Development Of Primary Caregiver Readiness Scale For First-episode Severe Stroke Patients And Its Test Of Validity And Reliability

Objective:To develop and test the reliability and validity of the primary caregiver readiness scale for first-episode severe stroke patients,so as to provide a specific assessment tool for the evaluation of the readiness of the primary caregivers of patients with first severe stroke.Methods:1.Based on the transition theory,combined with literature review and semi-structured interviews with the primary caregivers of patients with first-episode severe stroke to determine the dimension framework of the scale;2.Item pool was established by literature review combined with semi-structured interview results,disease characteristics of severe stroke,combined with clinical practice experience and Chinese medical cultural background;3.Delphi expert consultation method: the items of the item pool were sorted out into an item revision suggestion table,and the item pool was condensed according to the opinions of clinical workers in the field of stroke nursing and critical care.Experts in neurology and critical care were invited to conduct expert consultation to evaluate the dimensions and items of the proposed scale;4.By convenience sampling method,the primary caregiver Readiness Scale for patients with first severe stroke was used to investigate the caregivers.Item selection analysis method,critical ratio method,correlation coefficient method and Cronbach’s α coefficient method were used to analyze and screen the items.The reliability of the scale was evaluated by internal consistency reliability and split-half reliability.Content validity,construct validity and criterion-related validity were used to test the validity.Results:1.Through literature review,semi-structured interviews,referring to existing relevant scales and combining with the characteristics of severe stroke,the item pool of the primary caregiver readiness scale for first-episode severe stroke patients was established,which contained 62 items and 5 dimensions;2.After two rounds of expert consultation,suggestions were put forward to modify the dimensions and each item.Combined with pre-survey,a preliminary scale with 40 items and5 dimensions(including adapting to the role of caregivers,care skills preparation,psychological preparation,knowledge mastery and application,family and social support)was formed;3.Item selection analysis method,critical ratio method,and so on were used to analyze items.Delete items 15 “I have mastered the methods to help patients deal with personal hygiene(such as washing,bathing,perineal care,brushing hair,cutting nails,etc.)”,16 “I have mastered the methods to help patients to place their limbs and turn over and change their position in bed”,24 “I can urge patients to follow the doctor’s advice and change some bad living habits(such as smoking,drinking,high salt and fat diet,etc.)” 3 Item analysis of unqualified items;4.Validity test of the scale:(1)Content validity: 6 experts were invited to evaluate the content of the scale by expert evaluation method,the results showed that the average content validity of the scale was 0.978,and the content validity of items ranged from 0.83 to 1.00,the content validity of the scale was good;(2)Construct validity: five common factors were extracted from the three exploratory factor analysis,and the total variance explained by the five common factors was 69.244%,the scale had good construct validity;(3)Criterion-related validity: the correlation coefficient between the scale and the Chinese version of CPS was0.713,and the correlation coefficient between each dimension and the Chinese version of CPS was 0.326～0.687(P<0.05),the criterion validity of the scale was satisfactory.5.Reliability test of the scale:(1)Internal consistency reliability: Cronbach’s α coefficient of the total scale was 0.967,Cronbach’s α coefficient of each dimension ranged from 0.797 to0.959;(2)Split-half reliability: the split-half reliability coefficient of the total scale was 0.861,and the split-half reliability coefficient of each dimension ranged from 0.709 to 0.953,the internal consistency reliability coefficient and split-half reliability coefficient of the scale were all greater than 0.7,indicating that the scale had good reliability.Finally,the primary caregiver readiness scale for patients with first-episode severe Stroke was formed with 5dimensions and 35 items.Conclusion:The primary caregiver readiness scale for patients with first severe stroke developed in this study has good reliability and validity,which can accurately reflect the readiness of the primary caregivers of patients with first severe stroke before discharge.It can be used as one of the assessment tools for caregiver readiness,and provide a reference for clinical medical staff to formulate targeted nursing plans,improve caregiver readiness level and explore continuous nursing models.In the future,the scale can be further revised and improved by expanding the sample size and applying confirmatory factor analysis.