訪問看護における摂食・嚥下障害看護の質評価指標改訂版の妥当性と信頼性の検討

Evaluation of Validity and Reliability of Modified Quality Assessment Scale for Dysphagia Nursing in Visiting Nurses

要旨

　【目的】訪問看護における摂食・嚥下障害看護の質評価指標改訂版の妥当性と信頼性を検討することを目的とした．

　【方法】文献検討とエキスパート5名による評価をもとに作成された質評価指標39項目を改訂し，52項目とした．訪問看護ステーションに勤務する看護師228名に対して，質評価指標改訂版についての質問紙調査を郵送法にて実施した．

【結果】177名の有効回答から平均値，実施率を求め，その結果から49項目が選定された．構成概念妥当性を確認するために因子分析を行った結果，「リスク管理のアセスメントと介入」，「摂食・嚥下機能のアセスメント」，「摂食・嚥下リハビリテーション」，「評価とコーディネート」の4因子が抽出された．内的整合性を示すCronbach's α係数は，項目全体では0.95であった．

【結論】訪問看護における摂食・嚥下障害看護の質評価指標改訂版は，構成概念妥当性が確認され，信頼性が高い指標であることが示唆された．

Abstract

　Purpose：The purpose of this study was to modify a quality assessment scale of dysphagia nursing (QASDN) for visiting nurse and to evaluate its validity and the reliability.

　Methods：The study was approved by the Ethics Committee of Aichi Prefectural College of Nursing ＆ Health.Thirty-nine QASDN items were developed based on a literature review and assessed by five experts in dysphagia nursing.We modified the QASDN composed of 52 items. A questionnaire survey by mail regarding QASDN was conducted among 228 nurses who work at visiting nursing stations.

　Results：Valid responses to the QASDN were obtained from 177 visiting nurses. Forty-nine items were selected from considering the mean results. Construct validity was analyzed by factor analysis. Four factors were obtained, “assessment and practice of risk management,”“assessment of swallowing function,”“practice of dysphagia rehabilitation,” and “evaluation and coordination.”Reliability was analyzed by internal consistency. Cronbach's α was 0.95 for overall scores.

　Conclusion：These results suggested that the modified QASDN for visiting nurses has high validity and reliability.