| Objective1. To study the status and demand of community nursing practice in nursing postgraduates, and to discuss its affected factors in China.2. To Introduce questionnaire of course valuing inventory(CVI), and to modify CVI into a Chinese Version through a few steps including translation, counter-translation and inspection of its psychometric characteristics; and then applying it to evaluate community nursing practice curriculum so as to provide a theoretical basis in China.3. To construct a set of community nursing practice mode according to the current development of community nursing care and the need of postgraduates by using questionnaire survey, literature searching and semi-structured interviews.MethodsThis study was an observational study,20 nursing school were investigated with stratified equal ratio sampling in northeast, north, northwest,east China, central south China and southwest region. A questionnaire was used to assess the status and need of community practice mode by 350 nursing postgradustes. The study includes two parts, one is to describe the status and needs of community practice,the other is to analyse its affected factors. All data were input into SPSS 13.0 software for statistical description and inference.1. Using Item analysis for Chinese version CVI, and to conform reliability and validity. The reliability analysis included the Cronbach'a coefficient, split-half reliability and test-retest reliability.The validity analysis included content validity,construct validity.2. Descriptive statistics, t-test, analysis of variance, Chi-square test, Kruskal-Wallis H test, Spearman correlation analysis and multiple linear regression analysis were employed to analyse the status,need and affected factors.Results1. More than 87.5% nursing postgraduates have learned community nursing course in theory, but only about half of the students attended community nursing practice (53.1%),the reason for not having attended practice was mainly that school/entity had not arranged. While more than 80.0% students thought it was "very necessary and necessary to" attend practice in the survey.2. The Psychometric index of CVI scale as a valuing course measurement tool are as follows:(1) Item analysis:A 36-item Chinese version of CVI was well developed through critical ratio(CR) and correlation coefficient.(2) Reliability verification:a. Internal consistency reliability:The Cronbach'a coefficients for the CVI questionnaire and dimensions were 0.937,and 0.771to 0.826 respectively. The split-half reliability coefficients for CVI dimensions ranged from 0.766 to 0.840,and0.923 for the total questionnaire. b. The test-retest reliability coefficients for the CVI questionnaire and dimensions were 0.743, and 0.547 to 0.788.(3) Validity verification:a. The content validity index of CVI was 0.965. b. Structure validity:Two factors were extracted using exploratory factor analysis (EFA),which accounted for 48.042% of the accumulated variance.3. The results of t-test showed that the score of CVI were significantly different between postgraduates and undergraduates, as well as in China and abroad (P<0.001).The score of CVI in China nursing postgraduates is lower than the foreign graduate students, but higher than undergraduates.4. By two-independent samples t-test, analysis of variance, Chi-square test, Kruskal-Wallis H test, Spearman correlation analysis and multiple linear regression analysis, the results were showed:①There were not statistically significant difference between having learned/practiced and not having learned/practiced community nursing (P >0.05).②The score of CVI were not significantly different among different areas, research fields, and also not statistically significant difference between different sex, degree types, whether graduating students, postgraduate recommendation and nursing as former profession (P>0.05).③The score of CVI were significantly different among different grades (P=0.001), which was 2010>2009>2008; By Chi-square test, there were not statistically significant in theoretical study among different grades (P>0.05), whereas statistically significant in practice(2008 grade was lower than 2009 grade, P=0.001<0.0125).④There were not statistically significant difference among different practice models (P>0.05).⑤There were statistically significant difference among different level of understanding on community nursing care((P<0.05).The higher level of understanding, the higher the CVI score.⑥Correlative analysis showed that there was a positive correlation between demand of knowledge & skill and CVI score. The Correlation coefficient was 0.436 (P<0.01).5. Stepwise regression equation analysis results showed that the CVI score were correlated with the postgraduates'attitude towards community nursing and the demand of knowledge & skill, which could account for about 40.2%of variance.Conclusion1. At present, the need of nursing postgraduates for community practice is strong, but practical situation is not perfect. There exist certain gap between Practice status and demand in China.2. The Internal consistency reliability of Chinese version CVI achieve psychometric index, yet the test-retest reliability coefficients are lower than accepted value which need to be modified. The questionnaire is good in content validity, but structural validity is different with English version.When using Chinese version, it would be appropriate to divided into two dimensions:positive and negative evaluation.3. The CVI score in domestic nursing postgraduates is lower than foreign postgraduates.The main factors of infulencing course evaluation are students'attitudes and demand of community nursing knowledge &skill.4. There are no difference between different practice mode,and postgraduates'recognition on community nursing have not been raised by the existing practice mode. As a result, to construct a set of community nursing practice mode according to the development of community care has realistic directive significance to community nursing education from the angle of humanism. |
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