| Objectives To compile a questionnaire Knowledge,Attitude and Practices（KAP）of ICU nurses on central venous catheter maintenance and evaluate the reliability and validity by using the standard measurement development methods,to provide an assessment tool for understanding KAP of ICU nurses on central venous catheter（CVC）maintenance in China.Methods Based on the theory of Knowledge,Attitude and Practice and prototype of questionnaire were formed by referring to relevant literature and guidelines.We invited 19 experts to conduct two rounds of expert correspondence to modify and improve the initial questionnaire content,and the predicted version of the questionnaire was formed.Next 20 ICU nurses were selected for pre-survey by convenient sampling,and the readability of the questionnaire was tested,and the measuring version of questionnaire was formulated.The second stage:A convenience sample of 360 ICU nurses of 5 hospitals in Anhui Province was investigated.In terms of reliability,internal consistency of Cronbach’s was used to retest the stability of the reliability questionnaire.In terms of validity,item content validity index（I-CVI）and questionnaire content validity index（S-CVI）were used to measure the content validity of the questionnaire,factor analysis was used to test the structural validity of the questionnaire,and extreme grouping method and correlation analysis method were used to analyze the discrimination of the questionnaire.After item analysis and reliability and validity test,the clinical application version of questionnaire was finally formed.ResultsThe first stage:After literature review and discussion,the initial questionnaire of ICU nurses’ knowledge,attitude and practice about central venous catheter maintenance consisted of 48 items in 3 dimensions,A total of 19 experts participated in the expert correspondence,and the effective recovery rate of the two rounds of expert correspondence was 95%and 100%;The first round of expert consultation coefficient of determination（Ca）was 0.80-1.00,coefficient of familiarity（Cs）was 0.60-1.00,authority coefficient（Cr）was 0.75-1.00;the second round of expert consultation judgment coefficient（Ca）was 0.80-0.95,familiarity coefficient（Cs）was 0.80-1.00,authority coefficient（Cr）was 0.83-0.98.the mean value of the importance score of the two rounds of items was 4.13-5.00 and 4.73-5.00 respectively;the variation coefficient was 0.00～0.20 and 0～0.16 respectively;the coordination coefficient of the two rounds of experts was 0.200 and 0.284 respectively（P<0.001）.After two rounds of expert consultation and pre-investigation,the ICU nurses’knowledge,attitude and practice about central venous catheter maintenance with 3 dimensions and 31 items was formed.The second stage:A total of 360 questionnaires were issued to investigate ICU nurses who met the inclusion and exclusion criteria,and 334 effective questionnaires were recovered,with an effective recovery rate of 92.78%.In terms of validity,The item content validity（I-CVI）and questionnaire content validity（S-CVI）were 0.889 to 1.000 and 0.974,respectively.Using extreme group test method,41 cases with top 27%（total score higher than 146）were set as high group,while those with bottom 27%（total score lower than 128）were set as low group.Comparison of items:t value was 2.893-16.030（P<0.05）,critical ratio was 2.89-16.03（P<0.05）,24 items with critical ratio<3.00 and relationship number<0.30 were deleted,There were 11 knowledge items,1 attitude item and 12 behavior items（P>0.05）.The Pearson correlation coefficient（r）of each item score and total score was 0.419 and 0.729 respectively（all P<0.05）.Exploratory factor Select relevant factors to analyze,corresponding contribution rate is 65.656%,Exploratory factor analysis the information can show that the number of common factors corresponding to each entry is above 0.40.The factor model had good fitting degree,the factor load was greater than 0.4,the fitting index CMIN/DF=2.907,CFI=0.977,GFI=0.973,AGFI=0.928,IFI=0.979,RMSEA=0.071,TLI=0.943,PGFI=0.675,RMR=0.019.The Cronbach’a coefficient of the total questionnaire is 0.843,and the Cronbach’s a coefficients of the three dimensions of KAP are 0.754,0.887,and 0.940,respectively.The split-half reliability is 0.816.The test-retest reliability of the total questionnaire is 0.813.The final questionnaire contained 31 items in three dimensions:7 knowledge items,8 attitude items and 16 behavior items.Conclusion The ICU nurses’ CVC maintenance KAP questionnaire has good reliability and validity.It can be used as a measurement tool to evaluate the knowledge,attitude and practices of ICU nurses’ central venous catheter maintenance. |
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