Development And Reliability And Validity Test Of A Nursing Needs Scale For Elderly Patients With Urinary Incontinence

ObjectivesTo develop a nursing needs scale for elderly patients with urinary incontinence and to test the reliability and validity of the scale,thus providing a quantitative assessment tool for geriatric nursing practitioners to more accurately assess the nursing needs of elderly patients with urinary incontinence and providing a scientific basis for quality-of-life interventions and standardized nursing for patients with urinary incontinence,promoting the development of nursing practice toward standardization.Methods1.Literature analysis method: Literature related to the nursing needs of elderly patients with urinary incontinence was found in the domestic and foreign databases and relevant guideline websites based on keywords to construct a preliminary scale framework and item pool.2.Qualitative interview method: 12 elderly patients with urinary incontinence and 10 medical staff attending a tertiary hospital in Guangdong Province were selected with purposive sampling as interviewees to understand the real nursing needs of patients.Then,the item pool was supplemented and improved after refining the interview theme.3.Delphi method: 22 experts were invited to conduct a total of two rounds of questionnaire correspondence,and the items were added,deleted,revised,organized,and combined after group discussion based on the importance ratings and suggestions of the experts in each round.4.Pre-test method: 30 cases of elderly patients with urinary incontinence were selected for the pre-survey of the scale using the convenience sampling method,and the patients’ opinions on each item were collected.Then,the scale items with ambiguities were revised after group discussion,finally forming a pre-test version of the scale.5.Questionnaire survey method: 530 elderly patients with urinary incontinence in two tertiary hospitals in Guangdong Province were selected for the study using the convenience sampling method,with the items of the scale being analyzed by correlation coefficient method,critical ratio method,and homogeneity test.Principal component analysis was used for exploratory factor analysis,the maximum-likelihood method was used for confirmatory factor analysis,and finally,the official nursing needs scale of elderly patients with urinary incontinence was formed by the reliability and validity test.Results1.Through literature analysis and qualitative interviews,it was tentatively determined that the elderly urinary incontinence patients’ nursing needs scale contains 5 dimensions of daily care needs,medical nursing needs,health education needs,social participation needs,and psychological comfort needs as well as 48 entries.2.The recovery rates of the 2 rounds of expert correspondence questionnaires were 92.3% and 100.00%,respectively,with the authority coefficients of experts being 0.832 and 0.850,respectively.Kendall ’s coordination factors of the dimensions and entries in the final round of correspondence were 0.359 and 0.522,respectively(P < 0.001).Finally,a pre-test nursing needs scale for elderly patients with urinary incontinence was formed,which contained 5 dimensions of daily care needs,medical nursing needs,health education needs,social participation needs,and psychological comfort needs as well as 36 items.3.250 elderly patients with urinary incontinence were surveyed to test the pre-test version,in which one entry was deleted and five common factors were extracted by exploratory factor analysis after the statistical screening,with a cumulative variance contribution rate of 67.643%,thus forming the final version of the scale.4.280 elderly patients with urinary incontinence were surveyed to test the final version of the scale,which was used for confirmatory factor analysis,showing that the model fit was good,the model fit indicators were within the standard range,and the scale had good construct validity.The Cronbach’s αcoefficient of the total scale was 0.901,the split-half reliability was 0.865,and the content validity was 1;the test-retest reliability after 2 weeks was 0.928.Conclusions1.The nursing needs scale for elderly patients with urinary incontinence developed in this study includes 5 dimensions of daily care needs,medical nursing needs,health education needs,social participation needs,and psychological comfort needs,with a total of 35 entries.Each entry has 5 options:not needed,not too needed,somewhat needed,needed,and very needed,which were scored from 1 to 5 in that order.The total score on the scale ranges from35 to 175,with higher scores indicating a higher degree of nursing care needs.2.With good reliability and stable factor structure,this scale can be used as a valid tool to assess the nursing care needs of elderly patients with urinary incontinence.