循证护理实践准备度评估量表的研制及信效度评价

目的：研制适合我国国情的循证护理实践准备度评估量表，并检验其信度和效度。方法：对PARIHS模式核心元素的衍变进行文献范畴分析，结合质性访谈结果构建循证实践准备度评估量表项目池，经两轮德尔菲专家函询确定量表测试稿，并请专家对形成条目相关性进行评估，测试内容效度。选取2016年12月-2017年1月参与复旦大学护理学院“第一期证据应用培训项目”的三级医院中所有参与实践项目的临床护士为调查对象，通过项目分析对测试量表进行条目筛选、探索性因素分析进行量表维度划分，并进行信度分析，形成正式量表。结果：共纳入300名调查对象，剔除44份无效问卷，最终256份（85.33%）问卷纳入正式分析。各条目与对应维度总分的相关系数为0.569~0.829（P<0.01），各条目与量表总分的相关系数为0.482~0.781（P<0.01），量表内容效度为0.976，探索性因素分析共提取出3个因子，各条目的因子负荷量为0.455~0.853，累积解释总方差为62.524%，3个因子分别命名为证据、组织环境、促进因素，正式量表包括31个条目。总的Cronbach′sα系数为0.959，3个维度的Cronbach′sα系数分别为0.940、0.933、0.915，拆半信度为0.978，重测信度为0.917。结论：研制的循证护理实践准备度评估量表具有良好的信度和效度，能够指导我国循证护理实践的开展。

Development and evaluation of reliability and validity of Clinic Readiness to Evidence-based Nursing Assessment scale

Objective To develop a Clinic Readiness to Evidence-based Nursing Assessment(CREBNA)scale and test its reliability and validity.Methods According to the qualitative interviews,scoping review of promoting action on research implemrntation in health severice(PARIHS)model results obtained primary item pool of CREBNA.After two rounds of experts evaluation,the CREBNA item pool of EBNP readiness was established,the questionnaire was formed based on item pool,the test version of CREBNA was identified by experts,judgment of the relevance between the item and dimensions in the expected structure,and the content validity of questionnaire.Convenience sampling was used in the research,clinical nurses who were participants in training course of Fudan University School of Nursing in 2016 were selected as investigators.The dimensions,reliability and validity of this scale were tested by exploratory factor analysis and reliability analysis.Results The CREBNA item pool included 3 dimensions,36 items.CREBNA questionnaire of 36 entries was formed based on item pool,the S-CVI of scale was 0.976.256 questionnaires were included in the final analysis,the correlations between items and the scale total score ranged from 0.482-0.781(P<0.01),3 factors were extracted by exploratory factor analysis and labeled as Evidence,Context,Facilitation,62.524%of total variance were explained.The formal scale contained 31 items,The Cronbach α coefficients were 0.959 for the total scale and 0.915-0.940 for the subscales.The test-retest reliability was 0.917 and split-half reliability coefficient was 0.978 for the total questionnaire.Conclusion It suggested that the CREBNA scale was reliable and valid enough to be applicable to evaluate the evidence-based practice process.