Current Status And Influencing Factors Of Training Migration Of Stroke Specialist Nurses In Henan Province

Objective:1.Compiling a questionnaire on the status of training and transfer of stroke specialist nurses and conducting the reliability and validity tests.2.Investigating the current status of the training and transfer of stroke specialist nurses and exploring corresponding-influence factors.Methods:This study includes two parts:Part Ⅰ:The compiles of a survey questionnaire on the current status of the training and transfer of stroke specialist nurses,which consists of two stages:Stage 1:Research on the work experience of stroke specialist nurses after trainingThe direct sampling method was applied to select 12 stroke nursing specialists and 10 stroke managers and a semi-structured interviews were conducted to gain insights into the on-the-job experience of stroke specialist nurses after receiving training at the current stage,as well as the manager’s perspectives on the current status of training and transfer of stroke specialist nurse.The aim of above is to provide reference for compiling the questionnaire item pool.Stage 2:Formation of the first draft of the questionnaire on the status of training and transfer of stroke specialist nurses and the examination of its reliability and validity.On the basis of qualitative research,after reviewing the relevant literature,the first draft of the questionnaire on the status of the stroke specialist nurse training and transfer was compiled,and then the questionnaire survey draft formed through two rounds of Delphi expert consultation.A small sampling and large sampling surveys were conduct to test the reliability and validity of the questionnaire.260 stroke specialist nurses and 320 stroke specialist nurses were selected as the research objects by cluster sampling method in 6 stroke specialist nurse training base hospitals outside the province during August to September 2020 and October to December 2020,respectively.Thereinto,260 samples were used for project analysis,exploratory factor analysis and reliability analysis while later 320 samples were used for verification factor analysis.Research tools include general information questionnaires and questionnaires on the status of training and transfer of stroke specialist nurses.SPSS 21.0 software was used for data analysis while item total score correlation method and decision value method were used for item analysis.The validity of the questionnaire content was evaluated through item-level content validity index(item-level CVI,I-CVI)and questionnaire average content validity(S-CVI/Ave)).The structural validity of the questionnaire was evaluated by exploratory factor analysis and confirmatory factor analysis.The reliability of the questionnaire was assessed by calculating internal consistency and test-retest reliability analysis.Part Ⅱ:Investigation on the current situation and influence factors of training and transfer of stroke nursing specialists.270 trained stroke specialist nurses during February to March 2021 were selected as the research object by the convenience sampling method from five hospitals in Henan Province,including the First Affiliated Hospital of Zhengzhou University,the Fifth Affiliated Hospital of Zhengzhou University,and the First Affiliated Hospital of Henan University of Science and Technology.The general information questionnaire,the questionnaire on the training and transfer status of stroke specialist nurses,the nurse organization innovation atmosphere scale,the nurses’ working environment scale,and the questionnaire on the self-learning ability of nurses were used to investigate the current status of the stroke specialist nurse training and transfer,and the influencing factors.SPSS21.0 software was used to analyze the survey results.Statistical methods include descriptive analysis,Pearson correlation analysis and multiple linear regression analysis.Results:Part Ⅰ:Collecting data in the form of semi-structured interviews.12 stroke specialist nurses and 10 stroke managers were interviewed on their experience of returning to work after training and their expectations for training transfer,respectively.Ultimately,three major expectation themes of the effectiveness of the training transfer,the confusion of the stroke specialist nurses after returning to work,and the expectations for the effectiveness of the training transfer,were obtained.Combining with literature analysis and Delphi expert consultation,a 37-item questionnaire on the current status of stroke specialist nurse training and transfer formed finally.The related analysis showed that the correlation coefficients between the scores of each item in the questionnaire and the total score were all greater than 0.4,except for item 19 which was less than 0.4.However,considering the clinical significance of this item in consideration of the current situation of training transfer,it was not deleted.The CR value revealed that the difference among the items is statistically significant(p<0.001).The I-CVI of the questionnaire ranges from 0.83 to 1.00,and the S-CVI value is 0.96.Using exploratory factor analysis,a total of 5 common factors are selected as the research aims,namely attitude change,clinical nursing practice transformation,management education optimization,professional development,interpersonal communication,which are exactly the same as the original questionnaire.The cumulative variance contribution rate is 60.082%.The confirmatory factor analysis results showed that the factor model fits well,and the fitting indexs are c2/df=1.896,RMR=0.042,CFI=0.963,RMSE=0.047,respectively.The total Cronbach’s a coefficient of the questionnaire is 0.964,and the Cronbach’s a coefficient of each dimension is between 0.731 and 0.876.The test-retest reliability result is 0.951.Part Ⅱ:The score of training transfer of stroke specialist nurses is(127.54±26.51).The mean scores of acquisition of attitude change,attitude change,clinical nursing practice transformation,management education optimization,professional development,interpersonal communication items are 2.94±0.84,3.72!±0.75,3.91±0.78,3.27±1.09 and 2.58±1.20,respectively,indicating the current training transfer is at a medium level.The highest score dimension is management education optimization item,and the lowest score dimension is interpersonal communication item.One-way analysis of variance showed that the influence of 9 factors including the highest degree,professional title,working years,number of children,monthly income,whether to rotate stroke-related departments,training period,training form,and training method,on the training and transfer of stroke specialist nurses,had statistical significance.Related analysis showed that the training transfer of stroke specialist nurse and its five dimensions are positively correlated with nurses’organizational innovation atmosphere,nurses’ working environment,and nurses’self-learning ability.The results of multiple linear regression analysis showed that training methods,number of children,whether to rotate stroke-related departments,organizational innovation atmosphere,working environment and independent learning ability are the main influencing factors for the training transfer of stroke specialist nurses.These six variables could explain 57.5%of total variation.Conclusions:1.The questionnaire on the status of training and transfer of stroke specialist nurses has good reliability and validity,and it can effectively evaluate the status of training and transfer of stroke specialist nurses.2.The current status of the training transfer of stroke specialist nurse is at a medium level.Training methods,number of children,whether to rotate stroke-related departments,organizational innovation atmosphere,working environment and self-learning ability are important influencing factors of stroke specialist nurse training transfer.