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中国循证儿科杂志

中国循证儿科杂志 ›› 2023, Vol. 18 ›› Issue (6): 447-451.DOI: 10.3969/j.issn.1673-5501.2023.06.007

• 论著 • 上一篇    下一篇

中国新生儿重症监护室父母部分陪伴情境下父母满意度测评量表的汉化及信效度研究

李丽玲1a,3,刘婵1a,3,胡晓静1b,张舒文1a,Jos.M. Latour2   

  1. 1复旦大学附属儿科医院上海，201102，a 新生儿科；b 护理部；2 英国普利茅斯大学卫生学院；3 共同第一作者
  • 收稿日期:2023-02-13 修回日期:2023-06-22 出版日期:2023-12-25 发布日期:2024-01-22
  • 通讯作者: 胡晓静

Reliability and validity of Chinese EMPATHIC-N scale in the context of partial parental accompaniment in neonatal intensive care units in China

LI Liling1a,3, LIU Chan1a,3, HU Xiaojing1b, ZHANG Shuwen1a, Jos M.Latour2   

  1. 1 Children's Hospital of Fudan University, Shanghai 201102, China; a Neonatal Intensive Care Unit, b Nursing Department; 2 Faculty of Health, University of Plymouth, United Kingdom; 3 Co-first author
  • Received:2023-02-13 Revised:2023-06-22 Online:2023-12-25 Published:2024-01-22
  • Contact: HU Xiaojing, email: humama2015@126.com

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摘要： 背景：NICU住院患儿父母的满意度和体验是评估临床实践的效果和提高护理质量的基础，中国目前缺乏NICU患儿家长满意度的专业测评工具。 目的：通过汉化形成适合中国NICU的以家庭为中心的父母满意度评估工具（EMPATHIC-N）。 设计：横断面调查。 方法：遵循Wild归纳总结的量表翻译及文化调适的流程对原版EMPATHIC-N量表进行汉化，形成中文版EMPATHIC-N量表，行样本量估计，纳入复旦大学附属儿科医院NICU 2021年3月至2022年6月出院的出生胎龄<37周，出生体重<1 500 g，首次入NICU且入住时间>72 ｈ的患儿父母，剔除住院期间死亡的患儿。由经过培训的宣教护士向患儿父母解释研究的目的，每个家庭发放1份问卷。由父母当场填写，宣教护士通过问卷星后台检查数据。通过Cronbach's α系数和折半信度系数检验中文版EMPATHIC-N量表的内部一致性信度和Spearman-Brown折半信度，通过探索因子分析和验证因子分析检验中文版EMPATHIC-N量表的结构效度。 主要结局指标：中文版EMPATHIC-N量表的信度和效度。 结果：发放和回收问卷330份。中文版EMPATHIC-N量表有57个条目。探索性因子分析中，主成分分析一共提取出5个因子（信息提供、照护治疗、父母参与、病房环境、专业态度），特征根值均＞1，累积方差解释率为87.4%，各条目的因子载荷0.706~0.953。验证因子分析模型拟合结果显示，卡方自由度比（χ2/df）=6.635，近似误差均方根（RMSEA）=0.131，比较拟合指数（CFI）=0.807，载荷因子数0.792~0.999；聚合效度评估显示，量表平均提取方差值（AVE）为0.757～0.964，组合信度值为0.974～0.996。区分效度评估显示，量表5个因子的AVE平方根值为0.870～0.982，各因子的AVE平方根值均大于该因子与其他因子间的相关系数绝对值。内部一致性：5个因子及总量表的Cronbach's α系数为0.976、0.996、0.975、0.995、0.973、0.982。Spearman-Brown折半信度：5个因子及总量表折半信度系数依次为0.988、0.998、0.980、0.994、0.984、0.771。 结论：中文版EMPATHIC-N量表信度、聚合效度、区分效度良好，模型拟合效果不佳，有待在NICU全程陪伴情境下验证NICU父母满意度的测评工具。

关键词: EMPATHIC-N量表, 满意度, 信度, 效度, 父母, 新生儿重症监护病房

Abstract: Background: The effectiveness of clinical practice and the improvement of care quality are evaluated based on the satisfaction and experience of parents whose infants have been admitted to the neonatal intensive care unit (NICU). Currently, there is a lack of a professional assessment tool in China for evaluating parental satisfaction in the NICU. Objective: To translate the Empowerment of Parents in The Intensive Care-Neonatology (EMPATHIC-N) into Chinese to make it a family-centered parent satisfaction assessment tool appropriate for NICUs in China. Design: Cross-sectional study. Methods: The original version of the EMPATHIC-N scale was translated into Chinese using ten steps of scale translation and cultural adaptation summarized by Wild. The sample size was estimated to facilitate sampling methods. The parents were included for infants admitted to the NICU at Children's Hospital of Fudan University between March 2021 and June 2022，with a gestational age＜37 weeks，the birth weight＜1,500 g, and the length of stay ＞72 hours. Infants who passed away during their hospitalization were excluded. A nurse who has received training explained the purpose of the study to the parents and guided them to complete the questionnaire. Each family received one copy. The parent, either the mother or the father, filled out the questionnaire on the spot, and the data were checked by the nurse. The internal consistency reliability and Spearman-Brown split-half reliability of the Chinese version of the EMPATHIC-N scale were tested using Cronbach's α coefficients and split-half reliability coefficients. The construct validity of the Chinese version of the EMPATHIC-N scale was evaluated through exploratory factor analysis and confirmatory factor analysis. Main outcome measuresReliability and validity of EMPATHIC-N scale in Chinese. Results: A total of 330 questionnaires were distributed and all were effectively collected. The Chinese version of the EMPATHIC-N scale comprises 57 items. During exploratory factor analysis, principal component analysis resulted in the extraction of five factors including information provision, care and treatment, parental involvement, unit environment, and professional attitude. These factors exhibited characteristic root values exceeding 1, contributing to a cumulative variance explanation rate of 87.4%. The factor loadings for each item ranged from 0.706 to 0.953. The validation factor analysis model's fitting results revealed a chi-square degree of freedom ratio of χ2/df=6.635, with an RMSEA of 0.131, a SRMR of 0.053, a CFI of 0.807, and load factor numbers ranging from 0.792 to 0.999. The evaluation of convergent validity revealed that the average variance extracted (AVE) of the scale ranged from 0.757 to 0.964, while the composite reliability value was between 0.974 and 0.996. The discriminant validity evaluation revealed that the square root of the AVE of the five factors in the scale ranged from 0.870 to 0.982. Furthermore, the square root of each factor's AVE was greater than the absolute value of its correlation coefficient with other factors. Internal consistency test showed that the coefficients for Cronbach's alpha of the five factors and the total scale α are 0.976, 0.996, 0.975, 0.995, 0.973, and 0.982, respectively. The Spearman-Brown split-half reliability results revealed that the split-half correlation coefficients for the five factors and the total scale were 0.988, 0.998, 0.980, 0.994, 0.984, and 0.771, respectively. Conclusion: The Chinese version of the EMPATHIC-N scale exhibits satisfactory reliability, convergent validity, and discriminant validity, however, the model fitting effect is not satisfactory. It is imperative to validate the evaluation tool for parental satisfaction in the full-time accompanying NICU setting.

Key words: EMPATHIC-N scale, Satisfaction, Reliability, Validity, Parent, Neonatal Intensive Care Units