長照機構異常事件通報文化量表之建構與測試

Development and psychometric tests of the long-term-care incident reporting culture

楊惠卿(Hui-Ching Yang)

指導教授 ： 林淑媛

高雄醫學大學/護理學院/護理學系研究所/碩士(2014年)

摘要

長照機構為了改善住民安全及建立正向安全文化首要是建立正向的異常事件通報文化，異常事件通報文化是屬於病人安全文化之下的次文化，藉由評估異常事件通報文化可以瞭解機構人員對異常事件通報的關注程度。本研究目的旨在發展長照機構異常事件通報文化量表，並測試其信度與效度。
本研究採橫斷式描述性研究設計，以自擬的結構式問卷，包括：個人基本及工作屬性及異常事件通報文化量表作為研究工具，隨機取樣全國35家長期照護機構，以396位照護人員為測試對象，郵寄並回收問卷396份，以SPSS 19.0統計軟體進行資料建檔及統計分析。
量表建構方面，研究者依據異常事件通報相關文獻與臨床實務經驗來發展量表題項。量表信效度檢定方面，由五位專家審查後計算量表的內容效度指數值為.92，顯示量表具良好的內容效度：量表進行探索性因素分析之建構效度檢定，量表21題共萃取三個因素，分別為通報認知、通報意願、通報管理與學習回饋，總解釋變異量達65.61%。以內在一致性信度與兩週後再測信度來檢定量表信度，總量表之Cronbach’s α值為0.93，三個次量表的Cronbach’s α值介於0.91-0.95之間；兩週後再測信度為0.72。
研究結果顯示長照機構異常事件通報文化量表具良好之信度與效度，建議可做為長照機構照護人員在異常事件通報文化的評估工具。

關鍵字

異常事件通報文化 ； 量表發展 ； 長照機構

並列摘要

In order to improve the safety of residents and develop a positive safety culture, long-term care institutions should give priority to building a positive culture of incident reporting. The culture of incident reporting is a subculture of patient safety culture. By evaluating this culture of incident reporting in a long-term care institution, one can understand how staff of the institution is concerned about incident reporting. The purpose of this study was to develop a scale for evaluating the culture of incident reporting in long-term care institutions and test the validity and reliability of the scale.
A cross-sectional and descriptive study design was adopted. The instrument was a self-developed structured questionnaire consisting of questions about basic data of the respondents, job attributes, and culture of incident reporting. The survey was administered to 396 nurses by mail, and subjects were selected randomly from 35 long-term care institutions nationwide. A total of 396 validated questionnaires were obtained. The collected data were analyzed using SPSS 19.0.
The scale was developed according to previous literature on incident reporting and clinical experiences of the researcher. The validity and reliability of the scale was evaluated by five experts. The content validity index of the scale was .92, suggesting good content validity. An exploratory factor analysis was performed to assess the construct validity of the scale. Three factors were extracted from 21 items. Three factors were named as cognition of reporting, willingness of reporting, and reporting management and feedback learning. The total variance explained by the three factors reached 65.61%. The reliability of the scale was evaluated by internal consistency and the two-week test retest reliability. Cronbach’s α for the total scale was 0.93, and the α coefficients for the three subscales were 0.91~0.95. The two-week test retest reliability was 0.72.
Results indicated that the incident reporting culture scale in long-term care institutions has good reliability and validity. Therefore, this scale can be used as an instrument to evaluate the culture of incident reporting in staff of long-term care institutions.

並列關鍵字

incident reporting culture ； scale development ； long-term-care institutions

參考文獻

中文部分

古巧琴(2005)•老人照護機構之照護安全相關性研究•未發表碩士論

文•台中：中臺醫護技術學院醫護管理研究所。

石崇良、侯勝茂、薛亞聖、鍾國彪、蘇喜、廖熏香(2005)•異常事件

通報系統與通報障礙•臺灣醫學，9(1)，63-70。