住院患者满意度问卷的研制及信效度检验

目的 发展住院患者满意度问卷,并进行信效度检验,为评价住院患者对住院服务的满意度提供有效工具.方法 抽取北京市某三级甲等医院的314名出院患者,使用问卷进行电话调查.对调查结果进行探索性因子分析,结合因子分析的结果和专家组讨论,对条目进行筛选和调整,并进行信度和效度检验.结果 最终形成的住院患者满意度问卷由5个因子、15个条目组成,5个因子的累计解释量为67.921％；问卷的CVI系数为0.987,Cronbach's α系数为0.868,均在测量学可接受的范围.结论 最终形成的住院患者满意度问卷有较好的信效度及可行性,可作为住院患者满意度的评价工具.     

出院患者护理满意度问卷初步编制与分析

目的:初步设计一个合理、有效、有针对性、适合中国国情的出院患者护理满意度调查问卷,为医院出院患者满意度调查提供标准。方法:参考北美HCAHPS患者满意度调查问卷,自行设计出新的出院患者护理满意度问卷,经过3轮专家评阅后形成问卷。向北京市某三甲医院出院患者发放自行设计的150份问卷,对全部条目进行内部一致性检验及效度检验。结果:12个条目总的Cronbach’α系数为0.84,内容效度各条目CVI为0.8～1.0,全部条目的平均CVI为0.98。因子分析得到5个公因子,大多数条目负载大于0.4,共解释了68.0%的方差。结论:初步形成了信效度较高的《出院患者护理满意度问卷》,可为临床护理工作评价提供依据。     

住院患者陪护需求调查问卷的初步研制

目的:研制住院患者陪护需求问卷,并测定其信度和效度,为评估住院患者对陪护的实际需求及其心理状况提供量化工具.方法:在广泛参阅国内外相关文献的基础上,以人类基本需要层次理论和人性关怀照护理论为理论构架,结合专题讨论和专家咨询,从生理、安全、爱与归属、尊重和自我实现需要5个维度,共30个条目全面了解住院患者对陪护的需求情况,并对380名住院患者进行调查,检验该问卷的信度和效度.结果:该问卷的内部一致性信度Cronbach's α系数为0.939 ;内容效度(CVR)为0.853;经相关分析,各维度与总问卷的相关系数在0.817 ～ 0.909之间,各维度之间的相关系数为0.481 ～ 0.664;经主成分因子分析,5个共同因子可解释总方差的69.159％.结论:该问卷具有较好的信度和效度,具有临床使用价值.     

《住院患者对护士工作满意度调查表》信度及效度调查

目的 测定《住院患者对护士工作满意度调查表》信度及效度以制定出适用于临床的调查表.方法 自制《住院患者对护士工作满意度调查表》(以下简称调查表),请西安市中心医院护理专家、护士长10名对调查表进行效度测定;对各科室共25名住院患者进行前后2次调查,间隔2周时间,计算重测信度.结果 调查表的毒面、内容效度在中度以上相关条目为100％(20/20),未出现“不相关”条目,调查表重测信度好(r=0.767,P＜0.05).结论 此调查表具有较好的信度及效度,可用于评价我院住院患者对护士的工作满意度.     

约翰霍普金斯跌倒风险评估量表应用于住院患者的信效度分析

目的对约翰霍普金斯跌倒风险评估量表汉化并进行信效度分析,确定其应用价值,为我国住院患者提供有效的跌倒评估工具。方法采用分层随机抽样方法抽取浙江省1所三级甲等综合医院成年住院患者400例,由2名研究者运用中文版约翰霍普金斯跌倒风险量表独立对同一例患者进行测定并进行信效度分析。结果中文版约翰霍普金斯跌倒风险评估量表总的Cronbach’sα系数为0.791,剔除当前条目后量表Cronbach’sα系数在0.649~0.703,评定者间信度r=0.949,探索性因素分析提取的4个公因子累积方差贡献率为62.437%。结论中文版约翰霍普金斯跌倒风险评估量表具有较好的信度和效度,可用于我国住院患者的跌倒风险评估。     

