Aim: To develop and psychometrically test the Nurse Health Education Competence Instrument for assessing nurses' knowledge, skills and personal attributes concerning competent health education practice.
Design: A psychometric instrument development and validation study.
Methods: A four-step approach was used: Step 1) operational definition based on an up-to-date concept analysis and experts' judgement; step 2) item generation and content validation by expert panel and target population; step 3) item analysis based on acceptability, internal consistency and face validity; and step 4) psychometric evaluation based on construct validity, criterion validity, internal consistency and stability, conducted from January -February 2019 with 458 hospital-care nurses.
Results: The operational framework and expert groups showed good content validity, resulting in the first version. From the initial 88-item pool, 58 items were retained after item analysis. Exploratory factor analysis revealed three scales concerning the cognitive (three-factor solution with 23 items), psychomotor (two-factor solution with 26 items) and affective-attitudinal (one-factor solution with nine items) competency domains, which respectively accounted for 58%, 53% and 54% of the variance. Known-group study demonstrated significant differences by years working in the service and training received in health education, providing evidence for the measure's sensitivity. The three scales correlated positively with the criterion variable. Overall Cronbach alphas for the cognitive, psychomotor and affective-attitudinal scales were 0.95, 0.95 and 0.90, respectively. Intraclass correlation coefficients were >0.70.
Conclusions: The newly developed Nurse Health Education Competence Instrument is an original and tested self-reporting psychometric tool, being the first to identify nurses' knowledge, skills and attributes necessary for planning and assessing health education practice competency.
Impact: The instrument permits measurable insights into nurses' perceptions regarding their health education competence and related educational needs. This study provides a valid and specific learning tool that is appropriate to use both in clinical practice and in nursing education programmes.
目的: 开发《护士健康教育能力工具》,并进行心理测量学测试,就适当的健康教育活动评估护士的知识、技能及个人品质。 设计: 心理测量学工具开发及验证研究。 方法: 采用的方法分为四步:第1步,基于最新的概念分析和专家判断,定义操作;第2步,由专家小组及目标人群生成项目并验证内容;第3步,基于可接受性、内部一致性以及表面效度,进行项目分析;第4步,于2019年1月 ~2月,在458名医院护理护士中,基于结构效度、效标效度、内部一致性和稳定性,进行心理测量学评估 结果: 操作框架和专家组显示了较好的内容效度,形成了初始版本。最初题库中有88道题目,题目分析后,保留了58道。探索性因素分析揭示了有关认知的三个标准(解决方案包括三个因素和23道题目)、心理测量(解决方案包括两个因素和26道题目)及情感-态度(解决方案包括一个因素和九道题目)能力域,分别占方差的58%、53%和54%。已知组别的研究证明,根据工作年限及在健康教育中接受培训的年限不同,差异十分显著,这证明了测量的灵敏度。三个标准与效标变量呈正相关。认知、心理测量和情感-态度的整体克隆巴赫系数分别为0.95、0.95和0.90。组内相关系数>0.70。 结论: 新开发的《护士健康教育能力工具》是一种经测试的原创自报告心理测量工具,首次能识别护士的知识、技能及品质,这些对规划和评估健康教育实践能力而言是必不可少的。 影响: 就护士对其健康教育能力和相关教育需求的看法而言,工具提供了可测量的见解。本研究提供了有效且具体的学习工具,适合在临床实践和护理教育计划中使用。.
Keywords: competence; health education; instrument development; nursing; nursing education; psychometrics; reliability; validity.
© 2020 John Wiley & Sons Ltd.