血管活性药物输注护理知信行问卷的编制及信效度检验

doi:10.3761/j.issn.2096-7446.2025.03.009

摘要/Abstract

摘要：

目的编制血管活性药物输注护理知信行问卷并检验其信效度。方法以知信行理论为框架，通过文献分析、专家咨询、问卷项目分析以及预调查形成血管活性药物输注护理知信行初始问卷。采用便利抽样法，于2024年2月—6月选取四川省6所三级甲等和3所二级甲等医院的239名从事急危重症、心血管护理等专业的临床护士开展调查，进行信效度检验；从中便利抽取20名护士，两周后进行第2次调查，以测量重测信度。结果形成的问卷包括3个维度共33个条目，其中知识维度15个条目、态度维度5个条目、行为维度13个条目，探索性因子分析显示，3个公因子的累计方差贡献率为78.03%，各条目在所属公因子上的载荷为0.56~0.89；问卷的条目水平内容效度指数为0.91~1.00，问卷整体的平均内容效度指数为0.98。问卷的Cronbach’s α系数为0.974，各维度的Cronbach’s α系数为0.965~0.979；问卷的重测信息组内相关系数为0.889，各维度的组内相关系数为0.890~0.989。结论血管活性药物输注护理知信行问卷具有良好的信效度，可作为测评临床护士血管活性药物输注护理知信行水平的调查工具。

关键词: 血管活性药物, 护理, 知信行理论, 问卷, 信度, 效度

Abstract:

Objective To develop and test the reliability and validity of a Knowledge，Attitude，and Practice （KAP） Questionnaire for the Nursing Care of Vasoactive Agents Infusions. Methods Using the KAP theory framework，an initial questionnaire was developed through literature review，expert panel，item analysis，and a pilot survey. A convenience sample was used to select 239 clinical nurses specializing in critical care and cardiovascular nursing from six tertiary and three secondary hospitals in Sichuan Province from February to June 2024. The reliability and validity of the questionnaire were tested. Additionally，20 participants were re-surveyed two weeks after the initial round to gather test-retest reliability data. Results The final questionnaire comprised 33 items under three dimensions，including 15 items on knowledge，5 on attitude and 13 on practice. Exploratory factor analysis（EFA） showed that the cumulative variance contribution rate of the three common factors was 78.03%，with item loadings ranging from 0.56 to 0.89. The item-level content validity index（I-CVI） ranged from 0.91 to 1.00，and the scale-level content validity index（S-CVI/Ave） was 0.98. The Cronbach’s alpha coefficient for the entire questionnaire was 0.974，with each dimension’s Cronbach’s alpha ranging from 0.965 to 0.979. The intraclass correlation coefficient（ICC） for test-retest reliability was 0.889 for the entire questionnaire，and it ranged from 0.890 to 0.989 for each dimension. Conclusion The KAP Questionnaire for the Nursing Care of Vasoactive Agents Infusions demonstrates excellent reliability and validity，making it a suitable tool for assessing clinical nurses’ knowledge，attitudes，and practices regarding the nursing care of vasoactive agents infusions.

Key words: Vasoactive Agents, Nursing Care, Theory of Knowledge, Attitude and Practice, Questionnaire, Reliability, Validity

陈艺, 方亚平, 牟骏杰, 艾中平, 苏中林, 刘丹, 朱代容, 刘力, 黄艳芳. 血管活性药物输注护理知信行问卷的编制及信效度检验[J]. 中华急危重症护理杂志, 2025, 6(3): 317-322.

CHEN Yi, FANG Yaping, MOU Junjie, AI Zhongping, SU Zhonglin, LIU Dan, ZHU Dairong, LIU Li, HUANG Yanfang. Development and testing the reliability and validity of the Knowledge，Attitude，and Practice（KAP） Questionnaire for the Nursing Care of Vasoactive Agents Infusions[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(3): 317-322.

