Construcción y validación de una escala de evaluación del nivel de competencia en la interacción de cuidado para estudiantes de Grado en Enfermería

Resum

The competence acquirement is described in the European Higher Education area recommendations, and Universities should adapt their programs to get this standard using appropriate instruments, like the evaluation rubric. In addition, the nurse-patient relationship competence acquirement, as a specific competence in Nursing Degree programs, becomes an object to be evaluated. The objective of this study was the validation of a tool which measures the nurse-patient interaction competence in nursing students, based on Caring Nurse Patient Interaction Scale (CNPI)- 70 items and Jean Watson’s model. A clinimetric validation study was conducted in three phases. First, the translation and cultural adjustment of the CNPI questionnaire was developed, using the translation-back translation method, by a panel of experts. Secondly, a pilot study was carried out on a sample of last-year Nursing Degree students at the University of Seville. Thirdly one, we achieved the analysis construct, criteria and internal consistency analysis. Furthermore, exploratory factorial analysis (EFA), confirmatory factorial analysis (CFA), and partial least squares (PLS) method were performed. The scores of the created questionnaire were also correlated with those obtained in another questionnaire that measures social skill competence, obtained by the same subjects of the study sample. Data were collected in 2016 from a sample of students belonging to the six teaching centres of the University of Seville. Permissions were requested, and all participants signed an informed consent. A Spanish version of the CNPI Scale was obtained and tested in a pilot study on a sample of 74 students. Using EFA, a reduced version of 28 items was made, with a dimensional structure of 8 factors and 63% explained variance. The scale reliability was α of 0. 94, ranging between 0. 62 and 0. 87 in its dimensions. This reduced version was tested again on a sample of 332 subjects. 80% were women, with an average age of 24 years. The CFA applied on these new data reduced the number of factors to 5, although the CFA did not obtain satisfactory results. Therefore, taking into account theoretical and fundamental criteria, a model of paths was built, demonstrating a lineal relationship among the 5 constructs. So, the PLS method was used, which offered, among others, a value of SRMR <0. 08, acceptable reliability values (α Cronbach, composite reliability, and mean extracted variance), demonstrating discriminant validity (HTMT <0. 85) and effect sizes of the related constructs (named factors in EFA and CFA). A structure of 5 constructs and 16 items was validated, and the questionnaire was named “Nursing Interactions in Caring - Competence Assessment (NIC_CA)". No correlation was obtained between the NIC_CA questionnaire and the questionnaire chosen as “gold standard", so the criterion validity could not be studied; however, it was made a scale of competence levels using the median and percentiles values. There was also no convergence between the scores of the NIC_CA questionnaire and those of the questionnaire that assessed social skill competence. In summary, this research provides a reliable and valid questionnaire to measure the nurse-patient competence in Nursing Degree students. There is no correlation between nurse-patient competence and social skill competence, so this is not related with higher levels of nurse-patient relationship competence or vice versa. Future researches should study the criterion validity, providing data on sensitivity and specificity, as well as consider the gender perspective in the conceptualization and execution of the behaviours and attitudes that characterize the nurse-patient relationship.