Development And Application Of Risk Perception Questionnaire Of Airway Management

BackgroundRisk perception is the cognition,attitude and subjective judgment when people faces risk.Risk perception will probably affect nurses’work attitude and behaviors,which affects the quality of nursing work and patient safety.In the recovery period of anesthesia,patients’respiratory and circulatory systems are disorganized due to factors such as anesthesia and surgery.Meanwhile,the metabolism of anesthetic drugs is not complete,and the body’s protective reflex is not fully recovered,patients are always facing a variety of potential risks.Therefore,whether post-anesthesia care unit nurses can timely identify,deal with and respond to risk factors in airway management of patients after general anesthesia plays a crucial role in ensuring patient safety.There are few studies on risk perception of airway management in China.Therefore,this study will construct a questionnaire of risk perception for patients’airway management by post-anesthesia care unit nurses,and conduct a status survey and analysis of influencing factors,and provide reference for nursing managers to formulate related management policies and systems.Objective1.Explore the structural dimensions of risk perception of patients’airway management in post-anesthesia care unit nurses,and develop risk perception assessment tools.2.Investigate the risk perception of patients’airway management in post-anesthesia care unit nurses and analyze the influencing factors.Methods1.This study used qualitative interview method to interview PACU nurses and doctors in a Class-Ⅲhospital in Henan Province and combined with literature review analysis to establish the risk perception of airway management item pool.Then formed the first round of expert consultation questionnaire.Through two rounds of Delphi method expert consultation to screen and revise the questionnaire items,the preliminary questionnaire was constructed.2.Questionnaire preliminary investigation:The convenient sampling method was used by selecting 265 PACU nurses who come from Class-II and above hospitals in Henan Province and issuing the preliminary questionnaire for the preliminary investigation.The formal questionnaire was formed by the item analysis and exploratory factor analysis.3.Formol investigation:A formal investigation was conducted on 280 post-anesthesia care unit nurses,who come from Class-II and above hospitals in Henan Province,in order to test internal consistency,reliability,retest reliability,Content validity and structure validity of the questionnaire.4.Present situation:Used the risk perception questionnaire of airway management to analyze 295 post-anesthesia care unit nurses risk perception from Class-II and above hospitals in Henan Province.Then used t test,analysis of variance and multiple linear regression to analyze the influence factors of nurses’risk perception.Results1.A total of ten PACU nurses,four PACU doctors were interviewed.Combined with literature review,an item pool with 5 dimensions（risk knowledge,risk control,risk attitude,risk behavior and risk measures）and 48 items was formed.The expert positive coefficient of the two rounds of Delphi expert consultation were 100%.The degree of expert authority was 0.89.The Kendall W coefficients in the two rounds were 0.227,0.320.After expert letter consultation,a preliminary questionnaire with 5 dimensions and 47items was formed.2.Questionnaire preliminary questionnaire:After item analysis,a total of 43 items were retained.Exploratory factor analysis extracted 5 common factors,and the cumulative variance contribution rate was 71.157%.A questionnaire with 5 dimensions and 42 items was formed.3.Formol investigation:The Cronbach’sαcoefficients of the total scale and each dimension were 0.970,0.883～0.963.Spearman-Brown split-half reliability was 0.853.Guttman split-half reliability was 0.849.Retest reliability was 0.838（P<0.05）.Scale level content validity index（S-CVI）was 0.948.Item level content validity index（I-CVI）were0.80～1.00.The results of the confirmatory factor analysis showed that each indexes of the structural model all in the standard range.（χ~2/df=1.886,RMSEA=0.056,CFI=0.940,IFI=0.941,TLI=0.934,NFI=0.881）.4.Present situation:In the 295 post-anesthesia care unit nurses,total score of the risk perception questionnaire is 174.74±21.62.The highest score dimension on the questionnaire was risk behavior（4.43±0.62）,and the lowest score was risk knowledge（3.92±0.52）.Single factor analysis results showed there was statistical significance in the scores of risk perception questionnaire of airway management in PACU nurses in the following factors such as different ages,hospital levels,years of work,professional title,professional source,frequency of airway risk events,whether to conduct airway management knowledge training,whether have emergency plan for airway risk events,degree of knowledge of airway management of nurses.Multiple stepwise regression analysis results showed that the influence factors of the risk perception questionnaire of airway management were degree of knowledge of airway management,whether to conduct airway management knowledge training,whether have emergency plan for airway risk events,years of work,professional source.Conclusion1.The risk perception questionnaire of airway management has good reliability and validity.It can be used in measuring the risk perception of nurse as assessment tool.2.The influence factors of the risk perception questionnaire of airway management were degree of knowledge of airway management,whether to conduct airway management knowledge training,whether have emergency plan for airway risk events,years of work,professional source.