临床护士评判性文化能力量表的汉化及信效度评价  

Evaluation of reliability and validity regarding the Chinese version of Critical Cultural Competence Scale for clinical nurses

作　　者：王蓉 吴媛媛[3] 段功香 蒲玉翠[2] 梁聪 肖丽艳 徐慧兰 WANG Rong;WU Yuanyuan;DUAN Gongxiang;PU Yucui;LIANG Cong;XIAO Liyan;XU Huilan(Xiangya School of Public Health,Central South University,Changsha 410078;School of Nursing,University of South China,Hengyang Hunan 421001;Department of Mental Rehabilitation,Wuxi MentalHealth Center,Wuxi Jiangsu 214000;Department of Nursing,Second Affiliated Hospital ofUniversity of South China,Hengyang Hunan 421001,China)

机构地区：[1]中南大学湘雅公共卫生学院,长沙410078 [2]南华大学护理学院,湖南衡阳421001 [3]无锡市精神卫生中心精神康复科,江苏无锡214000 [4]南华大学附属第二医院护理部,湖南衡阳421001

出　　处：《中南大学学报（医学版）》2022年第10期1425-1434,共10页Journal of Central South University ：Medical Science

基　　金：湖南省教育科学“十二五”规划课题(XJK015BGD061);衡阳市社会科学规划办公室课题(2014D132)。

摘　　要：目的:不同社会环境和文化背景的患者具有不同的护理需求。如果护士忽视患者的文化差异,就容易导致护患关系紧张,影响护理效果,甚至对患者造成伤害。评判性文化能力可以帮助护士满足不同文化背景下患者的护理需求,有利于构建和谐的护患关系,提高护理质量。Almutairi等编制的评判性文化能力量表(Critical Cultural Competence Scale,CCCS)可用于评估护士的评判性文化能力。国内尚未有研究报道护士评判性文化能力测量工具的开发或国外量表的引进。本研究旨在对英文版CCCS进行汉化、跨文化调适并检测其信效度,以期形成适合我国文化背景的CCCS,为临床护士评判性文化能力的现状调查提供有效的评估工具。方法:根据Brislin经典回译模型对英文版CCCS进行翻译和回译,通过专家咨询法和对30名临床护士的预调查进行跨文化调适,形成中文版CCCS。采用整群抽样法于2019年8至10月对580名临床护士进行调查。按照7:3的比例随机分为两组,一组(n=406)用于探索性因子分析和信度分析,另一组(n=174)用于验证性因子分析。6名专家采用量表水平内容效度指数(scale-level content validity index,S-CVI)和条目水平内容效度指数(item-level content validity index,I-CVI)评定量表的内容效度。在探索性因子分析中,采用临界比值法对量表条目进行筛选,KMO(Kalser-Meyer-Olkin)值、Bartlett球形度检验、主成分分析法测验条目。在验证性因子分析中,采用平均方差提取值(average variance extracted,AVE)、拟合优度指数(goodness-of-fit index,GFI)、修正的拟合优度指数(adjusted goodness-of-fit index,AGFI)、近似误差平方根(root mean square error of approximation,RMSEA)评价所构建模型的拟合程度。采用总量表和4个分量表的Cronbach’s α系数、分半信度和重测信度评定量表的信度。结果:总量表的S-CVI为0.930;I-CVI为0.833~0.944。所有条目的临界比值>3Objective: Patients from different social environments and cultural backgrounds have different nursing needs. If nurses ignore the cultural differences of patients, it is easy to lead to the strained nurse-patient relationship, affect the nursing effect and cause harm to patients. Critical cultural competence(CCC) can help nurses to meet the nursing needs of patients from different cultural backgrounds, which is beneficial to building a harmonious nurse-patient relationship and improving the quality of nursing. Almutairi, et al designed the Critical Cultural Competence Scale(CCCS) which can be used to evaluate accurately nurses’ CCC. No studies have reported the development of a critical cultural competence measurement tool for nurses or the introduction of foreign scales in China. This study aims to conduct Chinese and cross-cultural debugging and test the reliability of the English version of the CCCS in order to form CCCS suitable for Chinese cultural background and provide an effective evaluation tool for investigating the current situation of clinical nurses’ CCC.Methods: This study used Brislin’s back-translation model to translate and backtranslation the English version of CCCS. The Chinese version of CCCS was then created through cross-cultural debugging by expert consultation and a pre-survey with a sample size of 30 clinical nurses. From August to October 2019, 580 clinical nurses were surveyed using a whole group sampling method. The participants were randomly divided into 2 groups with a 7 : 3 ratio. One group(n=406) was used for exploratory factor analysis and reliability analysis, while the other group(n=174) was used for confirmatory factor analysis. Six experts used the scale-level content validity index(S-CVI) and the item-level content validity index(I-CVI) to assess content validity. In the exploratory factor analysis, items were screened using the critical ratio method, and were tested using the KMO(Kalser-Meyer-Olkin) index, Bartlett’s sphericity test, and principal component analysis

关 键 词：评判性文化能力量表 临床护士 汉化 信度 效度 

分 类 号：R192.6[医药卫生—卫生事业管理]