中文版護理師發展性照護能力量表之信效度檢驗

The Reliability and Validity Examination of the Development Support Competency Scale for Nurses: Traditional Chinese Version (DSCSN-TC)

背景：發展性照護旨在提供以早產兒需求為中心的照護模式，藉由降低環境的壓力以協助早產兒在新生兒加護病房中穩定成長，此為早產兒照護的核心理念。然而國內甚少使用測量工具評估護理師的發展性照護能力。為了增進早產兒照護品質及加強護理師在職教育，確認護理師發展性照護能力之現況實乃必要，經系統性文獻搜尋，發現源自韓國Kim及Shin發展之護理師發展性照護能力量表（Developmental Support Competency Scale for Nurses，DSCS-N）符合臨床需求。
目的：本研究旨在將DSCS-N量表中文化，並進行其信效度檢驗。
方法：採用Brislin翻譯模式將量表翻譯成中文，並以Jones流程進行文化對等性檢視，隨後進行內容效度檢驗（內容適用性及文字清晰度），驗證性因素分析、項目分析及內在一致性等方式進行信效度驗證。
結果：經8位專家評估內容效度指標為.92，本研究採方便取樣納入3家醫學中心之新生兒加護病房年資滿一年以上之護理師共153位。此量表共19題，總分為19–76分，平均總分數為64.91分（SD = 7.61）；以驗證性因素分析證實六因素架構有良好適配：比較性配適指標值為.935、非規範配適指標值為.919、近似均方根誤差值為.063、標準化均方根殘差值為.05；6個因素分別命名為互動、批判性思考、父母支持、專業發展、夥伴關係及環境支持，整體量表之Cronbach’s alpha為.935，其次量表則是介於.676–.833。
結論：顯示中文版護理師發展性照護能力量表（Development Support Competency Scale for Nurses- Traditional Chinese Version，DSCSN-TC）具良好之信效度，可於臨床或研究中測量護理師之發展性照護能力；本研究根據初步測試結果，已針對原工具進行修訂，演進為DSCSN-TC 2.0版本，期能更精確地評估護理人員之發展性支持照護能力。

Background: The primary purpose of developmental care, the core requirement of premature infant care, is to provide a demand-central care model that reduces pressure in the environment to assist preterm infants in neonatal intensive care units (NICUs). While developmental care is the care aim of NICUs, no validated measures are currently available in Taiwan to evaluate the developmental care ability of nurses. To improve the quality of care provided to preterm infants and strengthen the on-the-job education received by nurses, the current status of relevant competencies in NICU nurses must be elucidated.
Purpose: In this study, the original English version of the Developmental Support Competency Scale for Nurses (DSCS-N) developed by the Korean scholars Kim and Shin was translated into a Traditional Chinese version (DSCSN-TC) and evaluated for reliability and validity.
Methods: The DSCS-N was translated using the Brislin translation model and cross-cultural equivalence was reviewed using the Jones process. Content validity (including content relevance and item clarity) was subsequently verified. Reliability and validity were assessed using descriptive statistics, confirmatory factor analysis, item analysis, and internal consistency reliability.
Results: Convenience sampling was used to enroll 153 nurses (N = 153) as participants, all of whom had worked for more than one year in a NICU at one of three medical centers. The 19-item DSCSN-TC has a total possible score range of 19 to 76. Content Validity Index, evaluated by eight experts, was .92. The mean total score was 64.91 (SD = 7.61). CFA confirmed a good fit for the six-factor structure: CFI = .935, TLI = .919, RMSEA = .063, and SRMR = .05. The Cronbach’s alpha values for the six factors were: interaction (.717), critical thinking (.833), parental support (.676), professional development (.762), partnership (.784), and environmental support (.688). The overall Cronbach’s alpha for the scale was .935.
Conclusion: The findings show the DSCSN-TC to be a reliable and valid measure when applied in either research or clinical settings to evaluate developmental care competency in nurses. Based on the preliminary testing results, the original instrument was further refined and evolved into a DSCSN-TC 2.0 version with the aim of providing an even more precise assessment of the developmental supportive care competence of nursing staff.