Development And Evaluation Of Human Care Needs Scale For Inpatients With Mental Disorders During Rehabilitation

Objective: In order to provide the basis for clinical application,the scale of humanistic care needs of inpatients with mental disorders in rehabilitation period was compiled and evaluated.Methods:(1)Based on the theory of Jean Harman Watson’s humanistic care,an item pool was constructed by literature analysis,semi-structured interview and group discussion.After two rounds of 21experts’ correspondence and 60 patients’ pre investigation,the initial scale was formed.(2)Using cluster sampling method,516 inpatients with schizophrenia in rehabilitation period who were hospitalized in three tertiary psychiatric hospitals and general three tertiary hospitals with psychiatric departments from July to November 2018 were investigated.Item distribution method,discrete trend method,critical ratio method,correlation coefficient method and internal consistency analysis method are used to analyze and screen items;structural validity and content validity are used to test the validity of the scale;internal consistency reliability,split half reliability and retest reliability are used to test the reliability of the scale.Finally,a formal version of the scale is formed.(3)With the formal scale as the research tool,the current situation and influencing factors of 516 inpatients with schizophrenia in rehabilitation were analyzed.(4)SPSS 18.0 was used to enter data and analyze data.The main statistical methods are: statistical description,Pearson correlation analysis,exploratory factor analysis,two independent samples t-test,one-way analysis of variance,multiple linear regression analysis,etc.The test level a = 0.05,and the P value is taken as a two-sided probability.Results:(1)The scale of humanistic care needs of inpatients with mental disorders in rehabilitation period includes 6 dimensions,49 items in total,namely the need for humanitarian altruism(11 items),the need for help and trust(6 items),the need to encourage emotional expression(3items),the need for health education(9 items),the need to provide a safe,protected,and supportive environment(13 items)to meet the needs of basic care(7 Entries).The calculation method of the scale: the scale items from "not needed" to "very needed" are scored 1 to 5 points,with a total score of 49 to 245 points.The higher the score,the stronger the patient’s need for humane care.(2)Validity analysis:(1)Structural validity: After exploratory factor analysis,6 common factors were extracted,and the explainable variation was 65.71%.The correlation coefficient between each item and each dimension is between 0.511 and 0.740,and the correlation coefficient between each item and the scale total score is between 0.574 and 0.774;The correlation coefficient between each dimension is between 0.711 and0.884,the correlation coefficient between each dimension and the total score of the scale is between 0.862 and 0.925.The significance is less than0.05,all dimensions are positively correlated.(2)Content validity: The content validity index(S-CVI)of questionnaire level was 0.914 after being evaluated by experts.(3)Reliability analysis: The Cronbach’s a coefficient of the total table is 0.979,and the Cronbach’s a coefficient of each dimension is between0.801 and 0.938;the half-reliability of the total table is 0.924,and the half-reliability of each dimension is 0.795-0.905.The retest reliability of the total scale is 0.839.(4)The overall score of the nursing care needs of hospitalized schizophrenic patients was(202.85 ± 35.06)points,and the total items were(4.14 ± 0.16)points.The items and dimensions that the patient considers to be the most caring are the points of "Do treatment and medication for me on time"(4.39 ± 0.79)and the point of "Need to provide a safe,protective and supportive environment"(54.79 ± 9.52),the least The caring items and dimensions are "Express the concern for me with proper physical contact(such as shaking hands,shoulder-shouldering)"(4.02 ± 1.06)points and "Need to encourage emotional expression"(11.97 ± 2.73)points.(5)The main influencing factors affecting the humane care needs of inpatients with mental disorders during the rehabilitation period are thepatient’s gender,marital status,educational level,family’s average monthly income.Female patients have a higher demand for humanistic care than male patients;Patients with stable marriage need more humane care than patients with unstable marriage;Patients with high school(including secondary school)education have higher demand for humane care than patients with college education and above,but the patients with junior high school education and below do not follow this rule in some dimensions;Patients with income of 2000 yuan or more have a high need for humane care than monthly income of less than 2,000 yuan.Conclusion:(1)The scale has good reliability and validity,which is suitable for evaluating the needs of humanistic care of patients with mental disorders.(2)The demand for humanistic care for inpatients with mental disorders during the rehabilitation period is high and diverse.They should be personalized and received standardized care according to the actual needs of patients.