Development And Application Of A Scale For Assessing The Emergency Response Ability Of Stroke Caregivers To Stroke Recurrence

ObjectivesIn this study,we constructed a scale for assessing the emergency response capability of caregivers for stroke recurrence,and evaluated the reliability and validity of the scale,providing an objective and scientific evaluation tool for understanding the current situation of the emergency response capability of stroke caregivers and verifying the effect of related interventions.We also preliminarily explore the impact of relevant demographic variables on the emergency response ability of stroke caregivers,and provide a theoretical basis for building a deeper stroke recurrence treatment system and improving the family’s treatment capacity for stroke recurrence in the later stage.Methods1.Conduct literature research on Chinese and English databases,determine the theoretical framework of the scale,and establish dimensions.On the basis of literature research,we conducted interviews with stroke caregivers,and collected their relevant suggestions as an important basis for the preparation of the scale,and initially constructed the scale entry pool.2.Using Delphi Expert Correspondence Method and Pre-survey to form Beta Scale.Formal scale through rigorous reliability and validity tests.Results obtained were entered using Epidata software,and SPSS statistical software was used for item analysis,content validity and reliability tests,and exploratory factor analysis.Confirmatory factor analysis was performed using AMOS.3.The general data method and the official version of the scale were used as the survey tools,combined with descriptive statistics,univariate analysis and multiple linear regression to analyze the level of emergency response ability of caregivers to stroke recurrence and explore its influencing factors.Results1.Through literature analysis,the research progress at home and abroad was summarized,and a scale with 33 items in 5 dimensions was initially formed with reference to existing guidelines,expert consensus,and emergency treatment procedures for stroke.Semi-structured interviews were conducted with 19 stroke caregivers.,forming a 45-item initial scale with 5 dimensions.2.The positive coefficients of experts in the two rounds of expert letter inquiries were100%and 92.3%,respectively,the authoritative coefficients were 0.929 and 0.932,the mean values of item importance assignments were 3.77～4.92,4.29～4.96,and the coefficients of variation were 0.06～0.41,0.04～0.27,Kendall coordination coefficients were 0.196 and 0.209,respectively(P<0.001).Based on the results of data statistics,experts’revision opinions,and after the review of the research group,a total of 5 items were deleted,2 items were added,2 items were split,1 item was adjusted,11 items were revised,and 1 item was merged to form a beta version.The scale has 5 dimensions and 37items.After the item analysis,the items that did not reach the goal were deleted.The overall Cronbach,sαcoefficient was 0.882,the five dimensions was 0.721 to 0.854,and the split-half reliability coefficient of the total scale was 0.851.The intraclass correlation coefficient(ICC)was 0.848,and the 95%CI ranged from 0.735 to 0.929.The content validity(S-CVI)of the scale was 0.935,and the content validity index(I-CVI)of the items was 0.780-1.000.Exploratory factor analysis(EFA)extracted a total of 10 common factors with eigenvalues greater than 1,which belonged to 5 dimensions,and the cumulative variance contribution rate was 63.792%.The extracted common factors were consistent with the structural assumptions designed in advance according to the theoretical framework.The correlation coefficient of each dimension score is 0.177～0.568,and the Pearson correlation coefficient between each dimension of the scale and the total score is 0.455～0.867.Confirmatory factor analysis chi-square/degrees of freedom(χ~2/df)was 1.542,goodness-of-fit index(GFI)was 0.873,root mean square residual error(RMSEA)was 0.041,and Tucker-Lewis index(TLI)was 0.910,comparing The fit index(CFI)was 0.920,and the parsimony fit index(PGFI)was 0.730,all of which met the model fitting requirements.Combined with the results of the above methods,a 5-dimension and 35-item scale was constructed.3.Through the statistical analysis of 326 valid scales,it is known that the total average score of the family members of stroke patients on the emergency response ability of stroke recurrence is(124.23±13.95),stroke knowledge(3.39±0.56),risk awareness(3.56±0.45),coping attitude(4.20±0.45),self-efficacy(3.39±0.60),emergency behavior(3.57±0.53).The results of univariate analysis showed that the age of family members,relationship with the patient,place of residence,occupation,education level,average monthly income of the family,and whether the family members were present at the scene when the patient first suffered the disease were the influencing factors of the caregivers on the emergency response ability of stroke recurrence(P<0.05).The results of multivariate analysis showed that the relationship with the patient,the occupation of the caregivers,the average monthly income of the family,and whether or not he was on the scene were the main influencing factors of caregivers on the emergency response ability of stroke recurrence(P<0.05).Conclusions1.The development process of the scale is scientific and rigorous,with good reliability and validity,and it can effectively evaluate the emergency response ability of caregivers of stroke patients to stroke recurrence.2.The caregivers have a moderate level of emergency response ability for stroke recurrence,and the awareness rate of stroke knowledge is low,followed by self-efficacy,risk awareness,emergency behavior and coping attitude.Medical workers can use this scale to quantitatively evaluate the emergency response ability of stroke caregivers,so as to judge the degree of emergency response ability and existing problems of caregivers,and take relevant intervention measures.Emergency assistance system to improve the success rate of stroke recurrence treatment.