外科住院患者参与患者安全知信行量表的编制

目的 编制外科住院患者参与患者安全知信行量表并对其进行信效度检验,为临床评估外科住院患者参与患者安全的知识、态度、行为提供有效测评工具。 方法 以知信行理论为框架,采用文献回顾、质性访谈法、Delphi专家函询法构建条目池,并进行小样本测试形成预式量表。 选取淄博市某三级甲等医院的外科住院患者196例进行调查,对量表进行信效度检测。采用临界比值法、相关分析法进行量表的项目分析;采用内容效度和结构效度进行效度分析;采用内部一致性信度和重测信度进行信度分析。 结果 最终形成的正式量表包括知识、态度、行为3个维度共40个条目,累计方差贡献率为63.846%;总量表Cronbach''s α系数为0.932,折半信度为0.956,重测信度为0.932;总量表内容效度为0.925,各条目的内容效度为0.832～1.000。结论 外科住院患者参与患者安全知信行量表具有较好的信效度,可用于评价外科住院患者参与患者安全的相关知识、态度、行为水平。     

住院患者护理满意度量表的研究进展

住院患者护理满意度量表是测量患者住院时对护理服务满意水平的工具。患者对护理服务的满意度是衡量医疗服务质量的核心指标[1],是对护理工作质量最客观、最公正的评价[2]。     

住院患者护理工作满意度量表的研制

目的检验患者对医院护理工作满意度量表的信度、效度。方法向某三甲综合性医院出院患者发放244份自行设计的量表,进行量表内部一致性检验、相关性分析和因子分析,并对调查项目进行筛选。结果24个项目总的Cronbach′sα系数为0.9693,各因素间的Spearman相关系数均小于该因素的Cronbach′sα系数;各因素得分与总得分间的相关系数均小于总的Cronbach′sα系数;各项目得分与其所属因素得分间的Spearman相关系数均大于它们与其他因素间的相关系数。采用主成分分析法提取了3个公因子,累积贡献率为70.38%。经最大斜交旋转方法提取因子,共提取出因子21个。结论初步形成包括“服务与技术”、“关心与爱护”、“环境与指导”3个维度,共22个条目(含总体评价1个条目)的量表。     

《维持性血液透析患者舒适量表》的研制及信效度检验

目的 研制中文版《维持性血液透析患者舒适量表》,并进行信、效度检验.方法 结合维持性血液透析( maintenance hemodialysis,MHD)患者的特点,通过翻泽、回译、文化调适和预调查等步骤,在简化舒适状况量表(general comfort questionnaire,GCQ)的基础上修订形成《维持性血液透析患者舒适量表》,并采用方便抽样法以该量表测定100例MHD患者的舒适状况,对量表的信度、效度和可行性进行评价.结果 《维持性血液透析患者舒适量表》总体Cronbach α系数为0.935,各维度a系数在0.879～0.930之间;总体重测相关系数为0.944,各维度重测相关系数在0.817～0.924之间;量表全部条目平均内容效度指数为0.883;采用主成分分析法提取特征值＞1的4个公因子,即心理、生理、社会和环境舒适,累计方差贡献率为68.758％.量表的回收率和有效率均为100％,完成量表的中位时间为10 min,所有研究对象均能理解和接受量表.结论 《维持性血液透析患者舒适量表》具有良好的信度、效度和可行性,可用于MHD患者的舒适状况测定.     

