高齢者における胃ろう離脱のためのケアプロトコール構成項目の理解度評価指標の信頼性・妥当性

Reliability and Validity of Evaluation Index for Level of Understanding Regarding Configured Items of Care Protocol for Percutaneous Endoscopic Gastrostomy Removal among the Elderly

抄録

【目的】高齢者における胃ろう離脱のためのケアプロトコールの構成項目に対する看護師の理解度に関する評価指標の信頼性・妥当性の検証を行った．

【方法】2008年11月〜2009年1月に療養病床を有する病院，介護老人保健施設の看護師を対象に，経口開始の判断基準，フェースシート，アセスメントシート，ケアシートを構成する94項目の理解度に関して自記式質問紙調査を2度行い，回答は4段階のLikert Scaleで求めた．項目分析，および信頼性検証に再テスト法，I-T相関分析，Cronbach's α係数を求め，妥当性検証として内容妥当性，既知グループ法を用いた構成概念妥当性を検証した．調査は千葉大学看護学部倫理審査委員会の承認を受け実施した．

【結果】有効回答数は389人，各項目の平均値，標準偏差，尖度，歪度より除外項目はなかった．再テスト法では全項目で有意な相関がみられ，I-T相関分析でもr＝0.424〜0.914で除外項目はなく，Cronbach's α係数は0.776〜0.982であった．内容妥当性，構成概念妥当性も確認された．

【考察】胃ろう離脱のためのケアプロトコールの構成項目の理解度評価指標について，信頼性・妥当性が得られた．将来これらを用いた教育，実践介入による効果検証研究等の必要性がある．

[Purpose] The purpose of this study was to clarify reliability and validity of Evaluation Index for Level of Understanding regarding configured items of care protocol for removal of percutaneous endoscopic gastrostomy among the elderly.

[Methods] Self-reported questionnaires were sent to the nurses in recuperation bed groups and geriatric health services facilities. The survey consisted of items regarding evaluation criteria of starting oral feeding, face sheet, assessment sheet, and care sheet. The survey was conducted twice between November 2008 and January 2009. Responses to level of understanding about items of care protocol were measured using a 4-point Likert scale. The data were analyzed using item analysis, test-retest reliability, Item-Total correlations, Cronbach's α as reliability, and content validity and known-groups method as construct validity. This research was approved by the ethical review board of Chiba University.

[Results] There were 389 valid responses. Mean value, standard deviation, kurtosis, and skewness were analyzed statistically and there were no exclusions. Each item of the 1^st and 2^nd survey showed significant correlations in test-retest analysis, and scores of IT correlation analysis were r＝0.424〜0.914. In this result, there were no exclusions Cronbach's α ranged from 0.776 to 0.982. These results led to content and construct validity.

[Discussion] The results showed reliability and validity of evaluation index of understanding level regarding configured items for removal of percutaneous endoscopic gastrostomy. In the future, education or study to verify the effects of practical intervention using the results in this study will be needed.