護理之家照護品質觀測性指標量表中文版之信效度初探
本研究旨在建構中文版「護理之家照護品質觀測性指標」量表之信效度。本 研究量表由 Rantz (1999) 所研擬，屬觀測式評估量表，次量表包含溝通 5 項
、照護 9 項、工作人員 6 項、環境 16 項、居家情境 / 家人參與 6 項，共分五 大界面、 42 項指標。研究方法乃先將「 The Observable Indicators of Nursing Home Care Quality 」量表翻譯成中文，延聘多位護理專家進行內容效度檢定 與雙次翻譯驗證；再以立意取樣方式收集五所北部地區醫院附設型護理之家 實地觀測資料，以針對量表進行項目分析、內在一致性及漸進式觀測者間信 度檢定。研究結果顯示： ( 一 ) 在效度方面，經專家效度檢定量表內容之正 確性、重要性與適切性顯示 42 項均為保留項，且內容效度指數 CVI 值均達 8 0% 以上；雙次翻譯驗證結果 90% 內容一致； ( 二 ) 在信度方面，經漸進式 觀測者間信度檢定，三家護理之家觀測者間同意程度依次為 81% 、 83% 、 9 2% ，其顯示三次觀測者間信度有逐漸提升之趨勢；量表內在一致性以 Spear man’s Coefficient 檢定， Cronbach’s α 值為 0.94 ，研究結果發現量表能夠觀測 到護理之家住民照護品質。同時，於觀測過程中發現量表具有簡便易懂的特 性，並可以區分照護品質的優與劣，經修正後可應用為醫院附設型護理之家 照護品質評估之工具。
關鍵詞：護理之家、照護品質指標、信效度
A Preliminary Study of The Reliability and Validity of A Chinese Version of The Observable Indicators of Nursing Home Care
Quality Instrument
The purpose of this research is to examine the reliability and validity of a Chinese version of
「 The Observable Indicators of Nursing Home Care Quality Instrument 」 (OINHCQI). The observable indicators of OINHCQI by Rantz (1999) was translated into Chinese. The OINHC QI consisted five dimensions, (42 observable indicators), including communication (5 items), care (9 items), staff (6 items), environment (16 items), home/family involvement (6 items). Th e validity of Chinese version was then assessed by nursing experts and pertinent reverse transl ation was also verified. Then observation was conducted at five hospital-based nursing homes at northern of Taiwan, which also incorporated assessments of item analysis, internal consiste ncy, and incremental inter-rater reliability of all indicators. The results of accuracy, relevance, and suitability of indicators showed that all of the 42 indicators should be preserved with cont ent validity index (CVI) of 80%. Verification of double translation showed 90% consistency.
As to incremental inter-rater reliability, the observation at three nursing homes were 81%, 83
%, and 92%. The results showed that the incremental inter-rater reliability were upward trend.
Internal consistency was assessed with Spearmen’s coefficient, Cronbach’s αwas 0.94. The res ult indicated that indicators can help to assess the quality of nursing care at nursing homes wit h observable information. The findings also demonstrated that these indicators were not only e asy to use and to understand, but also in convenient. This Chinese form of OINHCQI can be a dopted to examine the quality of nursing care among hospital-based nursing homes.
