專科護理師護理能力量表之信效度研究

護理品質的提升，必須從要求護理能力著手，專科護理師學會在2009年明訂專科護理師的四項專業能力，及教學醫院評鑑制度也將專科護理師之「專業能力進階-繼續教育」列入評鑑項目，故本研究擬定專科護理師護理能力量表並探討信度與效度。本研究旨在運用德爾菲研究法(Delphi technique)建立專科護理師的護理能力項目及構面，並測試此量表之信度與效度。採橫斷式探索性研究設計及立意取樣，以臺灣中部地區醫學中心與區域醫院之護理人員，並具有專科護理師證照者為研究對象，收集樣本數為281人。結構式問卷收集期間為自2015年3月至2015年6月。使用SPSS 18.0 for Windows 統計軟體進行統計分析，採用描述性統計、信度分析、因素分析、項目分析等方法分析資料。研究結果得知經二次德爾菲研究，專科護理師護理能力的項目均≦收歛值0.6，顯示專家意見具中高度以上一致性，平均CVI值介於0.8~1之間，顯示具有良好專家效標指數。本量表之Cronbach’s α係數為0.97，表示內在一致性高，八週後再測信度相關係數為0.74 (P＜0.001)，顯示再測信度值高。經探索性因素分析萃取出七個構面，分別為照顧能力(12題)、評估能力(8題)、教學能力(6題)、溝通協調能力(10題)、品質管理能力(13題)、研究能力(8題)及專業成長能力(8題)，護理能力共計65個題目，累積總變異數為 72.71%，Cronbach’s α係數為0.97。本研究結果顯示專科護理師護理能力量表應用於測量臨床專科護理師之護理能力是具有良好的信度與效度，建議此量表可作為評核臨床專科護理師之護理能力，並針對專科護理師在職教育訓練提供機構主管規劃專科護理師進階制度之參考。

關鍵字

德爾菲研究法；護理能力；專科護理師

並列摘要

To improve the quality of nursing care, we must emphasize the requirements of nursing competence. The Taiwan association of nurse practitioners expressed the four professional competences for nurse practitioners (NPs) in 2009. The professional ladder program-continuing education has been recently added to evaluation systems of NPs in teaching hospitals. Therefore, the purpose of this study is to accomplish the reliability and validity of questionnaire “The nursing competence inventory of NPs”. We use the Delphi technique to erect this tool’s dimensions, and apply it to prove the nursing competency of NPs. The study was designed to do a cross-section and exploratory design by purposive sampling to achieve the sample size of 281 subjects. Registered nurses have NP licenses and are enrolled from medical centers and the regional level hospitals. The data are collected by a structured questionnaire from March 2015 to June 2015. The collected data are analyzed by SPSS 18.0 for Windows software. The data analyzed by using descriptive statistics, reliability analysis, factor analysis, and item analysis. The results in this study are shown that the Cronbach’s α for the scale was 0.97. A 8-week interval of test-retest reliability was 0.74 (P＜0.001). Exploratory factory analysis (EFA) identified 7 factors that explained 72.71% of total variance. These 7 extracted dimensions were caring (12 items), evaluating (8 items), teaching (6 items), c ommunication and coordination (10 items), quality management (13 items), researching (8 items), professional development (8 items). Total sixty items included in the nursing competence inventory. The expected results are to develop this inventory for NPs with good reliability and validity, and then apply it in evaluation of NPs’ nursing competence. It is expected that the results can serve references to arrange members for medical managers.