The Importance Of Humanistic Care For Patients With Chronic Diseases And The Initial Application Of The Experience Scale

Objective:1.In the first step:to cross-cultural adapt Humanistic Relationship Importance Scale(HRIS)and Humanistic Relationship Experience Scale(HRES),and test their reliability and validity.2.In the second step:to test the reliability and validity of HRIS and HRES.3.In the thrid step:to preliminary understand the degree of nursing humanistic care needs and the relative experience of chronic diseases patients in China.Methods:1.In the first step:after obtaining the consent of the source scales' author,the English version of HRIS and HRES were forward-translated,synthesized,back-translated,expertly consulted,and pretested,and then were formed the initial Chinese version HRIS and HRES.During the pretesting,thirty chronic diseases patients were selected as study subjects to assess the feasibility of the scale.2.In the second step:this study used a cross-sectional design,and strictly complied with the unified inclusion and exclusion criteria by a convenience sampling method.From March to June 2017,189 chronic diseases patients from 4 hospitals in Beijing were investigated.The instruments including self-designed general information questionnaires,the initial Chinese version Humanistic Relationship Importance Scale(HRIS)and Humanistic Relationship Experience Scale(HRES),Item analysis,reliability and validity test were carried out to analyze the collected data.SPSS 22.0 statistical software was used for statistical analysis.The analysis methods included statistical description,exploratory factor analysis,Cronbach's alpha coefficient,Spearman correlation analysis,and nonparametric test.3.In the thrid step:From July to August 2017,153 patients with chronic diseases from 3 hospitals in Beijing were selected for investigation.The instruments including self-designed general information questionnaires,Nursing Humanistic Care Importance Scale-Noninfectious Chronic Disease Patients Version and Nursing Humanistic Care Experience Scale-Noninfectious Chronic Disease Patients Version.The analysis methods included statistical description,Spearman correlation analysis,variance analysis and nonparametric tests.Results:1.Differences in the translation process of the scales mainly focused on the translation of items and certain words.The initial Chinese version scales were revised by expert opinions.For the titles,HRIS was revised as Nursing Humanistic Care Importance Scale-Noninfectious Chronic Disease Patients Version(NHCIS-NCDP),HRES was revised as Nursing Humanistic Care Experience Scale-Noninfectious Chronic Disease Patients Version(NHCIS-NCDP).2.The critical ratio(CR)values of all items of the NHCIS-NCDP were greater than 5.The correlation coefficient between the scores of each item and the overall scale were 0.503 to 0.715.No item was deleted.The content validity index(CVI)of NHCIS-NCDP was 1;the exploratory factor analysis extracted 5 common factors and explained a total variance of 64.072%.The overall alpha for the total NHCIS-NCDP was 0.932,with subscales ranging from 0.769 to 0.858.3.The CR values of all items of NHCES-NCDP were greater than 7.The correlation coefficient between the scores of each item and the overall scale were 0.616 to 0.808.No item was deleted.The CVI value of NHCES-NCDP was 1;three common factors were extracted from the exploratory factor analysis,and the cumulative contribution rate was 67.897%.The overall alpha for the total NHCES-NCDP was 0.965,with subscales ranging from 0.911 to 0.941.4.The preliminary application results of NHCIS-NCDP for 153 respondents showed the total score was 98.00(87.00,109.00).The dimension of the highest scoring metrics was relational availability,which was 86.67%.Chronic diseases patients with different ages,educational levels,employment status,economic burden,and from different hospitals had different perspective on the importance of nursing humanistic care(P<0.05).5.The preliminary application results of NHCES-NCDP for 147 respondents showed the total score was 90.00(75.00,100.00).The dimension with the highest scoring metrics was forstering more-being,with 78.33%.The dimension with the lowest scoring metrics was building relationships positively,with 68.57%.Compared with chronic diseases patients with different educational levels and from different hospitals,there were statistically significant differences in nursing humanistic care experience(P<0.05).6.The NHCIS-NCDP total score of 147 respondents was higher than the NHCES-NCDP total score(Z=-6.582,P<0.001).For the mean scores of each item in the two scales,the NHCIS-NCDP score was higher than the NHCES-NCDP score except the item 16.Conclusion:This study cross-cultural adapted HRIS and HRES,and formed NHCIS-NCDP and NHCES-NCDP,respectively.Although some items of NHCIS-NCDP and NHCES-NCDP and the dimensions of NHCES-NCDP were different from those of the source scales,the reliability and validity of the two scales were good.NHCIS-NCDP and NHCES-NCDP can be used for the measurement of nursing humanistic care in Chinese chronic diseases patients.Patients with chronic diseases in our country have a high demand for nursing humanistic care.However,the quality of the nursing humanistic care still needs improvement.Nursing humanistic care carried by nurses did not meet the expectations of chronic diseases patients.