Psychometric Evaluation Of The Chinese Version Of Normalization Me Asure Development(NoMAD)

Purpose:(1)To translate and culturally adapt the original Normalization Me Asure Development(NoMAD)into Chinese.(2)To evaluate the psychometric properties of the Chinese version of NoMAD(C-NoMAD).Methods:We first took the grant from the author of the original NoMAD,then following the translation procedure of the NoMAD translation guideline,we conducted forward translation,backward translation,and compare translations.We undertook two rounds of cognitive interviews with ten medical staff to achieve cross-cultural adaptation.Then we consulted seven experts in relevant domains to test the content validity of the C-NoMAD and to revise some items according to the experts’suggestion.And then the final version of C-NoMAD was answered by the clinical nurses who used the pressure injuries management system via We Chat Mini-program at one tertiary hospital in northwestern China.We used Cronbach’sαcoefficient to test internal consistency and conducted the confirmatory factor analysis to confirm whether the collected data fit for the theoretical structure of the normalization process theory.We also explored the criterion-related validity of C-NoMAD by correlating the observed mean factor scores with the means scores for the general normalization questions.Results:A total of two hundred and eighty questionnaires were distributed,then two hundred and fifty-eight clinical nurses completed the questionnaire,and the response rate was 92.1%.Most of the survey respondents were female(96.9%),senior nurse(60.5%),bachelor’s degree(95.0%).The average age of the nurses were 32.48±6.30,and the average working years of those were 9.66±7.34.The C-NoMAD consists of four dimensions(coherence,cognitive participation,collective action,and reflexive monitoring)including 19 items.Our results show that the correlation coefficients between item scores ranged from 0.065 to 0.739,and the correlation coefficients between items scores and the total score ranged from 0.473 to 0.831.The internal consistency of the four dimensions of the C-NoMAD ranged from 0.768 to 0.904,and the overall internal consistency of the C-NoMAD is 0.941.The confirmatory factor analysis results showed a good fit for theoretical structure(?~2/df=2.61,Comparative Fit Index=0.924,Tucker Lewis Index=0.910,Root Mean Square Error of Approximation=0.079,Standardized Root Mean Square Residual=0.046).The item-level content validity index of the C-NoMAD ranged from 0.857 to 1,and the scale-level content validity index of the C-NoMAD was 0.95.Conclusion:(1)Our research translated the English version of NoMAD into Chinese and developed the Chinese version of NoMAD.(2)The C-NoMAD is a reliable and valid tool to evaluate the promoting and inhibiting factors of implementing innovations in the clinic.