Compilation Of A Neonatal Missed Nursing Care Scale

Objective:To develop a scientific assessment tool for neonatal missed nursing care in the context of hospital culture in China,and to provide a specific tool for assessing the content and influencing factors of nurses’ missed nursing care in neonatal units,with a view to identifying deficits in neonatal care in a timely manner and providing a reference and basis for formulating relevant interventions.Methods:1.Literature research method: Guided by the theoretical model of nursing deficit,the entry frame of nursing deficit scale in neonatology department was constructed by consulting domestic and foreign literatures and referring to relevant hospital documents.2.Qualitative research method: Objective sampling method was adopted to conduct semi-structured interviews with 17 nurses working in the neonatology department.Colaizzi7-step analysis method was adopted to collate and analyze the data,extract nursing deficiency items and influencing factors from the neonatology department,and combine the literature review content to form a preliminary pool of nursing deficiency scale items in the neonatology department.3.Delphi expert letter consultation method: According to the inclusion and exclusion criteria,15 nursing experts in the field of neonatology were invited for two rounds of expert letter consultation.The average value of item importance assignment,coefficient of variation and full score rate were used as indicators to screen items in the scale.At the same time,the scale was modified based on expert suggestions to form the first draft of nursing deficiency scale in neonatology department.4.Pre-survey: 30 neonatology nurses who met the exclusion criteria were selected for pre-survey.According to the feedback results of the survey subjects,a test version of neonatology nursing deficit scale was formed.5.Formal investigation: Convenience sampling method was adopted to select 382 nurses in neonatology department of 9 Grade A hospitals in Shandong Province as research objects for investigation.The collected data were sorted and analyzed.The critical ratio method,correlation coefficient method and homogeneity test method were used to further screen the scale items,and the scale validity was evaluated by structural validity and content validity.Cronbach’s α coefficient,split half reliability and retest reliability were used to analyze the reliability of the scale,and finally the official version of the neonatal nursing deficit scale was formed.Results:1.Preliminary scale compilation results: Through literature research and combined with the qualitative interview results of 17 neonatology nurses,the scale of nursing items missing in neonatology including 12 dimensions and 63 items and the scale of factors affecting nursing items missing in neonatology including 5 dimensions and 31 items were preliminatively developed.2.Delphi expert letter consultation and pre-survey results: After two rounds of expert letter consultation and pre-survey,the scale items were added,deleted,modified,split and merged to form the test version of neonatology nursing item missing scale containing 12 dimensions and 65 items,and the test version of neonatology nursing item missing factor scale containing 5 dimensions and 28 items.3.Results of item analysis and validity analysis: After item analysis,no modification was made to scale items.The results of structural validity analysis showed that,according to the principle of exploratory factor analysis,four exploratory factor analyses were carried out on the scale of nursing item missing degree in neonatology department,22 items were deleted,and 6 common factors and 43 items were finally extracted.The cumulative contribution rate of variance was 69.833%.After exploratory factor analysis of 28 items,4factors were extracted,and the cumulative contribution rate of variance reached 74.693%.The correlation coefficients of 6 dimensions of the scale of nursing item missing degree in neonatology were between 0.760-0.914,and the correlation coefficients of 43 items were between 0.539-0.800,and the difference was statistically significant(P < 0.01).The correlation coefficients between the 4 dimensions of the scale and the total amount table were between 0.875 and 0.922,and the correlation coefficients between the 28 items and the total amount table were between 0.660-0.864,and the difference was statistically significant(P < 0.01).Content validity analysis showed that the score of I-CVI for each item of the scale of nursing loss in neonatology was between 0.90 and 1.00,and the score of S-CVI for each item of the scale of factors affecting nursing loss in neonatology was between 0.90 and 1.00,and the score of S-CVI was 0.996.4.Reliability analysis results: The total Cronbach’s α coefficient of the scale of nursing loss in neonatology was 0.974,the Cronbach’s α coefficient of the scale’s 6 dimensions ranged from 0.865 to 0.934,and the total Cronbach’s α coefficient of the scale of factors affecting nursing loss in neonatology was 0.974.Cronbach’s α coefficients of the four dimensions of the scale ranged from 0.920 to 0.957.The total breaking coefficient of the scale of nursing loss in neonatology department was 0.925,the breaking coefficient of 6dimensions was between 0.789 and 0.910,the total breaking coefficient of the scale of affecting factors of nursing loss in neonatology department was 0.920,and the breaking coefficient of 4 dimensions was between 0.898 and 0.919.The total retest coefficient of the scale of nursing item missing degree in neonatology department was 0.970,the retest coefficient of 6 dimensions of the scale was between 0.924 and 0.954,the total retest coefficient of the scale of influencing factors of nursing item missing in neonatology department was 0.993,and the retest coefficient of 4 dimensions of the scale was between0.978 and 0.991.Conclusion:1.This study completed the compilation of the Neonatology Missed Nursing Care Scale,which includes the subscale of missing nursing care in neonatology department and the subscale of influencing factors of missing nursing care in neonatology department.The scale of missing nursing care in neonatology department consists of 6 dimensions and 43 items,and the scale of influencing factors of missing nursing care in neonatology department consisted of 4 dimensions and 28 items,which fully reflected the items and causes of missing nursing care in neonatology department.2.The Neonatology Missed Nursing Care Scale has good reliability and validity,with all indexes within the range of psychometric acceptance.Besides,the scale items are simple and easy to understand,and the content coverage is comprehensive,and the nurses in the neonatology department have high acceptance.The scale can be preliminarily used as a measurement tool to evaluate the contents and causes of missing nursing care in the neonatology department.