| ObjectiveThe purpose of this study is to construct a scientific,reasonable,comprehensive,reliable and practical competency index system for online nurses,in order to provide a reference for the talent training,appointment,assessment and evaluation of online nurses,promote the healthy and sustainable development of online nurses,and improve the service quality of "Internet + nursing service ".Methods1.Compile the original entry pool: Compile the original entry pool of online nurses’ competency through literature analysis and semi-structured interviews with nursing managers,nurses and patients,and discuss the comprehensiveness of the content of the entry pool.2.Delphi expert consultation: In this study,25 experts were invited to complete two rounds of Delphi expert consultation,and the original entry pool was further screened and modified to preliminarily form the competency index system of online nurses,and the reliability of the index system was discussed.3.Analytic Hierarchy Process(AHP)was used to calculate the weight: Yaahp software was combined with analytic hierarchy method to calculate the weight of the competency index system of online nurses,highlighting the focus of the competency training of online nurses,and discussing the scientific and rational setting of weight.4.Reliability and validity test: the research group discussed and formulated the competency questionnaire for online nurses.After pre-experimental debugging,256 nurses from 13 hospitals in Yunnan Province were selected to conduct the survey to test the reliability and validity of the index system.Results1.Literature analysis of 37 items associated with online nurses competency dictionary,Semi-structured interviews were conducted with 16 nursing managers,15 nurses and 13 patients,and 9 interview themes were extracted,combined with literature analysis and interviews as a result,the group discussion compiled 67 net about online nurses competency original item pool.The entry pool has 4 first-level competency indicators,13second-level competency indicators,and 50 third-level competency indicators.2.In this study,a total of 25 experts participated in the two rounds of Delphi consultation.The experts work in clinical nursing,nursing management and education,clinical medicine and other fields,with 8 experts with senior titles and 17 experts with associate senior titles.The effective recovery rate of the first round of expert questionnaire was 86%,and that of the second round of expert questionnaire was 100%.The authority coefficient(CR)of the two rounds of experts was 0.832 and 0.862,respectively,and the CR>0.700.The coefficients of variation(CV)of the two rounds of experts were0.040—0.167 and 0.000—0.158,respectively,with CV<0.250.The Kendall coefficients(W)of the two rounds of experts were 0.364 and 0.370,respectively,P<0.010 after the chi-square test.Finally,the competency index system of online nurses constructed by Delphi method includes 4 first-level indicators,namely theoretical knowledge,skill practice,door-to-door service ability,characteristics and quality,13 second-level indicators,and 48 third-level indicators.3.AHP was used to calculate the weight of each competency index of online nurses.The higher weights of first-level indexes were theoretical knowledge(0.308),skill practice(0.308)and door-to-door service ability(0.308).Among the secondary indicators,the highest weighted values of each dimension were professional knowledge(0.750),specialized nursing skills(0.667),problem-solving ability(0.410),and ethics(0.517).Among the three indexes,the highest weighted values in each dimension were basic nursing knowledge(0.182),ethics and legal knowledge(0.683),basic therapeutic nursing skills(0.667),first aid nursing skills(0.393),etc.,and the CR values of all indexes were less than 0.100.4.The results of project analysis in this study showed that the absolute value of t ranged from 8.566 to 16.361(> 3.000 for all),and the P value of significance test for each item was < 0.050,so all items were retained.The reliability test showed that the Cronbach’s α coefficient of the four dimensions(theoretical knowledge,skill practice,on-site service ability,characteristics and quality)and the total table were 0.949,0.952,0.973,0.965,0.984(> 0.800 for all).The split and half reliability of the four dimensions and the total table were 0.920,0.945,0.922,0.927 and 0.940(> 0.700 for all).The retest reliabilities of the four dimensions and the total table were 0.960,0.892,0.963,0.972 and0.975(> 0.700 for all).Validity test showed that item content validity(I-CVI)was 0.880--1.000(> 0.780),and the mean content validity(S-CVI/ AVE)of the scale was 0.980(BBB>900).The structural validity of exploratory factor analysis showed that four common factors were extracted from the competency index system,the total variance contribution rate was 74.138,and the variance of common factor > was 0.500 for each item.Conclusion1.This study through literature analysis,wide coverage of compiles a semi-structured interviews and content more comprehensive online nurses competency original item pool,and on this basis,the Delphi method is used to construct the high enthusiasm and authoritative experts,the expert opinion concentration and coordination degree good,strong reliability about the online nurses competency index system.2.In this study,AHP was used to set the weight of the competency index system of online nurses.The results showed that the weight setting of each index was scientific,and the content construction and weight setting of the index system were reasonable.3.In this study,the reliability and validity of the competency index system of online nurses were tested,and it was confirmed that the index system had good reliability and validity,could be used as a measuring tool to evaluate the competency of online nurses. |
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