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参考文献 23

[1]	Mergoum AM, Rhone AR, Larson NJ, et al. A guide to the use of vasopressors and inotropes for patients in shock[J]. J Intensive Care Med, 2024:8850666241246230.
[2]	Häggström M, Bergsman AC, Månsson U, et al. Learning to manage vasoactive drugs:a qualitative interview study with critical care nurses[J]. Intensive Crit Care Nurs, 2017, 39:1-8.
[3]	江莹, 黎万汇, 陈莹莹, 等. 经外周静脉输注血管活性药物风险管理范围的综述[J]. 中华护理杂志, 2021, 56(7):1105-1110. doi: 10.3761/j.issn.0254-1769.2021.07.025
	Jiang Y, Li WH, Chen YY, et al. A scoping review on risk management of peripheral vasoactive medication[J]. Chin J Nurs, 2021, 56(7):1105-1110. doi: 10.3761/j.issn.0254-1769.2021.07.025
[4]	钟竹青, 秦宁, 高学琴, 等. 临床护士输注血管活性药物的现状调查[J]. 中华护理杂志, 2021, 56(8):1208-1215. doi: 10.3761/j.issn.0254-1769.2021.08.014
	Zhong ZQ, Qin N, Gao XQ, et al. Current status of infusion of vasoactive agents of nurses:a nationwide survey[J]. Chin J Nurs, 2021, 56(8):1208-1215.
[5]	王芳, 张树增, 聂岸柳, 等. 成人患者安全输注血管活性药物的最佳证据总结[J]. 中华急危重症护理杂志, 2024, 5(3):275-282.
	Wang F, Zhang SZ, Nie AL, et al. Summary of the best evidence for vasoactive drug infusion in adult patients[J]. Chin J Emerg Crit Care Nurs, 2024, 5(3):275-282.
[6]	中华护理学会. 血管活性药物静脉输注护理[EB/OL]. (2022-03-01)[2024-07-01]. http://www.cna-cast.org.cn/cna Webcn/article/3693.
	Chinese Nursing Association. Nursing care of patients with infusion of vasoactive agents[EB/OL].(2022-03-01)[2024-07-01]. http://www.cna-cast.org.cn/cna Webcn/article/3693.
[7]	余玲, 吕丽敏, 陈亚丹. 临床护士《血管活性药物静脉输注护理》团体标准的执行情况[J]. 中国卫生标准管理, 2023, 14(7):7-12.
	Yu L, Lü LM, Chen YD. Investigation on the implementation of intravenous infusion of vasoactive drugs among clinical nurses[J]. China Health Stand Manag, 2023, 14(7):7-12.
[8]	Grol R, Grimshaw J. From best evidence to best practice:effective implementation of change in patients’ care[J]. Lancet, 2003, 362(9391):1225-1230.
[9]	Guidance for:the use of vasopressor agents by peripheral intravenous infusion in adult critical care patients[EB/OL].(2020)[2024-07-02]. https://ics.ac.uk/resour-ce/peripheral-vasopressor-guide.html.
[10]	Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy standards of practice,8th edition[J]. J Infus Nurs, 2021, 44(1S Suppl 1):S1-S224. doi: 10.1097/NAN.0000000000000396 pmid: 33394637
[11]	中国医师协会急诊医师分会,中华医学会急诊医学分会,中国医疗保健国际交流促进会急诊分会. 血管加压药物在急诊休克中的应用专家共识[J]. 中华急诊医学杂志, 2021, 30(8):929-936.
	Emergency Physicians Branch of Chinese Medical Doctor Association,Emergency Medicine Branch of Chinese Medical Association,Emergency Medicine Branch of China Healthcare International Exchange Promotion Association. Expert consensus on the application of vasopressors in emergency shock[J]. Chin J Emerg Med, 2021, 30(8):929-936.
[12]	中国医师协会心血管内科医师分会心力衰竭学组,中国医师协会急诊医师分会循环与血流动力学学组,中国老年医学会心电与心功能分会. 多巴胺药物临床应用中国专家共识[J]. 中华医学杂志, 2021, 101(20):1503-1512.
