Development Of Readiness For Hospital Discharge Scale For Stroke Patients

Objective:Based on the concept of discharge readiness,this study aims to further clarify the connotation of discharge readiness of stroke patients and construct the evaluation scale of discharge readiness of stroke patients.Finally,the reliability and validity was tested.It can provide appropriate tools for evaluating the discharge readiness of patients with cerebral apoplexy,and can help clinical nurses accurately evaluate the readiness of patients with cerebral apoplexy in terms of physiology,psychology,knowledge acquisition and social support,so as to provide theoretical basis for improving the discharge readiness of patients with cerebral apoplexy.Methods:1.Literature analysis: according to the literature retrieval rules,relevant literature was searched and read.The key words such as "stroke","discharge readiness" and "scale" were searched to understand the latest research progress of discharge readiness assessment tools for stroke patients.2.Semi-structured interview: 13 stroke patients who met the inclusion and exclusion criteria were selected by the purpose sampling method for semi-structured interview,and the dimensions of the stroke discharge readiness assessment scale and the entry pool were initially constructed.3.Delphi expert consulting method: two rounds of expert consulting were conducted,and the data and opinions of each round of expert consulting were sorted out and analyzed.The items were screened by analyzing the importance of items and coefficient of variation.4.Pre-experiment method: 25 qualified stroke patients were selected for the pre-experiment,and the expression mode and scoring method of the scale items were evaluated.After the discussion between experts and the research group,the initial scale for evaluating the discharge readiness of stroke patients was formed.5.Questionnaire survey method: 293 stroke patients who met the inclusion and exclusion criteria were selected for the questionnaire survey.Item option analysis method,critical ratio method and correlation analysis method were used to screen and determine the items of the scale.The final scale for evaluating the discharge readiness of stroke patients was determined by reliability and validity test.Results:1.Twenty-nine items of the discharge readiness assessment scale for stroke patients were preliminarily determined by means of the mean of item importance,coefficient of variation,item option analysis,critical ratio method and correlation analysis.2.Validity test of the scale:(1)content validity: six relevant experts were invited to evaluate the contents of the scale by using the expert evaluation method.The average content validity of the scale was 0.93,and the content validity of the items was 0.83~1.00.(2)structural validity: four common factors were extracted through two exploratory factor analysis,and the contribution rate of the cumulative variance was 72.2035%,indicating that the scale has a good structural validity.3.Reliability test of the scale:(1)internal consistency reliability: the total Cronbach’sαcoefficient of the evaluation scale for discharge readiness of stroke patients was 0.905,and the Cronbach’s α coefficient of each dimension ranged from 0.933 to 0.942.(2)fractional half-reliability: the fractional half-reliability coefficient of the total scale was0.942,and the fractional half-reliability coefficient of each dimension ranged from 0.934 to0.957.(3)retest reliability: the retest reliability of the total scale was 0.926,the retest correlation coefficient r was 0.781,the retest correlation coefficient r was 0.914,the guide quality correlation coefficient r was 0.950,and the social support correlation coefficient r was 0.821.The internal consistency reliability,partial reliability and retest reliability of thescale were all greater than 0.7,indicating that the scale had a good reliability.Conclusion:The evaluation scale of discharge readiness for stroke patients developed in this study has good reliability and validity,and the four dimensions included in the scale are consistent with the concept of discharge readiness.It can be used as an evaluation index of the discharge readiness of stroke patients,accurately reflecting the readiness of stroke patients in physiological,psychological,knowledge and social support before discharge,and providing theoretical support for the discharge readiness of stroke patients and the continuous care after discharge.