中文版醫院出院準備度量表之信效度檢定

Psychometric Testing of the Chinese Version of the Readiness for Hospital Discharge Scale

林佑樺(Yu-Hua Lin) ； 高家常(Chia-Chan Kao) ； 黃阿美(A-Mei Huang) ； 紀媚慈(Mei-Tzu Chi) ； 周汎澔(Fan-Hao Chou)

《護理雜誌》 61卷4期 (2014/08) Pp. 56-65

https://doi.org/10.6224/JN.61.4.56

摘要

背景：過去對出院準備服務之評價，鮮少針對病患對自己是否有準備好出院之看法提出評值與探討，且缺少評量工具。目的：驗證中文版醫院出院準備度量表之信度與效度。方法：採橫斷性研究設計，分二階段進行收案，第一階段收集大腸直腸癌和肝癌病患223人，進行探索性因素分析。第二階段收集腦中風病患323人，進行驗證性因素分析。研究工具採Weiss和Piacentine所發展的醫院出院準備度量表。結果：驗證性因素分析結果顯示12題分配於3個次量表：個人狀態、適應能力和預期性支持的模式為量表最佳解釋模式（GFI = .92, AGFI = .88, NFI = .97），且與原量表呈現高度相關（r = .96, p ＜ .001）之效標關聯效度。整體量表內在一致性之Cronbach's α為.89，次量表之α值依序為.73、.90、.89。結論／實務應用：中文版醫院出院準備度量表具有良好效度與信度。本量表可以實際應用於病患對出院準備的評價。

關鍵字

出院準備度 ； 醫院 ； 量表信效度檢定

並列摘要

Background: Little has been published in the literature regarding how patients self-evaluate their degree of readiness for hospital discharge. Furthermore, there is currently no self-evaluation tool available in Chinese able to assess the discharge readiness of patients. Purpose: This study was used to psychometrically test the Chinese version of the readiness for hospital discharge scale (RHDS_C). Methods: This study used a cross-sectional design. Two samples were recruited in a two-stage process at two hospitals in Southern Taiwan. Two hundred and twenty-three patients with a diagnosis of either colorectal cancer or hepatic cancer were used to conduct an exploratory factor analysis (EFA) in the first stage of the study. Another 323 patients with a diagnosis of stroke were used conduct a confirmatory factor analysis (CFA). The instrument used was the Readiness for Hospital Discharge Scale (RHDS) developed by Weiss & Piacentine. Results: RHDS_C consists of three subscales: personal status (4 items), coping ability (4 items), and expected support (4 items) adapted from the CFA. The assessed goodness-of-fit index (GFI = .92, AGFI = .88, NFI = .97) indicate the model fit the data well based upon the CFA. Criterion-related validity was supported by the correlation between the original RHDS and the RHDS_C (r = .96, p ＜ .001). The Cronbach's alpha coefficients were .89 for the overall scale and .73, .90, and .89 for the 3 subscales, respectively. Conclusions/Implications for practice: This study confirms the validity of the RHDS_C and suggests this instrument is able to reliably assess the readiness of patients for discharge from the hospital. We recommend the scale be applied in the clinical setting to evaluate the discharge readiness of hospital patients.

並列關鍵字

discharge readiness ； hospital ； psychometric testing

參考文獻

史麗珠、莊凱嵐、黎慧芳、王惠玄、胡文潔、王曉慧…鄭學慧（2011）．出院準備服務：出院後不同照護模式的選擇、再入院率、死亡率的分析．中山醫學雜誌，22（1），23－33。[See, L. C., Chuang, K. L., Li, H. F., Wang, H. H., Hu, W. C., Wang, S. H., ... Jeng, S. H. (2011). Discharge planning: Care model, re-admission rate, and mortality rate after discharge. The Chung Shan Medical Journal, 22(1), 23－33.]

廖美南、卲榮華、李小菁、徐亞瑛（2000）．某醫學中心出院準備服務及居家護理個案後續照護品質與滿意度調查．長庚護理，11（3），1－13。[Liao, M. N., Shao, J. H., Lee, H. C., & Shyu, Y. I. (2000). Monitoring quality of care and satisfaction following discharge planning and home nursing in a teaching hospital. Chang Gung Nursing, 11(3), 1－13.]

謝生蘭、李金德、江秀珠、劉芹芳（2013）．經出院準備服務病患於14天非計畫性再住院之相關因素．醫院，46（2），34－44。[Hsieh, S. L., Lee, K. T., Chiang, H. C., & Liu, C. F. (2013). Study on 14-day unplanned readmission of patients in discharge planning (DP) and their related factors. Hospital, 46(2), 34－44.]

Bobay, K. L., Jerofke, T. A., Weiss, M. F., & Yakusheva, O. (2010). Age-related differences in perception of quality of discharge teaching and readiness for hospital discharge. Geriatric Nursing, 31(3), 178－187. doi:10.1016/j.gerinurse.2010.03.005

Brent, L., & Coffey, A. (2013). Patient's perception of their readiness for discharge following hip fracture surgery. International Journal of Orthopaedic and Trauma Nursing, 17(4), 190－198. doi:10.1016/j.ijotn.2013.01.001