摘要
目的检验医学叙事能力量表(NCS)在肿瘤科医护人员中的信效度。方法采用一般资料调查表、NCS、杰弗逊共情量表-卫生专业人员版(JSE-HP)、人文关怀能力量表(CAI)对台州市6所医院的324名肿瘤科医护人员进行调查。应用27%/73%分位法检验NCS各条目区分度,应用Pearson相关分析评估各条目得分与其所在维度得分的相关性。采用Cronbachα系数评价量表的内部一致性,并计算折半信度。以JSE-HP和CAI为效标,使用Pearson相关分析检验NCS的效标效度;应用探索性因子分析和验证性因子分析评价NCS的结构效度。结果高分组(NCS得分排名前27%)与低分组(NCS得分排名后27%)在NCS所有条目上的得分差异均有统计学意义(均P<0.01);各条目与其所在维度得分的Pearson相关系数为0.483~0.687(均P<0.01)。信度分析结果显示:NCS总量表的Cronbachα系数为0.899;关注倾听、理解回应、反思再现维度的Cronbachα系数依次为0.725、0.819、0.682;使用Spearman-Brown不等长公式校正后,总量表折半信度为0.894,关注倾听、理解回应、反思再现维度的折半信度依次为0.768、0.838、0.673。效度分析结果显示:(1)效标效度:NCS总分及其各维度得分与JSE-HP、CAI总分均呈正相关(r=0.433~0.562;均P<0.01);(2)探索性因子分析:Bartlett球形检验χ^(2)=2176.585(P<0.001),KMO值=0.92,采用主成分分析和最大方差正交旋转法,共提取5个公因子;(3)验证性因子分析:χ^(2)=447.553,df=321,χ^(2)/df=1.394,拟合优度指数=0.908,比较拟合指数=0.933,近似误差均方根=0.035,Tucker-Lewis指数=0.927,标准化均方根残差=0.046。结论NCS在肿瘤科医护人员中具有良好的区分度、信度、效度及内部一致性,可作为该人群叙事能力的有效测评工具,但其因子结构尚需在未来研究中进一步验证。
Objective To validate the reliability and validity of the Narrative Competence Scale(NCS)among oncology healthcare providers.Methods A total of 324 oncology healthcare providers from 6 hospitals in Taizhou were surveyed using the General Information Questionnaire,NCS,Jefferson Scale of Empathy-Health Professions(JSE-HP),and Caring Ability Inventory(CAI).The 27th/73rd percentiles method was used to test the discriminatory power of each item of the NCS,and Pearson correlation analysis was applied to evaluate the correlations between the score of each item and that of its corresponding dimension.Cronbach'sαcoefficient was used to assess the internal consistency of the scale,and split-half reliability was calculated.With JSE-HP and CAI as criteria,Pearson correlation analysis was used to test the criterion validity of the NCS;exploratory factor analysis and confirmatory factor analysis were used to evaluate the construct validity of the NCS.Results There were statistically significant differences in all items of NCS between the high-score group(participants scoring in the top 27%on the NCS)and the low-score group(participants scoring in the bottom 27%on the NCS)(all P<0.01),and the Pearson correlation coefficients between score of each item and its corresponding dimension ranged from 0.483 to 0.687(all P<0.01).Results of the reliability analysis showed that the Cronbach'sαcoefficient of the overall NCS was 0.899,and the Cronbach'sαcoefficients of the"Attention and Listening","Understanding and Responding",and"Reflection and Representation"dimensions were 0.725,0.819,and 0.682,respectively;after correction using the Spearman-Brown unequal-length formula,the split-half reliability of the overall scale was 0.894,and the split-half reliabilities of the"Attention and Listening","Understanding and Responding",and"Reflection and Representation"dimensions were 0.768,0.838,and 0.673,respectively.Results of validity analysis showed that:(1)criterion validity:the total score of NCS and its dimension scores were positively correlated with the total scores of JSE-HP and CAI(r=0.433-0.562;all P<0.01);(2)exploratory factor analysis:Bartlett's test of sphericity yielded aχ^(2)value of 2,176.585(P<0.001),with a KMO value of 0.92,and using principal component analysis with varimax rotation,five common factors were extracted;(3)confirmatory factor analysis:the following results were yielded:χ^(2)=447.553,df=321,χ^(2)/df=1.394,goodness-of-fit index=0.908,comparative fit index=0.933,root mean square error of approximation=0.035,Tucker-Lewis index=0.927,and standardized root mean square residual=0.046.Conclusion The NCS demonstrates good discrimination,reliability,validity,and internal consistency for assessing narrative competence among oncology healthcare providers.It can serve as an effective tool for this population,although its factor structure requires further validation in future studies.
作者
肖洁晨茗
汤佳静
杨恒
XIAO Jiechenming;TANG Jiajing;YANG Heng(Department of Nursing,Taizhou First People's Hospital,Taizhou 318020,Zhejiang Province,China;Department of Oncology,Taizhou First People's Hospital,Taizhou 318020,Zhejiang Province,China;Department of Emergency,Taizhou First People's Hospital,Taizhou 318020,Zhejiang Province,China)
出处
《内科》
2025年第4期405-411,共7页
Internal Medicine
关键词
医学叙事能力量表
叙事能力
信度
效度
肿瘤科
医护人员
Narrative Competence Scale
Narrative competence
Reliability
Validity
Oncology
Healthcare providers
