The Development And Preliminary Application Of The Training Program Of Children’s Environmental Health Competence For Community Nurses

Objective1.To translate the Children’s Environmental Health Knowledge and Skills Questionnaire(Ch EHK-Q and Ch EHS-Q)into Chinese and conduct cross-cultural debugging according to Chinese cultural background.Then to evaluate its reliability and validity in community nurses in China.2.Construct the environmental health competence training program for community nurses based on Risk Information Seeking and Processing Models.Then implement and evaluate the effectiveness and feasibility of the training program.MethodsThis study consists of three parts.The first and third parts adopt quantitative research method,and the second part adopts mixed research method.1.Psychometric Testing of Ch EHK-Q and Ch EHS-QAfter obtaining the authorization from the original author,the two questionnaires were translated into Chinese following the Brislin two-person translation mode.Then the test versions of CHEHK-Q and CHEh S-Q were formed through experts consultation and pre-test.A total of 319 community nurses were selected by purpose sampling method to evaluate the items and subject reliability,separation index,retest reliability,content validity and structure validity of the two questionnaires.2.Construction of the children’s environmental health competence training program for community nursesFirstly,to summarize the relevant research at home and abroad,which provided guidance for construction of the children’s environmental health competence training program for community nurses.Secondly,through interviews and quantitative survey,the nurses’ awareness,knowledge and skill level about children’s environmental health were deeply understood,as well as their opinions and suggestions about learning environmental health courses.Third,based on the Risk Information Seeking and Processing Models and the Integrative Model for Environmental Health,combined with the qualitative interview and quantitative survey results the first draft of the training program was constructed.The formal version of the training program was finally formed by modifying and refining according to the expert consultation.3.Implementation and evaluation of the children’s environmental health competence training program for community nursesNurses from 4 community health service centers in Zhengzhou that met the inclusion were selected as research objects.Taking the community as a whole,the 4communities were divided into 2 groups by drawing lots,2 communities per group.There were 34 nurses in experimental group and 32 in the control group.The nurses in control group only received weekly training on professional knowledge,,skills and nursing theories from the community health service center.The nurses in experimental group received 6-week training program of children’s environmental health competence in addition to the regular community nursing training.Results1.Psychometric Testing of the Ch EHK-Q and Ch EHS-QThe Ch EHK-Q has 26 items,and the Ch EHS-Q has 12 items.The characteristic value of the first component residual of the Ch EHK-Q was 1.85,and that of the Ch EHS-Q was 1.66.The person reliability of Ch EHK-Q was 0.85 and the item reliability was 0.97.The retest reliability was 0.85.The person reliability of Ch EHS-Q was 0.94 and the item reliability was 0.93.The retest reliability of Ch EHS-Q was 0.87.The absolute values of residual correlation of the both questionnaires were≤0.3.2.Construction of the children’s environmental health competence training program(1)Develop the first draft of the training programThis stage was divided into four steps.(1)Literature analysis: A total of 4 articles and 5 websites related to children’s environmental health training were involved.Then we analyzed the contents,methods,duration and evaluation methods of children’s environmental health competence training.(2)Cross-sectional: The average Ch EHK-Q score of nurses was(13.04±6.27)and that of Ch EHS-Q was(35.28±8.16).Among them,the proportion of nurses with insufficient or poor knowledge was80.27%,that of skills was 79.93%.(3)Qualitative interview: In this study,8community nurses were selected for interviewed by purpose sampling method.By using colaizzi7-step analysis method 3 themes were extracted.The themes include:cognitive deviation about children’s environmental health,lack of children’s environmental health competence and lack of external support.(4)First draft formation: the first draft of the training program was formed on the basis of literature research,cross-sectional investigation and qualitative interview.(2)Develop the implementation draft of the training programThe implementation draft of the children’s environmental health competence training program was finalized through experts consultation.The training lasts for 6weeks,once a week,each time 60-90 min,including 3 themes,“ enhance children’s environmental health awareness,improve children’s environmental health knowledge reserve,and promote the practical application of children’s environmental health knowledge”.3.The implementation and evaluation phase of the training programA total of 66 community nurses were included in this study,with 4 missing and an effective sample size of 62,including 31 in the experimental group and 31 in the control group.Comparison of the children’s environmental health knowledge score between two groups of nurses after training.The total knowledge score of nurses in the experimental group was higher than that in the control group,and the difference of effect between the two groups was statistically significant(P<0.05).For the experimental group,the total score of knowledge immediately after intervention and 1month after intervention was improved compared with that before intervention,with statistical significance(P<0.017).Comparison of the children’s environmental health skills score between two groups of community nurses after training.The total skills score of nurses in the experimental group was higher than that in the control group,and the difference of effect between the two groups was statistically significant(P<0.05).For the experimental group,the total score of immediately after intervention and 1 month after intervention was improved compared with that before intervention,with statistical significance(P<0.017).Comparison of the environment and health literacy score between two groups of community nurses after training.The total literacy score of nurses in the experimental group was higher than that in the control group,and the difference of effect between the two groups was statistically significant(P<0.05).For the experimental group,the total score of literacy immediately after intervention and 1 month after intervention was improved compared with that before intervention,with statistical significance(P<0.017).Conclusion1.The Chinese version Ch EHK-Q and Ch EHS-Q has reasonable reliability,good model fitting degree and reasonable difficulty distribution,which can be used to evaluate the knowledge and skill level of children’s environmental health of community nurses.2.The training program of children’s environmental health competence for community nurses was constructed based on the Risk Information Seeking and Processing Models and the Integrative Model for Environmental Health can effectively improve their children’s environmental health knowledge and skills,environmental and health literacy.3.This training program combines the existing environmental health problems in China and the shortcomings of community nurses in children’s environmental health,which has a certain practicality and can be extended in the practice of nursing education in China.