住院患者自杀风险评估量表的编制及信效度检验

目的 编制自杀风险评估量表并验证其信效度。方法 采用文献研究法、焦点小组讨论法、德尔菲专家咨询法形成初稿。对武汉市某三级甲等医院的374例住院患者进行问卷调查,测定自杀风险评估量表的信效度。结果 正式评估量表由18个条目组成。评估量表总Cronbach's α系数是0.779,各维度的Cronbach's α系数为0.605～0.743;内容效度指数是0.92,各条目的内容效度指数为0.83～1.00 ;各维度的相关性为0.701～0.912（P＜0.05）;经探索性因子分析得出3个公因子累积方差解释率为48.491%。利用ROC曲线确定住院患者自杀风险评估量表的临界值为8分,此时该曲线下面积为0.748, 灵敏度和特异度分别为73.58%、67.60%。结论 住院患者自杀风险评估量表信效度较好,为临床护士评估患者的自杀风险提供工具。     

The patient satisfaction with nursing care quality: the psychometric study of the Serbian version of PSNCQ questionnaire

Scand J Caring Sci; 2012; 26; 598–606 The patient satisfaction with nursing care quality: the psychometric study of the Serbian version of PSNCQ questionnaire Introduction: Patient satisfaction with nursing is the most important predictor of patients’ overall satisfaction with their hospital care. According to the Law of Health Care of Republic of Serbia monitoring of patients’ satisfaction with hospital service is mandatory; however, the questionnaire applied to that purpose includes only several questions directly addressing the nursing care issue. Aim: The aim of the present study was to evaluate psychometric properties of the Serbian version Patient Satisfaction Nursing Care Quality Questionnaire (PSNCQQ) and explore patients’ satisfaction of nursing care they received and assess the relationship between patient satisfaction and patient characteristics. Methods: This cross‐sectional study included a sample population of 240 patients who were discharged from surgical clinics of the Clinical Center of Vojvodina in Novi Sad. The PSNCQQ was translated into Serbian according to standard procedures for forward and backward translation. Factor analysis was used to determine the construct validity, and predictive validity of the questionnaire was previously assessed. Cronbach’s α coefficient and item analysis was conducted to evaluate reliability of the scale. Results: The Serbian version Patient Satisfaction Nursing Care Quality Questionnaire (PSNCQQ) showed a one‐factor structure, Cronbach’s α reliability coefficient was excellent 0.94 and was similar across hospital categories. The correlation coefficient between 19 items and the total scale was high, and ranged from 0.56 to 0.76. Patients’ age, educational level and previous hospitalization period were important factors that affected their satisfaction with nursing care. Conclusion: The study provides a new tool for measuring patient satisfaction with nursing care in Serbia that may present a useful instrument for nursing care managers in improving the nursing care process.     

The Newcastle Satisfaction with Nursing Scales: a valid measure of maternal satisfaction with inpatient postpartum nursing care

AIM: To test the validity of The Newcastle Satisfaction with Nursing Scales as measures of patient satisfaction with nursing care in an inpatient postpartum unit. BACKGROUND: The Newcastle Satisfaction with Nursing Scales (Experience of Nursing Care Scale and Satisfaction with Nursing Care Scale) were developed to measure the satisfaction of medical-surgical inpatients with nursing care. METHODS: The Newcastle Satisfaction with Nursing Scales were administered by interviewers to 189 postpartum women prior to hospital discharge. We tested the construct validity of the scales by making five a priori predictions: mothers who were more satisfied would be more likely to have one nurse caring for them and to recommend the postpartum unit to a friend. We also predicted that the Experience of Nursing Care and Satisfaction with Nursing Care Scales would be positively correlated with each other, with a global question about satisfaction with nursing care, and with a global question about satisfaction with overall postpartum stay. RESULTS: Four of the five a priori predictions were supported by the data. The mean Newcastle Satisfaction with Nursing Scale scores of mothers who would recommend the unit to a friend were higher (more satisfied) than those who would not (P < 0.001). The Experience of Nursing Care Scale and Satisfaction with Nursing Care Scale were positively and significantly correlated with each other (r = 0.9, P < 0.001). There was a positive and significant correlation between the scales and global ratings of nursing care (Experience Scale r = 0.79, P < 0.001; Satisfaction Scale r = 0.82, P < 0.001) and overall postpartum stay (Experience Scale r = 0.64, P < 0.001; Satisfaction Scale r = 0.68, P < 0.001). CONCLUSION: The Newcastle Satisfaction with Nursing Scales are valid measures of maternal satisfaction with inpatient postpartum nursing care.     

