ICU护士舒适化浅镇静策略理念知信行调查问卷的构建及信效度分析

  目的  通过应用德尔菲专家函询法构建ICU护士eCASH理念知信行调查问卷，并检验其信效度，为构建本土化的舒适化浅镇静策略(eCASH理念)培训体系，促进ICU护士镇静镇痛专科护理水平提供依据。  方法  基于知信行理论，通过文献分析法和半结构式访谈法建立问卷框架，选取了17位浙江省3所三级甲等医院ICU护理专家进行2轮专家函询形成问卷初稿，并通过浙江省3所三级甲等医院187名ICU护士进行问卷信效度评价，最终形成问卷终稿。  结果  两轮专家函询结果:两轮专家函询回收率分别为82.35%和100.00%，专家协调系数分别为0.32和0.45，权威系数分别为0.845和0.913。4个维度重要性平均得分3.56~3.77，满分比44.12%~65.24%；22个条目重要性平均得分3.43~3.77，满分比43.52%~65.72%，最终形成了包括eCASH基本知识、eCASH技能、eCASH信念、eCASH行为共4个维度，22个条目的eCASH理念知信行调查问卷。信效度评价结果:问卷4个维度的贡献率分别为21.91%、17.81%、13.32%、15.45%，累计贡献率为68.49%(＞40%)；总问卷的内容效度S-CVI为0.982，Cronbach's α系数为0.931，重测信度在0.814~0.923。  结论  ICU护士eCASH理念知信行问卷信效度良好，能准确反映ICU护士对eCASH理念的知识水平、执行意愿和临床实施现状，可作为测评ICU护士eCASH理念知信行水平的适用工具。 

The construction and reliability and validity analysis of the questionnaire on knowledge-belief-behavior of eCASH concept for ICU nurses

  Objective  To construct the questionnaire of knowledge-belief-behavior of ICU nurses' eCASH concept by means of Delphi expert letter consultation method, and to test its reliability and validity, so as to provide a basis for the construction of localized eCASH concept training system and the promotion of ICU nurses' nursing level of sedation and analgesia.  Methods  Based on the theory of knowledge-belief-behavior, the questionnaire framework was established by literature analysis and semi-structured interview. Total 17 ICU nursing experts from 3 Class A tertiary hospitals in Zhejiang Province were selected for 2 rounds of expert consultation to form the first draft of the questionnaire. Finally, the final draft of the questionnaire was formed by evaluating the reliability and validity of the questionnaire among 187 ICU nurses in 3 Class A tertiary hospitals in Zhejiang Province.  Results  Results of the two rounds of expert consultation: the recovery rates were 82.35% and 100%, the expert coordination coefficient was 0.32 and 0.45, and the authority coefficient was 0.845 and 0.913, respectively. The average score of the importance of the four dimensions was 3.56-3.77, with the full score ranging from 44.12% to 65.24%. The average score of the importance of 22 items was 3.43-3.77, and the full score was 43.52%-65.72%. Finally, a questionnaire on knowledge-belief-behavior of eCASH concept was formed, which included four dimensions of eCASH basic knowledge, eCASH skills, eCASH beliefs and eCASH behaviors, and 22 items. Results of reliability and validity evaluation: the contribution rate of the four dimensions was 21.91%, 17.81%, 13.32% and 15.45%, respectively, and the cumulative contribution rate was 68.49% (> 40%). The content validity S-CVI of the total questionnaire was 0.982, Cronbach's coefficient was 0.931, and the retest reliability ranged from 0.814 to 0.923.  Conclusion  The questionnaire on knowledge-belief-behavior of ICU nurses' eCASH concept has good reliability and validity, which can accurately reflect the knowledge level, executive intention and clinical implementation status of ICU nurses' eCASH concept, and can be used as an applicable tool to evaluate the level of ICU nurses' eCASH concept epistemic practice.