| Research objective1.The purpose of this study is to construct and evaluate the reliability and validity of the Cognitive Bias Questionnaire for Patients with Nasal Gastrointestinal Catheterization.2.The cognitive bias questionnaire was applied to evaluate the differences in cognitive bias between patients with nasal gastrointestinal catheterization unplanned extubation and the control group.Explore the association between cognitive bias and unplanned extubation,so as to provide scientific basis for the prevention of unplanned extubation.Methods1.Based on the theoretical framework of cognitive theory and behavioral decisionmaking theory,the preliminary construction of the Cognitive Bias Questionnaire for Patients with Nasal Gastrointestinal Catheterization was prepared by means of concept definition,literature review,qualitative study and group discussion.Delphi method was used to conduct two rounds of expert correspondence,forming the initial version.The pre-survey was carried out in 20 patients with different genders,ages,disease types and educational levels of nasal gastrointestinal catheterization.The feedback of patients was collated and analyzed and the corresponding adjustments were made to ensure the feasibility of the questionnaire.90 patients with nasal gastrointestinal catheterization were investigated.The software EpiData 3.1 was used to establish the database,and SPSS 25.0 was used to analyze data.The items of the questionnaire were further screened and simplified according to the differentiation analysis.The reliability of the questionnaire was evaluated by retest reliability and internal consistency reliability.The validity of the questionnaire was evaluated by surface validity,content validity and structure validity.Finally,the formal questionnaire was formed.2.Referencing case-control study,extracting patients with nasal gastrointestinal catheterization in 16 hospitals in Suzhou from January to December in 2020,83 patients with unplanned extubation events were selected as the case group(the group of extubation).According to the ratio of 1:2,166 patients without unplanned extubation events during the same period of catheterization were selected as the control group(the group of without extubation)and matching conditions as follows:same region,same gender,and less than 5 years of age difference.Self-made general data questionnaire was used to collect demographic and disease-related data of patients.The Cognitive Bias Questionnaire for Patients with Nasal Gastrointestinal Catheterization was used to measure the types and levels of cognitive bias.The software EpiData 3.1 was used to establish the database,and SPSS 25.0 was used to analyze data.Data description:the mean ± standard deviation was used for measurement data,and the constituent ratio was used for counting data.Comparison between groups:independent sample t test was used for measurement data;chi-square test and rank sum test were used for counting data.Multivariate analysis:conditional logistics regression was used to explore the association between different types and levels of cognitive bias and unplanned extubation in patients with nasal gastrointestinal catheterization.All P were bilateral probabilities,and P<0.05 was considered statistically significant.Results1.Construct the Cognitive Bias Questionnaire for Patients with Nasal Gastrointestinal Catheterization.(1)The formation of the initial questionnaire item pool:28 items were finally determined to form the item pool of the questionnaire,including representative bias(5 items),overconfidence(5 items),attribution bias(7 items),loss aversion(7 items),and cognitive compliance(4 items).(2)The result of expert letter inquiry:the five dimensions of the questionnaire remained unchanged,and 18 items were formed,including representative bias(3 items),overconfidence(4 items),attribution bias(3 items),loss aversion(5 items),and cognitive compliance(3 items).(3)The formation of the formal questionnaire:after pre-survey,project analysis and reliability and validity test,the final five dimensions remained unchanged,and 15 items were retained,with 3 items in each dimension.Cronbach’s a coefficients of the five dimensions were 0.835,0.784,0.703,0.791 and 0.838,respectively.The KMO value of the questionnaire was 0.630.A total of 5 common factors were extracted,and the cumulative variance contribution rate was 72.539%.2.The results of the investigation:Single factor analysis showed that the levels of four dimensions of cognitive bias in the extubation group,including overconfidence,attribution bias,loss aversion and cognitive compliance,were higher than those in the group of without extubation,with statistical significance(P<0.05).Multi-factor analysis showed that increased level of overconfidence was associated with increased risk of unplanned extubation,which was statistically significant(OR=3,101,95%CI 1.882-5.111,P<0.001);increased level of attribution bias was associated with increased risk of unplanned extubation,which was statistically significant(OR=1.542,95%CI 1.013-2.349,P=0.044);increased level of loss aversion was associated with increased risk of unplanned extubation,which was statistically significant(OR=2.219,95%CI 1.273-3.867,P=0.005);increased level of cognitive compliance was associated with increased risk of unplanned extubation,which was statistically significant(OR=2.728,95%CI 1.632-4.562,P<0.001).Conclusions1.The Cognitive Bias Questionnaire for Patients with Nasal Gastrointestinal Catheterization in this study has good reliability and validity,which can measure types and levels of cognitive bias of patients with nasal gastrointestinal catheterization quantitatively.2.Among the five dimensions of cognitive bias,the increased levels of overconfidence,attribution bias,loss aversion,and cognitive compliance were associated with the increased risk of unplanned extubation.Pay attention to the cognitive bias of patients,early detection and timely intervention can help reduce unplanned extubation events. |
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