The Development Of Assessment Tools Of Nurses’ Humanistic Practice Ability

BackgroundAlong with the transition of the nursing mode and in-depth development of "the demonstration project of high quality nursing service ",the nurse’s humanistic practice ability has become the important guarantee to improve the quality of clinical nursing service connotation. In recent years, in order to promote the project, nurses’humanistic practice ability has been paid more attention, many universities combined with the humane of medical education to educate the students, the hospital increased training to improve staffs humanistic practice ability, but the effectiveness of education and training remains to be evaluated by the objective assessment tools.ObjectiveBasing on literature review and Delphi, we construct evaluation index system of nurses’humanistic practice ability, and develop the assessment tool of nurses’humanistic practice ability to provide a workable quantitative tools of measuring the nurses’ humanistic practice ability.Methods1.Literature research and expert interview We searched for the related information about humanistic practice ability and assessment tools in domestic and overseas database, and analyzed the knowledge structure on nurses’humanistic practice ability. Combining we conducted semi-structured depth interview with experts, Then we construct the theory frame structure of the nurses’humanistic practice ability, and initially form the evaluation index system of nurse’humanistic practice ability.2.Delphi According to the evaluation index of nurse’humanistic practice ability we established the consultation table with5levels from " very important " to " very unimportant".Then conducted two rounds of Dephi with17experts who met the inclusion criteria. According to the revision of the experts advice and statistical results, we formatted the initial assessment tools of nurses’humanistic practice ability. Using "very consistent"、"consistent"、"general"、"inconsistent" and "very inconsistent" Likert-5scores, assignment of5levels respectively was5,4,3,2,1.3.Preliminary survey By convenient sampling,280nurses who met the inclusion criteria from Henan Province in3tertiary hospitals were assessed. We use item analysis and exploratory factor analysis to screen items to establish the assessment tools of nurses’ humanistic practice ability.4.Formal survey By convenient sampling,400nurses who met the inclusion criteria of Henan Province in4tertiary hospitals were assessed. We use internal consistency analysis, content validity and confirmatory factor analysis to analyze reliability and validity of the assessment tools of nurses’humanistic practice ability(ATNHPA).Results1.Dephi Through literature study and expert interview, we initially collect8dimensions,60items. Through concluding and analysis of the indexes, we delete two dimensions of the ability of humanistic nursing management and professional development retain the6dimensions and49items. Through first round of Dephi, we get6dimensions,40items, which removed "can continue to learn from tradition and reality’benevolence’ nutrition","aesthetic appeal"13indexes, increase the "master of beauty basic principles,""solid expertise" four indexes, modified nine indexes. Through second round of Dephi, we construct the initial assessment tools of nurses’humanistic practice ability consisted of6dimensions,37items, which removed "can withstand a certain degree of psychological pressure","guide clinical practice with care act" three indexes, modify five indexes.2.1tem Analysis Each item of critical ratio was7.790～13.826, P<0.001; Pearson correlation analysis showed that the correlation coefficient between0.544～0.720, P<0.001. 3.Validity TestContent Validity:The study conducted experts interviews and two rounds of Delphi, and Pearson correlation coefficient0.544～0.720, and the P<0.001.which guaranteed that the assessment tool of nurses’humanistic practice ability has good content validity.Structure Validity:Exploratory factor analysis extract5factors, deleted14items, retained23items, the factor loading of items is0.566～0.815, five principal components could explain64.294%of total variance. Confirmatory factor analysis showed that X2=386.243、x2/df=2.158, P<0.001、NFI=0.915、TLI=0.944、CFI=0.952、IFI=0.953、 RFI=0.901.We eventually determined that the assessment tool of nurses’humanistic practice ability, which is composed of five dimensions that included the ability of Nursing communication, Psychological adaptation, Nursing aesthetics, using law and Care practice,21items.4.Reliability Test Cronbach’s a of the overall scale is0.935, while the5dimensions are0.786～0.898,the split-scale reliability coefficient of the whole scale is0.827,while the5dimensions are0.726-0.905.The test-retest reliability overall is0.822, test-retest reliability of each dimension are0.782～0.848. ConclusionThe research constructed nurse the assessment tool of nurses’humanistic practice ability, and has a good reliability and validity.