| Objective:1.To Explore the missed nursing care in oncology units and influencing factors for missed nursing care.2.To develop the Oncology Missed Nursing Care Feedback Scale(OMNCFS)under the background of Chinese hospital's culture and test its reliability and validity,so as to provide a scientific and effective measuring tool for improving nursing service quality and optimizing the patients' experience.3.To investigate the nursing care regularly missed in oncology units and influencing factors using the OMNCFS;to analyze current situation by comparing that they have or not statistic difference between the score of different demographic characteristics and job characteristics.Methods:Based on the model of missed nursing care,qualitative research and quantitative research was conducted in this research for the development of the OMNCFS and preliminary application in Shanxi Provice.1.Totally 25 oncology clinical nurses were selected for interviewing and extracting themes and sub-themes by Colaizzi analytic method,the initial items pool of OMNCFS was developed on the basis of qualitative interview and literature review.2.20 experts was invited to assess the item importance,after two rounds of expert consultation and a small-scale pilot study,we formed the inital version of the scale.3.Totally 388 oncology clinical nurses from five tertiary hospitals in Shanxi Provice were selected by convenience sampling as the subject of study to test the reliability and validity of OMNCFS.Item analysis were used to filtrate items,construct validity and content validity were used to test the validity,the reliability was tested by internal consistency,split-half reliability and test-retest reliability.4.Oncology nurses from nine hospitals were investigated by OMNCFS and general information questionnaire to realize the current situation and influencing factors of oncology missednursing care,and to compare the between-group difference by t-test and variance analysis.Results:1.There was lack of recognition for missed nursing care among oncology nurses.After qualitative research,we extracted 3 themes and 23 sub-themes about missed nursing care in oncology units.And we extracted 3 themes and 15 sub-themes about the influencing factors for missed nursing care.Combining qualitative research with literature review,we formed the initial items pool of the missed nursing care in oncology units including 5dimensions and 40 items;and the items pool of influencing factors containing 3dimensions and 23 items.2.The reliability and validity of OMNCFS was acceptable.OMNCFS was comprised of A and B sub-scales,scale A was named as Oncology Missed Nursing Care self-rating Scale(OMNCS)including 33 items and 4 dimensions.Its internal consistency Cronbach's ? coefficient was 0.948;the Spearman-Brown coefficient was0.786;the scale's test-retest reliability was 0.833;expert content validity was 0.904.And the exploratory factor analysis shown 4 common factors which characteristic value >1explained 63.664% of the total cumulative variance.Scale B was the Missed Nursing Care Factors Scale(MNCFS)including 20 items and 3 dimensions which were human resources factors,material resources fators and communication factors.Its internal consistency Cronbach's ? coefficient was 0.942;the Spearman-Brown coefficient was 0.820;the scale's test-retest reliability was 0.927;expert assessment of content validity was 0.933.Exploratory factor analysis shown 3 common factors which characteristic value >1explained 64.370% of the total cumulative variance.3.The mean score of OMNCS was67.00±28.37,items mean score was 2.03±0.86.Nursing care that most frequently missed in oncology unit was nursing intervention,then nursing plan,basic nursing and nursing assessment.Oncology nurses' score of missed nursing care was significant different on different age,marital status,professional title,work experience,nurse scheduling.The most frequently mentioned influencing factors of missed nursing care was human resources fators,followed by material resources factors and communication factors.Conclusion:OMNCFS can scientifically and effectively reflect the degree of oncology missed nursing care and main influencing factors,nursing managers should explore somemeasures to decrease the missed nursing care against this questions.1.Oncology Missed Nursing Care Feedback Scale has a good validity and reliability which is suitable for Chinese oncology nurses.2.The score of missed nursing care was postitively correlated with age,professional title and work experience.3.Nursing care regularly missed in oncology units contained measuring vital signs by regulation,records of nursing documents,health education to oncology patients and their families,providing the medicine within the prescribed time.The most important influencing factors contained heavy workload,the increase in patient quantity or aggravation in patients' condition,auxiliary department support is not in place. |
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