Construction And Application Of Self-efficacy Energy Scale For Clinical Nurses To Manage Pressure Injuries

Objective:To develop a self-efficacy scale suitable for clinical nurses in my country to manage pressure injury,and to test its reliability and validity.The compiled scale was applied to clinical nurses to investigate the self-efficacy level of nurses in managing pressure injury,to explore its related influencing factors,and to provide theoretical basis for the prevention of pressure injury from the perspective of clinical nursing.Methods:1.Based on the theory of self-efficacy,through literature review,group discussion,semi-structured interview and other methods,the item pool of clinical nurse management stress injury self-efficacy scale was preliminarily formed.2.Nursing experts in the fields of nursing management,wound stoma and other fields were selected to conduct two rounds of expert letter inquiries,and dimensions and items were revised according to the experts’ letter inquiries to form the first draft of the scale.3.Convenience sampling method was used to investigate the nursing staff of a tertiary hospital in Jiangxi province with the first draft of the self-efficacy scale for clinical nurse management of stress injury.The items of the scale were screened again through item analysis and exploratory factor analysis,and the reliability and validity of the scale were re-screened.Test to form the final draft of the scale.4.Convenience sampling method was used to investigate the current situation of 199 clinical nurses in a tertiary hospital in Jiangxi province by using the general information questionnaire and the clinical nurses’ self-efficacy scale for managing pressure injuries.Stepwise regression analysis and other methods were used to explore its influencing factors.Results:1.Preliminary formation of scale item pool: through literature review,group discussions and semi-structured interview,a scale item pool with 5 dimensions and58 items including knowledge and experience(14 items),practical behavior and ability(17 items),communication and communication(12 items),nursing management(9 items),support and decision-making(6items)was preliminarily formed.2.Results of expert correspondence: the effective recovery rates of the two rounds of letter inquiry questionnaires were 94.12% and 100%,the expert authority coefficients were 0.93 and 0.94 respectively,Kendall’s W was 0.13～0.31,the average coefficient of variation was 0.07～0.17,and the coefficient of variation of each item was less than 0.25.Three items were deleted in the two rounds of expert correspondence,21 items were merged into 10 items,and 2 items were modified,and1 item was added.Finally,the first draft of clinical nurse management pressure injury self-efficacy scale with 5 dimensions and 45 items was formed.3.Further screening of scale items: through the critical ratio method and correlation analysis,a total of 5 items were deleted;the KMO value of exploratory factor analysis was 0.972,and 3 common factors with eigenvalues >1 were extracted after 4 factor analyses.Factor 1(knowledge and ability dimension),factor 2(nursing management dimension),and factor 3(support and decision-making dimension)accounted for 70.176% of the cumulative total contribution rate.The load values of the 30 items of the scale range from 0.566 to 0.867,all > 0.4 and there is no double load.The content validity index(S-CVI)of the total scale was 0.965,and the average content validity S-CVI/Ave of the questionnaire was 0.813 ～ 1.000.The Cronbach’s α coefficient of the total scale was 0.972,and the Cronbach’s αcoefficient of each dimension ranged from 0.835 to 0.973;the split-half reliability coefficient of the total scale was 0.902,and the split-half reliability coefficient of each dimension was 0.823～0.938;after 2 weeks,the test-retest reliability of the total scale was 0.934,and the test-retest reliability of each dimension was 0.824～0.939.Finally,a scale with 3 dimensions and 30 items was formed.4.Status of self-efficacy of clinical nurses in managing stress injury: the total score of the scale was(113.30±4.92).The average scores of each dimension were nursing management dimension(3.40±0.75),support and decision-making dimension(3.76±0.69)and knowledge and ability dimension(3.86±0.61)from low to high.Among them,age,working years,professional title,educational background and the number of PI related training in recent one year entered the regression equation,which could explain 33.6% of the total variation of clinical nurses’ self-efficacy in managing stress injury.Conclusion:1.The self-efficacy scale of clinical nurses in managing pressure injury prepared in this study has good reliability and validity,and is suitable for the investigation and research of nurses’ self-efficacy in managing pressure injury.2.The self-efficacy score of clinical nurses in managing stress injury was in the upper middle level.The influencing factors were age,working years,professional title,educational background and the number of PI related training in recent one year.Therefore,nursing managers should carry out targeted intervention for nurses with different levels of stress injury management self-efficacy to improve the level of nurses’ self-efficacy in managing stress injury,so as to further prevent the occurrence of stress injury.