| ObjectiveTo develop a knowledge,belief and behavior scale for full-time nursing to prevent falls in elderly inpatients and test its reliability and validity.This scale was used to investigate the status quo of knowledge,belief and practice of full-time escorts in the prevention of falls in elderly inpatients and analyze its influencing factors,so as to provide reference for the construction of training programs for full-time caregivers in the prevention of falls in elderly inpatients.Methods1.Scale compilation: Based on the knowledge,belief and action theory as the theoretical framework,the test version of the knowledge,belief and action scale for full-time accompanying elderly hospitalized patients to prevent falls was formed through the analysis of relevant literature,semi-structured interviews,expert correspondence and small sample pre-survey.From March to June 2022,a cross-sectional survey was conducted on 593 full-time escorts from 6 escorts from 12 Grade A hospitals in Qingdao,which were randomly divided into two pieces of data according to the sample size requirements to screen and evaluate the scale items and form a formal scale.2.Scale application: A convenient sampling method was adopted to select 278full-time escorts from 5 escorts from 10 comprehensive third-class A hospitals in Qingdao from July to August 2022 who met the standard of "scheduling" and had not participated in this study as survey objects to investigate the status quo of knowledge,trust and practice.With the general data questionnaire and the knowledge and behavior scale for the prevention of falls in elderly hospitalized patients by full-time caregivers as the research tools.SPSS25.0 and Amos22.0 were used for statistical analysis to understand the status quo of knowledge,belief and practice of full-time care-giving to prevent elderly inpatients from falling,and the influencing factors were analyzed.Results1.Scale compilation:(1)Based on the results of literature review,semi-structured interview and group discussion,the initial version of the 64-item scale was constructed.Sixteen experts were selected for two rounds of Delphi expert consultation.According to the results of the consultation,combined with small sample pre-survey and group discussion,items of the scale were screened and adjusted.3 items were modified,13 items were deleted and 2items were added,and a test version of the scale with 52 items in 3 dimensions of knowledge,belief and behavior was formed.The positive coefficient of experts in the two rounds was 100%,and the opinion giving rate was 68.75% and 12.50%,respectively.Expert authority coefficients were 0.888 and 0.881,respectively.Kendall coordination coefficients were 0.347 and 0.622,respectively(P<0.001).(2)According to the survey results,7 items were deleted from item analysis and 10 items were deleted from exploratory factor analysis,forming a formal scale with 35 items in 3 dimensions,and the cumulative variance contribution rate was 59.688%.According to the reliability and validity test,the content validity index(I-CVI)at the level of the total table item was 0.875-1.000,and the content validity index(S-CVI)at the scale level was 0.984.Confirmatory factor analysis confirmed that the model fit well and no items were deleted(χ2/df = 2.309,RMSEA = 0.070,CFI=0.904,TLI = 0.905,IFI = 0.917,RMR= 0.046,AGFI = 0.907).The Cronbach’s alpha coefficient of the aggregate table was 0.926,and Cronbach’s alpha coefficients of all dimensions were 0.924,0.914 and0.944 in turn.The broken half reliability of the total volume table was 0.681,and the broken half reliability of each dimension was 0.872,0.870,0.914.The retest reliability of the total table was 0.984,and the retest reliability of each dimension was 0.989,0.998,1.2.Scale application:(1)The knowledge score of full-time escorts was 44.78±7.54 points,and the scoring rate was 0.814;Belief score was 43.25 ±5.40 points,the scoring rate was 0.865;The behavioral score was 54.73±11.14 points,and the scoring rate was 0.782.(2)Regression analysis showed that the influencing factors of knowledge score were whether the students had received the knowledge training about falling and the source of the knowledge about falling(P<0.01);The influencing factors of belief score were gender,whether there was a carer certificate certified by Vocational Qualification Training Center of China Academy of Management Science or by human resources or other professional organizations at or above the municipal level of China,and whether there was a knowledge training about falling(P<0.01).The factors that influence the score of fall prevention behavior include gender,education level,whether the patients you care for have fallen,the source of fall knowledge,whether you have received fall related knowledge training,and whether you have the professional qualification training center of China Academy of Management Science or the attendant certificate certified by China Human Resources or other professional organizations at or above the municipal level(P<0.05 or P<0.01).Pearson correlation analysis showed that there were positive correlations between attitude and knowledge,behavior and knowledge,and attitude and behavior,with statistical significance(r=0.563,0.434,0.484,P < 0.05).Conclusions1.The reliability and validity of the knowledge,belief and action scale for full-time escorts to prevent elderly inpatients from falling is good,which can be used as a reliable tool to evaluate the level of knowledge,belief and action for full-time escorts to prevent elderly inpatients from falling.2.Full-time escorts have a positive attitude towards preventing falls of elderly hospitalized patients,and their knowledge level is relatively weak,which needs to be further improved and their behavior level needs to be improved.This suggests that managers should take advantage of the situation,seize the enthusiasm of full-time nursing work,develop targeted training plans,strengthen their knowledge reserve,guide them to standardize their own fall prevention behavior,and further improve their knowledge,belief and practice level of preventing elderly inpatients from falling. |
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