Objective To develop Knowledge-Attitude-Practice Scale of Initiating Do-Not-Resuscitate（DNR） among emergency medical staff,and to evaluate the reliability and validity. Methods We formed a pretest scale by literature review and expert consultation. To analyze items of the scale and test the reliability and validity,we processed a survey among 181 medical staff with initiating DNR Knowledge-Attitude-Practice Scale in emergency department of two tertiary hospitals in Zhejiang at August 2020. Participants were selected by convenience sampling. Results The Knowledge-Attitude-Practice Scale on Initiating DNR among emergency medical staff has 31 items and 3 dimensions. There were 10 items in the knowledge dimension,11 items in the attitude dimension,and 10 items in the practice dimension. The variance contribution rate of knowledge,attitude and practice on initiating DNR were 24.86%,21.24%,and 19.33% in order,and the cumulative variance contribution rate was 65.42%. The content validity index（CVI） of the 3 dimensions were 0.962,0.988,and 0.900. The CVI of each item ranged from 0.857 to 1.000. The Cronbach's α coefficients of the scale was 0.953,and the Cronbach's α coefficients of each dimension ranged from 0.919 to 0.940. The total split-half reliability coefficient of the scale was 0.770,and the split-half reliability coefficient of each dimension ranged from 0.843 to 0.909. Conclusion The Knowledge-Attitude-Practice Scale of Initiating Do-Not-Resuscitate（DNR） among emergency medical staff has good reliability and validity,and it can be used to evaluate the initiation of DNR knowledge and behavior level of emergency medical staff in China.
DING Chuanqi
,
JIN Jingfen
,
WANG Yuwei
,
WANG Sa
,
ZHANG Yuping
. Development and psychometric testing of Knowledge-Attitude-Practice Scale on Initiating Do-Not-Resuscitate among emergency medical staff[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022
, 3(5)
: 396
-401
.
DOI: 10.3761/j.issn.2096-7446.2022.05.002
[1] Al Farhan A,Al Harthi M,Bin Mosa M,et al.Patient reluctance to accept Do Not Resuscitate order:impact on clinical care[J]. East Mediterr Health J,2020,26(8):933-938.
[2] Azizi K,Waheed S,Barolia R,et al.Understanding perceptions and factors involved in do not resuscitate(DNR) decision making in the emergency department of a low-resource country:a mixed-methods study protocol[J]. BMJ Open,2020,10(9):e038915.
[3] Walkey AJ,Weinberg J,Wiener RS,et al.Hospital variation in utilization of life-sustaining treatments among patients with do not resuscitate orders[J]. Health Serv Res,2018,53(3):1644-1661.
[4] Holley A,Kravet SJ,Cordts G.Documentation of code status and discussion of goals of care in gravely ill hospitalized patients[J]. J Crit Care,2009,24(2):288-292.
[5] Ding CQ,Zhang YP,Wang YW,et al.Death and do-not-resuscitate order in the emergency department:a single-center three-year retrospective study in the Chinese mainland[J]. World J Emerg Med,2020,11(4):231-237.
[6] 丁传琦,金静芬,王钰炜,等. 急诊科患者不复苏应用现状及决策影响因素[J]. 中国实用护理杂志,2020,36(23):1830-1834.
Ding CQ,Jin JF,Wang YW,et al.Status quo of DNR application and influencing factors of decision-making in emergency department patients[J]. Chin J Pract Nurs,2020,36(23):1830-1834.
[7] Bremer A,Årestedt K,Rosengren E,et al.Do-not-attempt-resuscitation orders:attitudes,perceptions and practices of Swedish physicians and nurses[J]. BMC Med Ethics,2021,22(1):34.
[8] 张霞,张鑫,万晶晶. 妊娠期糖尿病孕妇自我管理评价量表的研制及信效度检验[J]. 中华护理杂志,2020,55(10):1509-1513.
Zhang X,Zhang X,Wan JJ.Development and psychometric test of self-management scale for patients with gestational diabetes mellitus[J]. Chin J Nurs,2020,55(10):1509-1513.
[9] 戴美玲,易欣然,张永爱,等. 护理专业学生母乳喂养知识问卷的汉化及信效度检验[J]. 中华护理教育,2021,18(12):1141-1146.
Dai ML,Yi XR,Zhang YA,et al.Translation and validation of the nursing student's knowledge about breastfeeding questionnaire[J]. Chin J Nurs Educ,2021,18(12):1141-1146.
[10] 赵晓燕,李彦儒,曾咏梅,等. 糖尿病健康素养量表的汉化和信效度评价[J]. 中华护理教育,2021,18(3):266-269.
Zhao XY,Li YR,Zeng YM,et al.Evaluation of the reliability and validity of Health Literacy Scale-Chinese[J]. Chin J Nurs Educ,2021,18(3):266-269.
[11] 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.
Wu ML.Practice of questionnaire statistical analysis:SPSS operation and application[M]. Chongqing:Chongqing University Press,2010.
[12] 王佳乐,杨巧红,于小雪,等. 孤独症谱系障碍患儿治疗依从性量表(家长版)的研制及信效度检验[J]. 中华护理杂志,2021,56(12):1812-1818.
Wang JL,Yang QH,Yu XX,et al.Development and reliability and validity test of treatment compliance scale for children with autism spectrum disorder(parental version)[J]. Chin J Nurs,2021,56(12):1812-1818.
[13] Albugami M,Bassil H,Laudon U,et al.Medical residents' practices and perceptions toward do-not-resuscitate(DNR) order[J]. J Palliat Care Med,2017,7:295.
[14] Gouda A,Alrasheed N,Ali A,et al.Knowledge and attitude of ER and intensive care unit physicians toward do-not-resuscitate in a tertiary care center in Saudi Arabia:a survey study[J]. Indian J Crit Care Med,2018,22(4):214-222.
[15] O'Hanlon S,O'Connor M,Peters C,et al. Nurses' attitudes towards Do Not Attempt Resuscitation orders[J]. Clin Nurs Stud,2013,1(1):43-50.
[16] O'Reilly M,O'Tuathaigh CMP,Doran K. Doctors' attitudes towards the introduction and clinical operation of do not resuscitate orders(DNRs) in Ireland[J]. Ir J Med Sci,2018,187(1):25-30.
[17] Fallahi M,Mahdavikian S,Abdi A,et al.Nurses and physicians' viewpoints about decision making of do not attempt resuscitation(DNAR)[J]. Multidiscip Respir Med,2018,13:20.
[18] 李峥,刘宇. 护理学研究方法[M]. 2版. 北京:人民卫生出版社,2018.
Li Z,Liu Y.Methods of nursing research[M]. 2nd ed. Beijing:People's Medical Publishing House,2018.
