机构实施循证实践准备度评估量表的汉化及内容效度验证

Localization and Content Validation of the Organizational Readiness of Implementing Evidence-based Practices Scale

  • 摘要:
    目的 本研究旨在汉化工作场所准备度问卷(workplace readiness questionnaire,WRQ),并验证其在中国基层医疗机构评估循证实践(evidence-based practices,EBP)实施准备度的适用性,为评估组织变革准备度(organizational readiness for change,ORC)提供实用测量工具。
    方法 采用改良Brislin翻译模型汉化WRQ,通过德尔菲法评价其内容效度、跨文化效度及可推广性,采用条目水平内容效度指数(item-level content validity index,I-CVI)、量表水平内容效度指数(scale-level content validity index,S-CVI)和矫正后的Kappa值评价专家反馈意见,结合层次分析法(analytic hierarchical process,AHP)确定指标权重。邀请量表目标使用人群对条目重要性(item importance score,IIS)进行定量评价,结合认知访谈定性反馈意见,评价表面效度。
    结果 为明确用途,修订量表名称为“机构实施循证实践准备度评估量表”(organizational readiness of implementing evidence-based practices scale,ORIEBP),内容包含变革背景、变革效价、信息评估、变革承诺、变革效能5个维度,共32个条目。经两轮德尔菲专家函询修改了3个维度的构念和11个条目的表述,量表内容效度较好,I-CVI为0.73~1.00,Kappa值为0.70~1.00,S-CVI≥0.92。ORIEBP量表各维度权重依次为0.2083、0.2022、0.1907、0.2193、0.1795,一致性比率(consistency ratio,CR)达标(CR<0.1)。81.8%(9/11)的专家认为量表条目具有较好的可推广性。各维度和条目的IIS评分分别为2.93~3.54和2.71~3.42,表面效度良好;认知访谈结果显示,受访者主要困惑于专业术语。
    结论 本研究验证了ORIEBP量表的内容效度,可推广性较好。后续可扩大量表使用范围,进一步开展结构效度与信度验证,比较不同变革下组织准备度的差异,促进量表的进一步完善。

     

    Abstract:
    Objective This study aimed to localize the workplace readiness questionnaire (WRQ) and validate its applicability for assessing readiness for implementation of evidence-based practices (EBP) in primary care settings in China. The localization of the instrument will provide a practical instrument for assessing organizational readiness for change (ORC).
    Methods The WRQ was translateed into Chinese version using the modified Brislin translation model, and its cross-cultural validity, content validity, and generalizability were evaluated by the Delphi method, and the expert feedback was evaluated using the item-level content validity index (I-CVI), scale-level content validity index (S-CVI), and corrected Kappa value. The index weights were evaluated by the analytic hierarchical process (AHP). The target users of the scale were invited to quantitatively evaluate its item importance score (IIS), and the surface validity was evaluated by combining the qualitative feedback from their cognitive interviews.
    Results To clarify the purpose of the scale, we revised its name to the Organizational Readiness of Implementing Evidence-Based Practices (ORIEBP) Scale. The ORIEBP scale contained five dimensions, which were Change Context, Change Valence, Information Evaluation, Change Commitment, Change Efficiency, and 32 items. After two rounds of the Delphi method to refine the construction of three dimensions and expressions of 11 items, the I-CVI were from 0.73 to 1.00, the Kappa value were from 0.70 to 1.00, and the S-CVI was over 0.92. All evaluation matrices of the hierarchical analysis method met the requirement of consistency ratio (CR < 0.1), and the weights of five dimensions were 0.2083, 0.2022, 0.1907, 0.2193, and 0.1795, in sequence. Nine out of eleven experts identified that items were applicable to other readiness assessment scenarios. The IIS scores for the five dimensions and 32 items were ranged from 2.93 to 3.54, and 2.71 to 3.42, presenting good face validity. The cognitive interview results showed that professional expressions were complex to understand.
    Conclusions This study validated the ORIEBP scale and has good content validity and generalizability. The scale can be further improved by expanding its scope of use and validating its structure validity and reliability in different settings.

     

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