脫離呼吸器護理評估量表之發展與測試

Development and Testing of Nursing Assessment Scale for Weaning Ventilator

本研究目的在於建立及測試「脫離呼吸器護理評估量表」，提供護理人員評估使用呼吸器病患脫離呼吸器之工具。本研究分二階段執行，以建立脫離呼吸器病患生理與心理的指標。首先是發展研究工具(Instrument deve1opment)：研究者以查證國內外之相關文獻，並與呼吸治療科及胸腔內科專科醫師、護理長、護理師討論，再加上使用呼吸器病患之護理記錄及臨床經驗來發展量表項目，並由十二位專家審閱，確立問巷的內容效度。第二階段是測試量表之信度：本研究是以內在一致性信度及囚素分析，檢定脫離呼吸器護理評估量表。採護理人員每日依據病患之實際情況填寫量表，取樣自北部某醫學中心加護病房及普通病房之229位使用呼吸器病患為研究對象。脫離呼吸器護理評估量表經由因素分析，萃取出因素，分別為生理問題、心理問題、感染問題及使用藥物等四個因素。此四個因素可解釋之總變異量為53.48%，顯示本量表具有良好的建構效度。在信度方面，「脫離呼吸器護理評估量表」之四個因素的Cronbach's α介於.84-.95，顯示本量表具有良好的內在一致性，且具穩定性。

The purposes of this study were to establish and to test an instrument as a nursing assessment scale in weaning ventilator patients. The study proceeded in two phases with developing the instrument to establish physiology and psychology indices for weaning ventilator patients. In the first phase, researcher reviewed literature related to the nursing assessment scale of weaning ventilator, and further discussed with respiratory therapists, chest physicians, head nurses and clinical nurse specialists to collect relevant personal experiences for developing the items of the nursing assessment scale. Twelve experts reviewed the instrument for content validity. In the second phase, the psychometric properties of the nursing assessment scale for weaning ventilator were examined, including internal consistency, reliability and factor analysis. With purpose sampling, and questionnaire survey researcher collected data from 229 patients' nursing documents at a medical center in Taipei. The nursing assessment scale for weaning ventilator were identified by factor analysis to be as follows: (l)physiology problem; (2)psychology problem; (3)infection problem, and (4)medications. These four factors could explain 53.48 % of the variance of the nursing assessment scale. The coefficients of the Cronbach's a for four factors were .84 - .95, respectively. The results demonstrated that the instrument had a satisfactory internal validity and reliability.