Study On The Development And Application Of A Questionnaire Of Care Knowledge-Attitude-Practice Of Caregivers In The Children With Acute Leukemia

Objective1.To develop a questionnaire to measure care knowledge-attitude-practice of caregivers in the children with acute leukemia and to provide a suitable tool for clinical nurses to evaluate the effect of education.2.To investigate the status of caregivers' care knowledge-attitude-practice in children with acute leukemia and to explore its influencing factors.Methods1.Twenty-eight caregivers in the children with acute leukemia participated in the semi-structure interview.Data were analyzed by Colaizzi's phenomenological analytic procedure.Guided by KAP theory and combined with literature review,clinical practice and expert opinions,the the first draft of care knowledge,attitude and behavior questionnaire for caregivers in the children with acute leukemia was formed.2.After 2 rounds of Delphy's expert consultation,the first draft of the questionnaire was revised to form the second draft.3.The project analysis was tested using a sample of 360 caregivers from the wards in 2 hospitals of grade A in Zhengzhou.The validity of the questionnaire wasanalyzed by exploratory factor analysis and content validity.The internal consistency coefficient and bisected reliability were used to evaluate the reliability of the questionnaire.4.Survey of the status quo: 256 caregivers of children with acute leukemia were conveniently selected for investigation by using of general information questionnaire and the final draft of care knowledge,attitude and behavior questionnaire for caregivers in children with acute leukemia.Data were input by EpiDate3.1 and analyzed by SPSS17.0.Descriptive statistics,independent sample t-test,one-way ANOVA and stepwise multiple linear regression were used to analyze the status and influencing factors of caregivers' care knowledge-attitude-practice in children with acute leukemia.Results1.Through the literature review and qualitative interviews,we have formed the first version of the care knowledge,attitude and behavior questionnaire for caregivers in the children with acute leukemia based on KAP theory including three dimensions,54 items.2.Through 2 rounds of Delphy's expert consultation,7 items were deleted.Five items were modified.the second draft of questionnaire have 3 dimensions and 47 items.3.Totally 6 items were deleted.The final draft of questionnaire was composed of41 items and three dimensions.The three dimensions were Knowledge(22 items),Attitudes(11 items),Behavior(8 items).The three dimensions included 4,2,1 factors respectively,and the factors explained for 72.141%,70.336%,55.798% variances respectively by using exploratory factor analysis.The S-CVI was 0.909,0.922,0.929 respectively,and I-CVI was 0.85~1.000.The Cronbach's ? of the general questionnaires and each dimensions was 0.967,0.953,0.916,0.885 respectively.The split-half reliability of the general questionnaires and each dimensions was 0.894,0.842,0.762,0.833 respectively.4.The average score of care knowledge of caregivers in children with acute leukemia was(57.66+10.98),which was low.Multiple linear regression analysis showed that treatment stage,education level,source of medical expenses,whether or not children were taken care of together and treatment time had an impact on the score.The average score of care attitude was(36.50+4.43),which was above the middle level.Multiple linear regression analysis showed that treatment stage,family per capita monthly income,source of medical expenses and whether or not children were taken care of together had an impact on the score.The average score of care behavior was(21.07+4.06),which was in the lower middle level.Multiple linear regression analysis showed that treatment stage,family per capita monthly income,source of medical expenses,occupation and whether or not children were taken care of together had an impact on the score.Pearson correlation analysis showed that there was a positive correlation among caregivers' care knowledge,attitude and behavior,and the correlation coefficients were 0.693,0.541 and 0.491 respectively,P < 0.01.Conclusion1.The questionnaire has good reliability and validity,and it can be used to evaluate care knowledge,attitude and behavior of caregivers in the children with acute leukemia.2.Care knowledge-attitude-practice of caregivers in the children with acute leukemia need to be improved.The main influencing factors are the stage and time of treatment,caregiver's occupation,education level,source of medical expenses and whether or not children were taken care of together.This suggests that clinical nurses should give health education and nursing guidance to different types of caregivers in order to improve the level of care knowledge-attitude-practice of caregivers,and then improve the quality of care for children.