Departmental Bulletin Paper 患者の看護介入評価を測定する尺度の信頼性・妥当性の検討
Examination of the Patient-assessed Nursing Intervention Scale Reliability and Validity

福武, まゆみ  ,  木村, 麻紀  ,  實金, 栄  ,  住吉, 和子  ,  平松, 貴子  ,  太湯, 好子

25 ( 2 )  , pp.259 - 267 , 2016
 本研究は,患者が受けた看護ケア,すなわち看護介入の質を患者が評価する看護介入尺度の開発を目的とした.調査は,A 県内の300床以上を有する急性期病院3施設に入院中で,2014年9月~11月に退院が決定した患者1,225名に自記式質問紙調査を実施した.調査内容は,基本属性と看護介入(手段的看護介入; 17項目,情緒的看護介入; 11項目)の28項目とした.回答は「そう思わない:0点」から「そう思う:3点」の4件法で尋ねた.分析には欠損値のない820名を対象に,項目分析,探索的因子分析を行い,その後,1次因子を「手段的看護介入」,「情緒的看護介入」,二次因子を「看護介入」とする2因子二次因子モデルのデータへの適合性を構造方程式モデリングにより検討した.結果,調査項目の12項目が削除され16項目の2因子二次因子モデルの看護介入尺度の適合度を検討したところ,χ2=415.582,df=103,CFI =0.985,RMSER=0.061と良好であり,看護介入尺度の因子構造モデルの側面からみた構成概念妥当性は実証的に検証された.結果,看護介入尺度は,手段的看護介入,情緒的看護介入の2因子から構成されること,また,総合得点が高い者ほど,看護介入を十分に受けていることを示すことを意味する尺度が開発できた.
 The purpose of this study is to develop a nursing intervention scale whereby patients evaluate the quality of nursing care, which is to say“ nursing intervention” received by the patients. Subjects: 1225 patients hospitalized in 3 acute care hospitals with over 300 beds in Prefecture A and whose discharges were determined from September to November 2014 were given self-administered questionnaires. Survey Contents: The contents were basic attributes and 28 nursing intervention scale items (17 instrumental items,11 emotional items). The answers were obtained via a 4-point scale ranging. Targeting the 820 subjects who had no missing values in the analysis,a 2 factor second order factor model was supposed with "instrumental intervention","emotional intervention" as first order factors and "nursing intervention" as second order factors,and compatibility with the data was examined via structural equation modeling. The degree of compatibility of the nursing intervention scale assuming the 2 factor second order factor model was favorable at χ2=415.582,df=103,CFI =0.985,RMSER=0.061,and the construct validity seen from the aspects of the factor structure model of the nursing intervention scale was empirically verified. The results mean that the nursing intervention scale is composed of the 2 factors of instrumental and emotional intervention factors,and that patients with higher overall scores are receiving more sufficient nursing intervention.

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