The Revision,Reliability And Validity Test Of The Core Nursing Outcomes Of Inpatients With Stroke And Its Preliminary Application

Objective:On the basis of the third edition of Nursing Outcomes Classification(NOC)Developed by Iowa University,select nursing outcomes of inpatients with stroke.Through Delphi expert consultation method to revise the core nursing outcomes,make them accord with local culture,clinical utility for nurses to assess core nursing problems with stroke inpatients.The revised core nursing outcome was measured in patients with stroke inpatients,to test reliability and validity.To measure the level of knowledge of stroke inpatients with “Knowledge:Illness Care” the first day of admission,the day before discharge,to explore the effect of health education during hospitalization.Methods:(1)Literature review and questionnaire survey: select the core nursing outcomes of stroke inpatients.(2)Delphi expert consultation: revise core nursing outcomes of stroke inpatients.(3)questionnaire survey(1)according to revised core nursing outcomes,investigators implement them to stroke inpatients in neurology department,to test and analyze core nursing outcomes' reliability and validity.(2)applying Knowledge:Illness into stroke inpatients,measure the level of knowledge the day of admission,the day before discharge.Results:(1)The criteria for selecting core nursing outcome of stroke patients is “outcomes which is related to common nursing diagnoses and the mean value of importance?4.50”.Six core nursing outcomes were selected:“Fall Prevention Behavior”,“Mobility”,“ Aspiration Prevention”,“Swallowing Status”,“Activities of Daily Living”,“Anxiety Self-Control”.(2)During two rounds of Delphi experts,through experts advice and group discussions,increase one nursing outcome “knowledge: Illness care”.the statistical results showed that the effective rate of two rounds of questionnaires were 100%,the authority coefficient of experts were between 0.76-0.99.Each item is more than 4.0 points,and CV<0.25.Finally,revised 7 core nursing outcomes including 70 indexes.(3)Cronbach's ? and split-half reliability of “Fall Prevention Behavior”,“Mobility”,“ Aspiration Prevention”,“Swallowing Status”,“Activities of Daily Living”,“Anxiety Self-Control”,“knowledge: Illness care” are 0.850,0.982,0.811,0.961,0.981,0.7980.822;0.793,0.969,0.696,0.918,0.973,0.601,0.833.The content validity index(S-CVI)of the scale level was 0.91-0.98.(4)“Knowledge: Illness care” test results showed that the day before discharge the total score of the patients' level of knowledge was improved compared with the first day of admission,P<0.001,and the difference was statistically significant.In addition to“describing the relevant health care resources”,the score of each item increased and the differences were statistically significant compared with the first day of admission(P<0.05).Conclusions:(1)Preliminary selected and revised 7 core nursing outcomes for the stroke inpatients:“Fall Prevention Behavior”,“Mobility”,“ Aspiration Prevention”,“Swallowing Status”,“Activities of Daily Living”,“Anxiety Self-Control”,“knowledge: Illness care”.Those core nursing outcomes are very important in hospital.With specialized characteristics,they can capture the essence of nursing practice for stroke inpatients.(2)Seven core nursing outcomes' Cronbach's ? are between 0.798~0.982,andsplit-half reliability between 0.610~0.973.The content validity index(S-CVI)of the scale level was 0.91-0.98.Seven core nursing outcomes have good reliability and validity.(3)According to the application effect of “Knowledge: Illness nursing”,health education during hospitalization can improve stroke inpatients' knowledge level.But patients lack knowledge of access to health care resources.It may be related to the lack of medical resources and unreasonable distribution of resources in China.