護理之家照護品質觀測性指標量表中文版之信效度初探

A Preliminary Study of The Reliability and Validity of A Chinese Version of The Observable Indicators of Nursing Home Care Quality Instrument

顧曉明(Sheau-Ming Ku)

指導教授 ： 張文英

臺北醫學大學/護理學院/護理學研究所/碩士(2002年)

摘要

本研究旨在建構中文版「護理之家照護品質觀測性指標」量表之信效度。本研究量表由Rantz (1999)所研擬，屬觀測式評估量表，次量表包含溝通5項、照護9項、工作人員6項、環境16項、居家情境/家人參與6項，共分五大界面、42項指標。研究方法乃先將「The Observable Indicators of Nursing Home Care Quality」量表翻譯成中文，延聘多位護理專家進行內容效度檢定與雙次翻譯驗證；再以立意取樣方式收集五所北部地區醫院附設型護理之家實地觀測資料，以針對量表進行項目分析、內在一致性及漸進式觀測者間信度檢定。研究結果顯示：(一 )在效度方面，經專家效度檢定量表內容之正確性、重要性與適切性顯示42項均為保留項，且內容效度指數CVI值均達80% 以上；雙次翻譯驗證結果90% 內容一致；(二)在信度方面，經漸進式觀測者間信度檢定，三家護理之家觀測者間同意程度依次為81%、83%、92%，其顯示三次觀測者間信度有逐漸提升之趨勢；量表內在一致性以Spearman’s Coefficient檢定，Cronbach’s α值為0.94，研究結果發現量表能夠觀測到護理之家住民照護品質。同時，於觀測過程中發現量表具有簡便易懂的特性，並可以區分照護品質的優與劣，經修正後可應用為醫院附設型護理之家照護品質評估之工具。 關鍵詞：護理之家、照護品質指標、信效度

關鍵字

護理之家 ； 照護品質指標 ； 信效度

並列摘要

The purpose of this research is to examine the reliability and validity of a Chinese version of「The Observable Indicators of Nursing Home Care Quality Instrument」(OINHCQI). The observable indicators of OINHCQI by Rantz (1999) was translated into Chinese. The OINHCQI consisted five dimensions, (42 observable indicators), including communication (5 items), care (9 items), staff (6 items), environment (16 items), home/family involvement (6 items). The validity of Chinese version was then assessed by nursing experts and pertinent reverse translation was also verified. Then observation was conducted at five hospital-based nursing homes at northern of Taiwan, which also incorporated assessments of item analysis, internal consistency, and incremental inter-rater reliability of all indicators. The results of accuracy, relevance, and suitability of indicators showed that all of the 42 indicators should be preserved with content validity index (CVI) of 80%. Verification of double translation showed 90% consistency. As to incremental inter-rater reliability, the observation at three nursing homes were 81%, 83%, and 92%. The results showed that the incremental inter-rater reliability were upward trend. Internal consistency was assessed with Spearmen’s coefficient, Cronbach’s αwas 0.94. The result indicated that indicators can help to assess the quality of nursing care at nursing homes with observable information. The findings also demonstrated that these indicators were not only easy to use and to understand, but also in convenient. This Chinese form of OINHCQI can be adopted to examine the quality of nursing care among hospital-based nursing homes. Key words：nursing home, care quality indicators, reliability & validity

並列關鍵字

Nursing home ； Care quality indicators ； Reliability and validity

參考文獻

許淑蓮、黃秀梨 (1996) . Mishel 疾病不確定感量表之中文版測試. 護理研究，4 (1)，59-68。

楊嘉玲、徐亞瑛 (2001) ?護理之家照護品質指標-以老年住民的觀點探討?護理研究，9 (1)， 53-63。

蔡欣玲、陳梅麗 (1996) . 護理人員壓力量表之信效度測試. 護理研究，4 (4)，355-361。

中華民國長期照護專業協會(2002)?台閩地區長期照護資源名冊。 史麗珠、李絳桃、徐亞瑛、高淑芬、徐麗華、陳美伶 譯 (1999)?護理研究法(上)，台北:桂冠。 行政院衛生署(1997)?跨世紀衛生建設衛生白皮書，台北:行政院。 行政院衛生署(1998)?老人長期照護三年計畫，台北:行政院。 吳淑瓊(2000)?機構式長期照護品質指標之建立?中華民國長期照護專業協會 (行政院衛生署八十八、八十九年度委託研究計畫)。 吳淑瓊、陳正芬(2000)?長期照護資源的過去、現在與未來?社區發展季刊，第92期，19-31。

徐永年、蔡素玲(1999)?台灣長期照護系統之現況及發展趨勢?Hospital，(28)，6。 徐畢卿、羅文倬、龍佛衛 (1999). 雙親教養態度量表之信效度研究. 護理研究，7 (5)，479-488。