient of variation method show that the coefficient of variation of all items is greater than 0.2,which basically meets the design requirements,except the "method specification and privacy protection",which is 0.19.The Alpha coefficient of Crobach's shows that the internal consistency of items is 0.710,and the Alpha coefficient of Crobach's goes up instead of dropping an item.The results of the correlation coefficient method showed that there were a pair of indicators greater than 0.8,namely "wear mask or gloves in the correct way before operation" and "remove mask or gloves in the correct way after operation".After the screening,the nursing staff skill operation scoring standards were finally formed with 5 first-level indicators,12 second-level indicators and 26 third-level indicators.4.Reliability and validity test of nursing staff skill operation scoring standard Crobach's Alpha coefficient of internal consistency reliability is 0.703.The results show that the guttmann folding coefficient is 0.855.The content validity was evaluated by the importance score of 20 experts on each item,that is,the ratio of the number of experts scoring 4 or 5 points to the total number of experts,and the item level validity(I-CVI)was 0.78 ~ 1,the Kappa value was 0.72 ~ 1,and the scale level(S-CVI)was 0.98.The Person correlation coefficient shows that the correlation coefficient between each dimension of the indicator system and the total score is 0.499~0.786(P<0.01),and the correlation coefficient between the scores of each dimension is 0.118~0.447(P<0.01).The structure of this study adopts the analysis exploratory factor analysis,reliability and validity of using principal component analysis,the maximum variance method to extract the common factor,the results showed KMO = 0.673,Bartlett's spherical chi-square test statistics = 2847.783(df = 325,P < 0.001),explain the correlation between variables is strong,suitable for exploratory factor analysis,in order to load factor value is 0.35 or higher standard to extract the common factor.Results a total of 12 common factors were extracted,the factor interpretation was consistent with the scale design,and the cumulative variance contribution rate was 80.627%.5.Determination of eligibility criteria Angoff method was used to determine the qualified score.Finally,15 experts completed the whole process(experts were from Delphi correspondence experts),and the qualified score was 62.15 points.Conclusion: The revised skill operation scoring standard for medical nursing assistangts in Shanxi Province has been screened and tested by a variety of methods,and has met the requirements of statistics and practical application of the scale.The analytic hierarchy process(AHP)was used to set the weights of all levels of indicators,and Angoff method was used to determine the qualified scores,with relatively scientific results. |
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