Measuring patient satisfaction with nursing care: experience of using the Newcastle Satisfaction with Nursing Scale

Patient satisfaction with care has frequently been used as a measurement of quality, especially in attempts to demonstrate the benefits of changes in nursing practice. Unfortunately such attempts have frequently failed as patient satisfaction ratings have lacked sensitivity, consistently achieving very high scores. They have also failed to isolate the nursing component from the whole health care experience. The Newcastle Satisfaction with Nursing Scale (NSNS) has been developed after extensive research work as an attempt to establish reliable and valid measures of patients' experiences of and satisfaction with nursing care. This study evaluated the use of the NSNS in practice and found that it was readily understood by patients and easily administered by clinical staff. However, several lessons were learnt which could help its administration. The results demonstrated a very high degree of satisfaction with nursing care which left the discriminatory ability of the scale open to question, although its potential benefits in standard setting were demonstrated. Further evaluative studies are needed if the potential benefits of the NSNS are to be fully realised.     

住院患者满意度指标体系的构建

目的：构建与我国当前优质护理服务rT作和责任制整体护理模式相适应的住院患者满意度评价指标体系,为各级护理管理者横向或纵向比较护理服务质量提供科学参考依据。方法：在文献研究的基础上,采用目的抽样法对上海市4所和河南省郑州市5所“优质护理服务示范工程”重点联系医院的6名护理部主任、3名护理部副主任、10名责任护士和9名住院患者进行了半结构访谈,采用持续比较法进行资料分析,以SERVQUAL模型为理论基础,结合现行的优质护理服务工作质量评价标准,初步拟定了优质护理服务住院患者满意度指标体系：草案。然后采用德尔菲专家咨询法对上述医院不同管理层次的15名护理专家进行了三轮意见征询。结果：确定了由环境设施、‘争业技能、人文关怀、患者安全和综合评价5个一级指标、13个二级指标和44个三级指标构成的优质护理服务住院患者满意度指标体系,并确定了各级指标的权重。结论：本研究构建的优质护理服务住院患者满意度指标体系,紧扣当前优质护理服务和责任制整体护理模式的工作要求,为评价优质护理服务质量提供了科学的参考依据。     

护理服务质量评价量表的初步研制

目的:探索研制适合我国现阶段综合医院的护理服务质量评价量表。方法:在住院患者护理服务需求调查的基础上,经小样本调查结合专家咨询形成正式量表,选取2所综合医院的700名住院患者进行调查。结果:调查量表回收率为98.71%,Cronbach’sα系数为0.881,证实性因子分析显示,5个因素与问卷设计的5个维度完全吻合,效标关联效度检验r=0.826。结论:所研制量表具有良好的信度和效度,对护理服务质量改进具有指导作用。     

Predictors of patient satisfaction with inpatient hospital nursing care

The purpose of this predictive nonexperimental study was to investigate the influence of registered nurse (RN) job satisfaction, context of care, structure of care, patient-perceived nurse caring, and patient characteristics on patient satisfaction with inpatient hospital nursing care in an academic medical center in north-central West Virginia. Convenience samples of patients (N = 362) and RNs (N = 90) were recruited from two medical units, two surgical units, and three intensive care step-down units. Causal modeling identified patient-perceived nurse caring as the major predictor of patient satisfaction, with nurse/physician (RN/MD) collaboration as the only other direct predictor. Age had an indirect influence on patient satisfaction. Strategies to achieve and maintain patient satisfaction should address the enhancement of patient-perceived nurse caring and RN/MD collaboration.     

提高老年病房服务满意率的做法与体会

老年人中枢神经系统及各脏器的退行性改变使老年病房护理难度及护理量加大、护患沟通障碍,病人对护士的服务难以达到满意。强化以老年病人为中心,围绕老年病人的特点,在临床工作中从多方面进行针对老年病人的护理,提高老年病房服务满意率收到了良好效果。