Psychometric properties of the Chinese version of difficulty scale for nurses who care for patients with delirium in the intensive care unit.

Abstract

Background: Intensive Care Unit (ICU) nurses experience many difficulties and challenges in caring for delirium patients. Identifying and measuring these difficulties experienced by nurses is critical for implementing precise interventions. We currently lack a standard tool for assessing the level of difficulty faced by ICU nurses in caring for delirium patients that fits the nursing context in China. This study aimed to translate the Difficulty Scale for Nurses who Care for Patients with Delirium in the Intensive Care Unit (DSNCPD-ICU) into Chinese (C-DSNCPD-ICU) and psychometrically validate the translated scale.

Methods: The English version of DSNCPD-ICU consisted of a main scale with eight factors and an additional scale of one factor. It was translated in strict accordance with Brislin's translation model to yield the Chinese versions. Using a convenience sampling method, 477 ICU nurses from ten general hospitals were recruited for online survey, which collected sociodemographic information, scores on C-DSNCPD-ICU and the Strain of Care for Delirium Index. Subsequent psychometric attributes of the C-DSNCPD-ICU were also tested by the validity and reliability.

Results: There were 437 valid responses. The content validity index was calculated as 0.96. Cronbach's alpha for the total scale and each factor were 0.919 and 0.705-0.878, respectively. Exploratory factor analysis verified an eight-factor scale and an additional scale structure with cumulative variance contributions of the factors of 63.78% and 57.62%, respectively. Confirmatory factor analysis showed that all data-model fits were acceptable.

Conclusions: The C-DSNCPD-ICU validated in this study showed satisfactory psychometric properties. This will help Chinese nurse managers to accurately assess the degree of difficulty and identify the causes of precise barriers in caring for patients with delirium. Using the scale, nurse managers can determine what kind of measures should be taken, including formulating effective and tailored educational programs and providing more resources to support nurses.