Development And Evaluation On Reliability And Validity Of The KAP Scale For Prevention Of Central Line Associated-bloodstream Infections

Objectives The purpose of this study is to construct the KAP scale on prevention of central line associated-bloodstream infections,and evaluated its reliability and validity,provide a scientific and effective surveying tool for nursing staff,understand the status quo of central line associated-bloodstream infections,explore its specific problems and reasons,formulating a targeted and personalized training scheme,implementing interventions and supervisions,improving central line associated-bloodstream infections preventive level of nursing staff,reducing the occurrence of central line associated-bloodstream infections.Methods1.Constructing indexs pool:based on the KAP model,the initial index pool is drawn up by synthesizing theoretical analysis and the theoretical framework of expert brainstorming.2.Delphi experts consulation:41 experts from 13 provinces were selected for experts consulation,to judge the content of the initial index pool.The reliability of this investigation was analyzed by the enthusiasm,authority of experts,and the concentration,coordination of experts opinions.The indexs were screened and modified by combination of mean of importance assignment,variable coefficient of the indexs,experts opinion,etc.so as to form the pretrial scale.3.Evaluation of reliability and validity:convenient sampling method was used to perform the study on 516 ICU nurses,and to further screen the index of the investigated data by index analysis,correlation coefficient,Cronbach’s α coefficient,factor analysis.The reliability of the scale was evaluated by Cronbach’s αcoefficient,retest reliability and split-half reliability;and the validity of the scale was evaluated by content validity,focus discrimination validity and exploratory factor analysisas,so as to form official scale.4.Verification of model structure:the scale structure formed after the reliability and validity,was performed with confirmatory factor analysis by using SPSS 25.0 and AMOS 23.0,and the model structure was further verifiedResults1.Delphi experts consulation:the expert enthusiasm coefficient for the two rounds of experts consulation were 91.11%and 100%respectively;the authority coefficient of experts for the two rounds of experts consulation were 0.938;Kendall’s W coordination coefficients for the two rounds of experts consulation were of significance(P<0.05).1.Indexs selection:①The initial indexs pool consists of 82 indexs,knowledge dimensions including 33 indexs,attitude dimensions including 14 indexs,practice dimensions including 35 indexs;②After two rounds of experts consulation,there were 7 newly added indexs,10 deleted indexs and 38 modifications in total;③According to the investigation results,5 indexs were deleted from the index analysis,5 indexs were deleted from the exploratory factor analysis,69 indexs were retained finally,knowledge dimensions including 26 indexs,attitude dimensions including 16 indexs and practice dimensions including 27 indexs.2.Reliability of scale:①Cronbach’s α coefficients of various dimensions and the general scale were 0.957,0.975,0.975 and 0.976 respectively;②Retest reliability of various dimensions and the general scale were 0.949,0.900,0.973 and 0.992 respectively,with significance(P<0.01);③The split-half reliability of various dimensions and the general scale were 0.854,0.948,0.950 and 0.758 respectively.3.Validity of scale:①Content validity:I-CVI was 0.76～1.0,S-CVI/Ave=0.97;②Focus discrimination validity:the correlation coefficient r of various item and the dimensions was 0.545～0.906,the correlationt coefficient r among various dimensions was 0.430～0.655,the correlation coefficient r between various dimensions and general scale was 0.807～0.838.All of the the above coefficients were of significance(P<0.01);③Structural validity:6 common factors were extracted from the first exploratory factor analysis,with accumulating contribution rate of variance of 72.229%;3 common factors were extracted from the first exploratory factor analysis,with accumulating contribution rate of variance of 64.077%.4.Model structure:χ2/df=2.714,RMSEA =0.076,RMR=0.038,GFI=0.905,AGFI=0.874,various parameters reached the standard value.It can be seen that the model fit better with actual data.Conclusions The scale based on knowledge-attitude-practice model,combined literature study,delPhi experts consulation,validity analysis,reliability analysis and confirmatory factor analysis,it has good reliability and validity,it can accurately and comprehensively reflect the deficiency of central line associated-bloodstream infections among nursing staff,it can be further popularized as an effective measurement tool for the prevention of central line associated-bloodstream infections.