Development and Psychometric Testing of Quality Nursing Care Scale in Public Hospital Settings in Mongolia

Abstract

Background: Quality Nursing Care (QNC) is fundamental to the profession of nursing practice. Perception of QNC differ across the globe because of differences in social norms, cultural values and political ambiance and economy. This study aimed to develop a QNC instrument congruent with the Mongolian (QNCS-M) healthcare system and cultural values and societal norms. Methods: We implemented sequential exploratory mixed-method study to develop and assess performance of QNCS-M. First, we focused on developing the components of QNCS-M and their operational definitions. The field testing consisted of assessing the construct validity and internal consistency reliability. Correlation between QNCS-M and the criterion tool, Quality of Nursing Care Questionnaire-Registered Nurse was evaluated. Inter-item correlation was examined by Spearman rank-order correlation. The internal consistency reliability was analyzed using Cronbach’s α. ANCOVA statistical technique was used to discern social desirability and the interaction between scores of each item and MSCDS. Results: The initial version of QNCS-M contained 66 items of which 7 were deleted after content validity assessment. The total-item correlation analysis yielded to exclusion of another 3 items. Additional 12 items were excluded after inter-item correlation. Results from ANCOVA analysis of the remaining 44 items indicated interaction between social desirability and 6 items. These items were excluded. A total of 38 items remained for exploratory factor analysis. Results from exploratory factor analysis yielded eigenvalues > 1.0 for the 9 domains. Three domains contained items fewer than 3. These domains and 2 items were eliminated, yielding to 6 domains with 36-item. Results from internal consistency reliability yielded an overall Cronbach’s α=.92; the coefficient values for the 6 domains ranging between .72 and .85. Results from test-retest reliability yielded an acceptable performance consistency (Cronbach’s α= .93). Conclusion: Improving the quality of healthcare services delivered by nurses is a priority for the Mongolian government. The development of QNCS-M is a major stride in addressing this concern. The final version of QNCS-M which contains 36 items, loaded into 6 domains, was morphed to the specifics of the Mongolian healthcare systems and cultural values and societal norms. QNCS-M demonstrates a high level of content and construct validity with acceptable reliability.

Emotional response of critically-ill cardiac patients during hygiene procedures in intensive care: a prospective and descriptive study

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Respuesta emocional de pacientes cardiológicos en estado crítico durante la higiene en cuidados intensivos: estudio prospectivo y descriptivo

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Resposta emocional de pacientes cardiológicos críticos durante a higiene em cuidados intensivos: um estudo prospectivo e descritivo

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