| Objective: To develop a missed nursing care assessment questionnaire for comprehensive intensive care unit and test its reliability and validity,so as to provide a scientific assessment tool for nursing managers to intervene in missed nursing care occurrence and improve nursing quality.Methods: 1.A descriptive study was used to collect information on missed nursing care items and influencing factors in the comprehensive intensive care unit.A qualitative interview outline was developed by literature review and missed nursing care model,and 2 subjects were selected for pre-interview.The final interview outline was determined according to the pre-interview results and the discussion of the research group.The interview was stopped when the data reached saturation and 23 subjects were finally included for analysis by content analysis method.Combined with literature review,the initial entry pool of common missed nursing care items and influencing factors in the comprehensive intensive care unit was obtained.2.The questionnaire items were screened,modified and supplemented by expert letter consultation of Delphi method.3.30 subjects were selected for small-scale pre-test to further adjust the items and form the initial questionnaire.4.Send out questionnaires and sort out data.5.Select items through project analysis,evaluate structural validity(exploratory factor analysis),evaluate content validity(expert relevance score),and evaluate reliability(internal consistency reliability,retest reliability,and broken half reliability).Results: 1.Through qualitative study,common missed nursing care items in comprehensive intensive care units were summarized into four categories: Basic nursing;Nursing intervention;Specialist care;Nursing evaluation and nursing planning.The influencing factors of missed nursing care in comprehensive intensive care unit can be summarized into five categories: Human resources;Personal characteristics of nurses;Teamwork and communication;Nursing management;Features of comprehensive intensive care unit.Combined with the literature review,the pool of common missed nursing care items in the comprehensive intensive care unit(containing 29 entries from 4 dimensions)and the pool of factors influencing missed nursing care in the comprehensive intensive care unit(containing 25 entries from 6 dimensions)were formed.2.The questionnaire of common missed nursing care items and influencing factors in the comprehensive intensive care unit is divided into two subscales: the questionnaire of missed nursing care degree in the comprehensive intensive care unit(Questionnaire A)and the questionnaire of influencing factors of missed nursing care in the comprehensive intensive care unit(questionnaire B).After the first round of expert letter consultation,entries A5 and A18 of questionnaire A were appropriately adjusted,entries A19 were removed,and a new entry was added into the basic nursing and specialized nursing dimensions,with a total of 30 entries remaining.In questionnaire B,the expression of item B2 is appropriately adjusted,items B6 and B24 are excluded,and a new item is added into the characteristics of the comprehensive intensive care unit,with a total of 24 items remaining.In the second round of consultation,experts’ opinions basically reached A consensus.Questionnaire A was not modified,and finally 30 items were obtained,while item B16 of questionnaire B was removed,and finally 23 items were obtained.3.According to the small-scale preliminary test,the average completion time of the questionnaire is 14 minutes.The expression of item B18 in the questionnaire B is adjusted appropriately for the formal test.4.A total of 245 questionnaires were distributed,239 questionnaires were collected,237 of which were valid,with effective recovery rate of 99.2%.5.After project analysis,all items in questionnaire A are retained,and item B10 is deleted in questionnaire B,leaving 22 items.Both questionnaires had good reliability and validity,and the internal consistency reliability of questionnaire A was 0.994.The broken half reliability was 0.975;The retest reliability was 0.958;The content validity of expert evaluation was 0.967.Four common factors were extracted from exploratory factor analysis,and the cumulative contribution rate of variance was 83.834%.B The internal consistency reliability of the questionnaire was 0.958;The broken half reliability was 0.921;The retest reliability was 0.913;The content validity of expert evaluation was 0.964.Five common factors were extracted from exploratory factor analysis,and the cumulative contribution rate of variance was 73.061%.Conclusion: Based on the theoretical framework of nursing deficiencies,this study formed a pool of questionnaire entries based on qualitative research results combined with literature review.After two rounds of expert correspondence consultation,entries were screened,supplemented and modified.Item analysis and reliability and validity test of the questionnaire were conducted through a survey of 237 nurses.Finally,a GICU nursing item missing degree questionnaire containing 4 dimensions and 30 items and a GICU nursing item missing factors questionnaire containing 5 dimensions and 22 items were formed.After testing,the reliability and validity of the questionnaire is good,and it is preliminarily confirmed that it can be used to evaluate the degree of nursing deficiency and the main influencing factors in GICU.Nursing managers should pay more attention to nursing deficiency,and improve the quality of critical care through targeted intervention in the scientific evaluation of nursing deficiency. |
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