以患儿和家庭为中心护理过程量表研制及其信度效度评价

摘要 目的 研制以患儿和家庭为中心护理（PFCC）过程量表，并检验其信度和效度。方法 根据PFCC核心概念，结合访谈法结果和文献回顾编制PFCC初始量表，经2轮专家咨询和家长咨询后形成PFCC预试量表。选取2013年10～11月上海市2家儿童专科医院住院患儿的主要照顾者为调查对象。选取预试量表人群，通过项目分析对预试量表进行条目筛选、探索性因素分析进行维度划分，形成正式量表。再选取正式量表人群采用因素分析、信度分析和相关分析法等对正式量表的信度和效度进行评价。结果 预试量表人群共纳入调查对象230名，剔除32份无效问卷，最终198份（86.1％）问卷纳入分析。正式量表人群共纳入调查对象450例，剔除71份无效问卷，最终379份（84.2％）问卷纳入分析。正式量表包括40个条目。探索性因素分析共提取5个维度，各条目在其维度的负荷值为0.419~0.729，累计方差解释率为58.797%，验证性因素分析的各项指标均达到了理想值水平或可接受值水平。将5个维度分别命名为：患儿的情感支持、减少焦虑、专业照护和指导、信息支持、信任和被信任。各维度与量表总分的相关系数为0.841~0.956（P<0.01），各维度之间的相关系数为0.627~0.830（P<0.01）。量表总的Cronbach′s α 系数为0.966，5个维度的Cronbach′s α 系数在0.776~0.966。结论 研制的PFCC过程量表具有良好的信度和效度，可用作儿科病房患儿家属对住院过程的测量工具。

Development and evaluation of an patient-and-family-centered care scale

Abstract Objective To develop an patient-and-family-centered care scale, and assess its reliability and validity. Methods The initial inventory combining with the core concept of patient-and-family-centered care, literature review and in-depth interview was developed. After two rounds of experts evaluation and parents consultant, the new scale was developed. Major caregivers of inpatients from two Shanghai third-grade-A children′s hospitals from November to December in 2013 were selected as investigators. Sample 1 was selected by purposive sampling, and pre-tested. Items were selected by project analysis and the dimensions were tested by exploratory factor analysis. Sample 2 was selected by the same purposive sampling and investigated. The reliability and validity of this scale were tested by factor analysis and reliability analysis and correlation analysis. Results 230 parents were included in sample 1, 32 questionnaires were invalid, 198 questionnaires (86.1%) were included in the final analysis. 450 parents were included in sample 2, excluding 71 invalid questionnaires, 379 questionnaires (84.2%) were included in the final analysis. The pilot scale contained 59 items and the formal scale consisted of 40 items. Five common factors were extracted by exploratory factor analysis and factor loading of each item ranged between 0.419 and 0.729. The 5 factors explained for 58.797% of total variance. The indicators had reached the ideal level or acceptable level by confirmatory factor analysis. The correlations between the subscales and the total scale ranged from 0.841 to 0.956（P<0.01）. The scale was reliable (α=0.966), and the subscales Cronbach α ranged from 0.776 to 0.966. Conclusion The newly developed patient-and-family-centered care scale has shown acceptable reliability and validity, which can be used as a useful tool for nurses in identifying and assessing parents′ hospitalization care process.