應用「3C」照護模式發展護理之家人性關懷照護品質量表之先驅性研究

Using a 3C Model to Develop a Quality Assessment Scale for Humanistic Care in Nursing Homes: A Pilot Study

余慧芬(Huei-Fen Yu) ； 黃俊維(Chun-Wei Huang) ； 朱素鳳(Su-Feng Chu) ； 廖秀珠(Hsiu-Chu Liao) ； 許秀月(Hsiu-Yueh Hsu)

《護理暨健康照護研究》 6卷3期 (2010/09) Pp. 219-230

https://doi.org/10.6225/JNHR.6.3.219

摘要

背景　近年來台灣老年人口激增，家庭及社會結構的改變，導致長期機構式的照顧需求快速成長，因之，機構照護品質的監測更顯重要。
目的　發展一份內容涵蓋身、心、靈的護理之家全人人性化關懷的照護品質量表。
方法　本研究以三大步驟進行先驅性發展量表。步驟一為題項發展，此步驟包含對「創造安全感的環境」、「有效能的工作人員」、「提升個人價值」、「促進獨立性」四構面之文獻查證，界定測量概念，訂定構面操作定義及編寫題項。第二步驟是經由預試刪除不適用之題項，再經專家審視後形成正式施測量表。第三步驟是以高屏地區護理之家87位同意參加研究之住民為施測對象。每位受試者依測驗題項回覆。本研究依受試者之回覆進行分析，分析內容包含項目分析、信度與效度分析。信度分析是以Cronbach's Alpha值分析量表內部一致性。效度是以因素分析進行建構效度分析。
結果　因素分析結果萃取19個題項，涵蓋四個因素，分別為「創造安全感的環境」、「工作人員關懷行為」、「提升個人價值」、「促進活動」。四個因素的可解釋變異量為62%。全量表信度為.89，各次量表的信度分別為.77，.88，.76，.71。
結論　研究結果顯示最後量表含有四個因素，包含19個題項。此量表具有良好之信、效度，可繼續應用在未來的研究中，作進一步的量表的改進與發展。

關鍵字

珍愛 ； 關懷 ； 照護模式 ； 量表 ； 信度 ； 效度

並列摘要

Background: Over the past several years, a significant increase in the elderly population and changes in family and social structures have increased demand significantly for long-term care provided by nursing home facilities. Consequently, monitoring nursing home facility quality has become an important issue.
Purpose: The purpose of this study was to develop a “whole person” (physic, mental, spirit) humanistic care scale to measure nursing home quality.
Methods: This study included three major steps. The first focused on items development. Relevant literature was reviewed and measurement constructs to be targeted were identified in terms of creating a safe environment, obtaining qualified staff, instilling a sense of self-value, and promoting independence. Additionally, operational definitions for these constructs were produced and items were written up. The second step was to test the items in a trial setting. Items found unable to measure quality correctly were deleted in the final study. Pilot measurements were reviewed by experts, whose recommendations were incorporated into the final study. In the third step, 87 nursing home residents in the Kaohsiung and Pingtung County areas (southern Taiwan) were recruited as study participants. Participant responses to items were analyzed using item-level analysis and a test of scale reliability and validity. Cronbach’s alpha was used to examine internal scale consistency. Factor analysis were used to study scale construct validity.
Results: Based on factor analysis, nineteen items were classified into four domain factors, namely creating a safe environment, staff caring behaviors, instilling a sense of self-value, and arranging activities. These four factors explained 62% of total variance. Overall scale reliability was .89. The reliability of subscales were .77, .88, .76, and .71, respectively.
Conclusion: Study findings indicate that the final scale of four factors and nineteen items possesses appropriate psychometric properties in terms of scale reliability and validity. Hence, the scale developed in this study can provide a basis for further validation and improvement in future studies.

並列關鍵字

Cherish/Concern/Care Model ； scale ； reliability ； validity