背景:临终关怀专业人员通常会在短时间内经历外伤患者死亡和多名患者死亡(比其他护士更多)。这种反复暴露于死亡过程和患者死亡导致临终关怀专业人员承受更大的心理压力。但目前,人们更关注临终患者家属的感受和护理负担,但对医务人员的关注较少。因此,本研究旨在制定一个关于临终关怀护理提供者护理负担的量表,并评估临终关怀专业人员的应对能力。提高对临终关怀专业人员心理负担的认识。
方法:通过文献综述,研究小组讨论,德尔菲法和护士专业应对技能的预调查,选择了200名从从事或提供临终关怀护理的试点机构接受过临终关怀培训的临终关怀专业人员进行调查。Cronbach的α系数和分裂半信度用于测试量表的内部一致性,采用内容效度和探索因子分析(EFA)检验量表的结构效度。
结果:进行了两轮德尔菲法,有效回收率为100%。两轮专家权威系数分别为0.838和0.833。第一轮专家的肯德尔W系数为0.121~0.200(P<0.05),第二轮肯德尔的W系数为0.115-0.136(P<0.05),表明了良好的专家协调水平。最终的临终关怀专业人员护理负担调查量表包括四个维度-工作环境(9项),专业角色(8项),临床护理(9项)和心理负担(7项)-共33项。量表的总克朗巴赫α系数为0.963,工作环境的克朗巴赫α系数为0.963,专业角色,临床护理和心理负担维度分别为0.920、0.889、0.936和0.910。量表的总分裂半信度为0.927,每个维度的分裂半信度分别为0.846、0.817、0.891和0.832。量表项目的内容效度范围为0.90至1.00。探索性因素分析揭示了5个共同因素,总累计贡献率为68.878%。量表中各项目的共同程度>0.4,各项目的因子负荷也>0.4。
结论:量表是开放获取的,短,易于管理的规模。在这项研究中开发的用于评估临终关怀专业人员的临终关怀负担的方法具有很强的信度和效度。该工具可以作为一种可靠的工具,用于评估临终关怀机构中专业人员对临终关怀患者的临终关怀负担。
BACKGROUND: Hospice care professionals often experience trauma patient deaths and multiple patient deaths in a short period of time (more so than other nurses). This repeated exposure to the death process and the death of patients leads to greater psychological pressure on hospice care professionals. But at present, people pay more attention to the feelings and care burden of the family members of dying patients but pay less attention to medical staff. Thus, this study aimed to develop a scale on the burden of care for hospice care providers and assess the coping capacity of hospice professionals. Raising awareness of the psychological burden of hospice professionals.
METHODS: Through a literature review, research group discussion, Delphi method and a pre-survey of professional coping skills among nurses, 200 hospice professionals who had received training in hospice care from pilot institutions engaged in or providing hospice care were selected for investigation. Cronbach\'s α coefficient and split-half reliability were used to test the internal consistency of the scale, and content validity and explore factor analysis (EFA) were used to test the construct validity of the scale.
RESULTS: Two rounds of Delphi methods were carried out, and the effective recovery rate was 100%. The expert authority coefficients of the two rounds were 0.838 and 0.833, respectively. The Kendall\'s W coefficient of experts in the first round was 0.121 ~ 0.200 (P < 0.05), and the Kendall\'s W coefficient of the second round was 0.115-0.136 (P < 0.05), indicating a good level of expert coordination. The final survey scale for the care burden of hospice professionals included four dimensions-working environment (9 items), professional roles (8 items), clinical nursing (9 items) and psychological burden (7 items)-with a total of 33 items. The total Cronbach\'s α coefficient of the scale was 0.963, and the Cronbach\'s α coefficients of the working environment, professional roles, clinical nursing and psychological burden dimensions were 0.920, 0.889, 0.936 and 0.910, respectively. The total split-half reliability of the scale was 0.927, and the split-half reliability of each dimension was 0.846, 0.817, 0.891, and 0.832. The content validity of the scale items ranged from 0.90 to 1.00. Exploratory factor analysis revealed 5 common factors, with a total cumulative contribution rate of 68.878%. The common degree of each item in the scale was > 0.4, and the factor loading of each item was also > 0.4.
CONCLUSIONS: The scale is an open-access, short, easy-to-administer scale. And which for assessing hospice care burden among hospice professionals developed in this study demonstrated strong reliability and validity. This tool can serve as a dependable instrument for evaluating the burden of hospice care for terminally ill patients by professionals in the hospice setting.