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  • 學位論文

護理過程紀錄稽核量表之建構及其信效度研究

Validity and Reliability of a Nursing Process Scale

指導教授 : 呂筑韻

摘要


護理紀錄是護理工作中非常重要的一部分,護理紀錄不僅是護理人員之間的溝通媒介,也是護理專業能力之呈現,護理主管為了監督護理紀錄品質過程中,會持續的運用稽核與追蹤來維持一定的品質。本研究目的探討護理過程稽核工具的內容效度,以及利用結構方程模型(SEM)分析稽核項目的因素結構( factor analysis)。本研究嘗試以護理部所設計之「護理人員護理過程紀錄稽核表」,發展量測護理過程所需之指標,研究對象與資料來源,根據研究問題選擇成人加護病房共9個單位 (CICU,VICU、MICU、MSCU、SICU、NICU、RICU、EMCU及RCC)、3個內科、3個外科病房之護理過程紀錄稽核成績為樣本族群。選擇2012年至2013年期間護理紀錄稽核之成績資料進行研究分析,共收集990份稽核成績據以進行模式之驗證與分析。研究結果顯示,「護理人員護理過程紀錄稽核表」具有良好之內在一致性,在探索性因素分析顯示,其Cronbach's α為0.637,KMO值為0.613,Bartlett's球形檢定結果亦呈現顯著,χ2 = 1404.288 , df =325 ,p < 0.001,可萃取出五個因子,分別命名為護理評估、護理診斷及計畫、護理措施落實、護理指導與護理評值。在驗證性因素分析顯示,卡方值(χ2)=0.083,絕對配適量指標GFI值0.989、AGFI值0.977、RMR值0.013、RMSEA值0.025、 增值配適量測指標NFI值0.945、CFI值0.983、RFI值0.904、IFI值0.983達理想指標,顯示各模式配適度指標皆達理想標準。本研究建議,依此結果提供未來修改護理記錄模式與護理紀錄稽核表之實證參考資料。

並列摘要


Nursing record is animportant part of nursing cares. Nursing records are not only a communicating tool among nurses but also a representation of nursing care ability. Auditing and tracking of nursing record is usually used to maintain he quality of nursing process.. This study was to investigate validity and reliability of a nursing process scale using structural equation modeling (SEM) to analyze the scale factor . Subjects and data sources were the nursing process audit record results were from six intensive care units (ICUs) : three internals, three surgical wards as the group sample . Data were nursing process audit records between 2012-2013, as a total of 990 entries of the audit results Results showed that “nursing process records audit table” has good reliability. Results of exploratory factor analysess , indicated that Cronbach α was 0.637, KMO was 0.613, and Bartlett’s spherical evaluation showed significant difference (χ2 =1404.288, df=325, p < 0.001). Five factors were extracted and they were named as nursing assessment, nursing diagnosis and planning, nursing practice and displacement, nursing instruction, and nursing evaluation. Results of confirmatory factor analyses showed good model fitness indices (χ2 =0.083, GFI=0.989, AGFI= 0.977, RMR= 0.013, RMSEA=0.025, NFI= 0.945, RFI= 0.904, IFI=0.983). Therefore, results suggested that this study could provide the reference for the adjustment of nursing record and audit.

參考文獻


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