Development of the Quality of Nursing Care Index for Patients with Advanced Illness (QNCI-PAI)

2.50
Hdl Handle:
http://hdl.handle.net/10755/237795
Category:
Abstract
Type:
Technical Report
Title:
Development of the Quality of Nursing Care Index for Patients with Advanced Illness (QNCI-PAI)
Author(s):
Izumi, Shigeko
Lead Author STTI Affiliation:
Delta Chi-at-Large
Author Details:
Shigeko Izumi, PhD, RN; To visit Dr. Izumi's faculty page please copy and paste the following link in your internet browser: http://directory.nursing.wsu.edu/faculty/?faculty/443
Abstract:

Improving the quality of nursing care in hospitals is an urgent national agenda. While reliable and valid instruments are needed to evaluate and improve quality of care, instruments that directly measure the quality of nursing care, particularly from the perspectives of care recipients, are scarce. Quality of Nursing Care Index for Patients with Advanced Illness (QNCI-PAI) is an instrument currently under development to measure quality of nursing care from the specific perspectives of hospitalized patients with advanced illness. Purpose of this study is to examine item- and instrument-level reliability/validity and feasibility of the QNCI-PAI.

Instrument: The draft of QNCI-PAI was developed based on descriptions of quality nursing care by hospitalized patients with advanced illness. After expert reviews and revisions, the QNCI-PAI has 45 statements describing nurses’ behaviors with 5-point Likert-type scale responses. Respondents (patients) are asked to rate how often their nurses demonstrate these behaviors, and more frequent demonstrations of these behaviors (higher score) indicate better quality of nursing care.

Research Design: Cognitive interviews with hospitalized patients with advanced illness were conducted to examine the question items in the QNCI-PAI to enhance the reliability and validity of the items. Cognitive interview analysis was followed by small scale mail survey to test the feasibility of the QNCI-PAI refined through the cognitive interviewing.

Findings:  Fourteen hospitalized patients were interviewed using cognitive interview techniques (think aloud and verbal prove): participants were asked to read and respond to each question item while thinking out loud everything that goes through their mind, and asked to clarify what they meant. The interview data were analyzed item-by-item to identify incomprehensible or inconsistent items, and items with these problems were either deleted or modified. As a result, out of 45 items, 13 items were deleted and 11 items were modified.  Modified QNCI-PAI (32 items) were mailed to 100 patients discharged from a local medical center. Nineteen responses received demonstrated that no items showed ceiling effects in their responses and all but one item were reasonable to respond for patients.

Conclusion and Recommendation: The findings from the cognitive interviews contributed to refine each item to be comprehensible and consistent to improve reliability of the items. The feasibility test demonstrated that the form of mail survey and the recruitment method were appropriate to evaluate the quality of nursing care in hospital from patients’ perspective. Further psychometric analysis with a larger sample size is necessary to establish the QNCI-PAI as a reliable and valid instrument to measure quality of nursing care in hospitals.

Keywords:
Quality of Health Care; instrument development
Repository Posting Date:
8-Aug-2012
Date of Publication:
8-Aug-2012
Sponsors:
Sigma Theta Tau International
Note:
The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.; This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryAbstracten
dc.typeTechnical Reporten
dc.titleDevelopment of the Quality of Nursing Care Index for Patients with Advanced Illness (QNCI-PAI)en_US
dc.contributor.authorIzumi, Shigeko-
dc.contributor.departmentDelta Chi-at-Largeen
dc.author.detailsShigeko Izumi, PhD, RN; To visit Dr. Izumi's faculty page please copy and paste the following link in your internet browser: http://directory.nursing.wsu.edu/faculty/?faculty/443en
dc.identifier.urihttp://hdl.handle.net/10755/237795-
dc.description.abstract<p>Improving the quality of nursing care in hospitals is an urgent national agenda. While reliable and valid instruments are needed to evaluate and improve quality of care, instruments that directly measure the quality of nursing care, particularly from the perspectives of care recipients, are scarce. Quality of Nursing Care Index for Patients with Advanced Illness (QNCI-PAI) is an instrument currently under development to measure quality of nursing care from the specific perspectives of hospitalized patients with advanced illness. Purpose of this study is to examine item- and instrument-level reliability/validity and feasibility of the QNCI-PAI.</p> <p><strong>Instrument: </strong>The draft of QNCI-PAI was developed based on descriptions of quality nursing care by hospitalized patients with advanced illness. After expert reviews and revisions, the QNCI-PAI has 45 statements describing nurses’ behaviors with 5-point Likert-type scale responses. Respondents (patients) are asked to rate how often their nurses demonstrate these behaviors, and more frequent demonstrations of these behaviors (higher score) indicate better quality of nursing care.</p> <p><strong>Research Design:</strong> Cognitive interviews with hospitalized patients with advanced illness were conducted to examine the question items in the QNCI-PAI to enhance the reliability and validity of the items. Cognitive interview analysis was followed by small scale mail survey to test the feasibility of the QNCI-PAI refined through the cognitive interviewing.</p> <p><strong>Findings:  </strong>Fourteen hospitalized patients were interviewed using cognitive interview techniques (<em>think aloud</em> and <em>verbal prove</em>): participants were asked to read and respond to each question item while thinking out loud everything that goes through their mind, and asked to clarify what they meant. The interview data were analyzed item-by-item to identify incomprehensible or inconsistent items, and items with these problems were either deleted or modified. As a result, out of 45 items, 13 items were deleted and 11 items were modified.  Modified QNCI-PAI (32 items) were mailed to 100 patients discharged from a local medical center. Nineteen responses received demonstrated that no items showed ceiling effects in their responses and all but one item were reasonable to respond for patients.</p> <p><strong>Conclusion and Recommendation</strong>: The findings from the cognitive interviews contributed to refine each item to be comprehensible and consistent to improve reliability of the items. The feasibility test demonstrated that the form of mail survey and the recruitment method were appropriate to evaluate the quality of nursing care in hospital from patients’ perspective. Further psychometric analysis with a larger sample size is necessary to establish the QNCI-PAI as a reliable and valid instrument to measure quality of nursing care in hospitals.</p>en_GB
dc.subjectQuality of Health Careen_GB
dc.subjectinstrument developmenten_GB
dc.date.available2012-08-08T16:20:27Z-
dc.date.issued2012-08-08-
dc.date.accessioned2012-08-08T16:20:27Z-
dc.description.sponsorshipSigma Theta Tau Internationalen
dc.description.noteThe Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.en
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.-
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