| Objectives(1)To explore the understanding of nurse-patient empathy motivation and what contents should be included in nurse-patient empathy motivation among nurses.(2)To develop a scale to be used in evaluating the empathy motivation of nurses who working in China and to test the reliability and validity of the scale.Methods Part 1:study on conceptual framework(January 2016-April 2016)A total of 21 nurses from four tertiary general hospitals in Hefei were recruited using purposive sampling.We performed semi-structured interviews to explore the understanding and perceptions of nurse-patient empathy motivation among nurses.Interviews were coded and analyzed following principles of grounded theory and used to amend and complete the initial list of themes,and developed a conceptual framework of Nurses' nurse-patient empathy motivation finally.Part 2:construction of the scale(May 2016-December 2016)(1)Development of scale: based on the results of previous studies and literature,this section constructed the theoretical framework of nurses' nurse-patient empathy motivation scale(NNPEMS)and formed the alternate item pool of the scale.The initial version of the scale was formed by two rounds of expert content validity and surface validity.(2)Test of the scale: pretest(July 2016-August 2016)and formal test of the scale(September 2016-December 2016)were included.(1)The pre testing phase: 340 nurses were selected by convenient sampling from four three tertiary general hospitals in Hefei and Wuhu,Anhui Province.The test version of the scale including 27 items was formed after item analysis and pre reliability and validity analysis;(2)The formal testing phase: 640 nurses working in the above four hospitals were selected by convenient sampling.The samples were randomly divided into two groups,one group was used for exploratory factor analysis(n=290)and one group for confirmatory factor analysis(n=289).The general questionnaire and test version of the nurses' nurse-patient empathy motivation scale were administered to research objects,besides,the Interpersonal Reactivity Index(IRI),Self-designed Questionnaire of Empathy,Satisfaction with Life Scale(SWLS),and Positive and Negative Affect Schedule(PANAS)were used to evaluate the validity of the new scale.The formal version of the scale including 27 items was formed finally.Results Part 1: The conceptual framework of nurses' nurse-patient empathy motivation consisted of three main themes,which were autonomy motivation,controlled motivation and amotivation.Sub themes within each theme were basically consistent with self-determination theory,also having the cultural characteristics of nursing specialty.Part 2:(1)The initial version of the scale including 28 items was formed after expert content validity and face validity evaluation.The test version of nurses' nurse-patient empathy motivation scale including 27 items was formed after pretest,and exploratory factor analysis yielded a six-factor and three-factor,accounting for 70.062% and56.997% of the total variation,respectively.(2)The results of formal test :(1)The dimensions and items of Nurses' Nurse-patient Empathy Motivation Scale were in accord with the basic theoretical framework.Exploratory factor analysis yielded a six-factors,the factor loading were 0.489~0.924,explained 71.266%of the total variation,the Cronbach's ? of dimensions were 0.815~0.895,and the split half reliability were 0.799~0.858;(2)When limited 3 factors,the factor loadings were 0.522~0.917,except for the item 14,which explained 56.578% of the total variance,the Cronbach's ? of dimensions were0.864~0.929,and the split half reliability were 0.763~0.854;(3)Exploratory factor analysis was carried out at each factor level,and only one common factor was extracted.The results showed that each item may be retained within the factor,all accounting for more than 52.248% of the total variance;(4)There were a positively correlated between autonomous motivation of three-factor of the scale,the subjective well-being and empathy(P<0.01),a weakly correlated or no correlated between controlled motivation,subjective well-being,and empathy(P<0.01 or P >0.05),a negatively correlated or no correlated(P<0.01 or P>0.05)between amotivation,subjective well-being and empathy.The results were consistent with the content of self-determination theory,which supported the construct validity of the three-factor model of the scale;(5)The confirmatory factor analysis showed that the six-factor model of the scale fitted well(?2/df=1.744,RMSEA=0.051,AGFI=0.855,GFI=0.882,TLI=0.942,RMR=0.039,IFI=0.950,CFI=0.949),and the modified three-factor model of the scale fitted well(?2/df=2.261,RMSEA=0.066,AGFI=0.814,GFI=0.847,TLI=0.902,RMR=0.049,IFI=0.914,CFI=0.913).Conclusion This study defined the concept of nurses' nurse-patient empathy motivation and developed a conceptual framework of Nurses' nurse-patient empathy motivation.The Nurses' nurse-patient empathy motivation scale showed good psychometric properties and could be used to explore nurses' motivation of the nursing empathy in China.The results of this study could provide a theoretical basis and support of tool for further investigation and intervention about empathy motivation. |
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