	Heart Failure Group of Cardiovascular Physicians Branch of Chinese Medical Doctor Association,Circulation and Hemo-dynamics Group of Emergency Physicians Branch of Chinese Medical Doctor Association,Electrocardiography and Cardiac Function Branch of Chinese Geriatrics Society. China expert consensus on clinical application of dopamine drugs[J]. Natl Med J China, 2021, 101(20):1503-1512.
[13]	卢姣娣, 石双姣, 钟竹青. 微量泵在血管活性药物使用中的最佳证据总结[J]. 中华现代护理杂志, 2023, 29(5):581-589.
	Lu JD, Shi SJ, Zhong ZQ. Summary of best evidence for mi-cropump use in vasoactive drugs[J]. Chin J Mod Nurs, 2023, 29(5):581-589.
[14]	Andrade C, Menon V, Ameen S, et al. Designing and conducting knowledge,attitude,and practice surveys in psychiatry:practical guidance[J]. Indian J Psychol Med, 2020, 42(5):478-481.
[15]	黄艳芳, 郭声敏, 李翠, 等. 标准预防措施问卷的汉化与信效度检验[J]. 中华护理教育, 2023, 20(12):1481-1486.
	Huang YF, Guo SM, Li C, et al. Translation and psychometric properties evaluation of the Chinese version of Standard Precautions Questionnaire[J]. Chin J Nurs Educ, 2023, 20(12):1481-1486.
[16]	岳速萍, 李洪毅, 王瑜, 等. 老年失智失能量表的编制:统计学方法在条目筛选中的运用[J]. 中国老年学杂志, 2020, 40(18):4009-4011.
	Yue SP, Li HY, Wang Y, et al. Development of senile dementia disability scale:application of statistical method in item selection[J]. Chin J Gerontol, 2020, 40(18):4009-4011.
[17]	张虎, 田茂峰. 信度分析在调查问卷设计中的应用[J]. 统计与决策, 2007(21):25-27.
	Zhang H, Tian MF. Application of reliability analysis in questionnaire design[J]. Stat Decis, 2007(21):25-27.
[18]	杨可娜, 徐玲芬, 李敏, 等. ICU护士对急性皮肤衰竭认知现状问卷的编制及信效度检验[J]. 中华急危重症护理杂志, 2023, 4(4):298-303.
	Yang KN, Xu LF, Li M, et al. Development and psychometric testing of ICU Nurses’ Cognition of Acute Skin Failure Questionnaire[J]. Chin J Emerg Crit Care Nurs, 2023, 4(4):298-303.
[19]	吴明隆. 问卷统计分析实务:SPSS操作与应用[M]. 重庆: 重庆大学出版社, 2010:166-281.
	Wu ML. Practice of questionnaire statistical analysis:SPSS operation and application[M]. Chongqing: Chongqing University Press, 2010:166-281
[20]	Mehta S, Bastero-Caballero RF, Sun YJ, et al. Performance of intraclass correlation coefficient(ICC) as a reliability index under various distributions in scale reliability studies[J]. Stat Med, 2018, 37(18):2734-2752.
[21]	Clark LA, Watson D. Constructing validity:new developments in creating objective measuring instruments[J]. Psychol Assess, 2019, 31(12):1412-1427. doi: 10.1037/pas0000626 pmid: 30896212
[22]	Cour M, Hernu R, Bénet T, et al. Benefits of smart pumps for automated changeovers of vasoactive drug infusion pumps:a quasi-experimental study[J]. Br J Anaesth, 2013, 111(5):818-824. doi: 10.1093/bja/aet199 pmid: 23761221
[23]	Burns KEA, Misak C, Herridge M, et al. Patient and family engagement in the ICU. Untapped opportunities and underrecognized challenges[J]. Am J Respir Crit Care Med, 2018, 198(3):310-319.