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Self-efficacy of caring for patients in the intensive care unit with delirium: Development and validation of a scale for intensive care unit nurses

  • Yu-Ling Chang
    Affiliations
    School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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  • Ming-Ju Hsieh
    Affiliations
    School of Medicine, Chang Gung University, Taoyuan, Taiwan

    Department of Thoracic and Cardiovascular Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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  • Yu-Che Chang
    Affiliations
    School of Medicine, Chang Gung University, Taoyuan, Taiwan

    Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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  • Shu-Ling Yeh
    Affiliations
    Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan

    Department of Nursing, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
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  • Shao-Wei Chen
    Affiliations
    Department of Thoracic and Cardiovascular Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Department of Thoracic and Cardiovascular Surgery, & Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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  • Yun-Fang Tsai
    Correspondence
    Corresponding author at: School of Nursing, Chang Gung University, No. 259, Wenhua 1st Rd., Taoyuan City 333, Republic of China (Taiwan)
    Affiliations
    School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan

    Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
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Published:September 19, 2022DOI:https://doi.org/10.1016/j.aucc.2022.08.006

      Abstract

      Background

      Improving the self-efficacy of intensive care unit nurses for delirium care could help them adapt to the changing situation of delirium patients. Validated measures of nurses' self-efficacy of delirium care are lacking

      Objectives

      The objective of this study was to develop a Delirium Care Self-Efficacy Scale for assessing nurses' confidence about caring for patients in the intensive care unit and to examine the scale's psychometric properties.

      Methods

      Draft scale items were generated from a review of relevant literature and face-to-face interviews with intensive care unit nurses; content validity was conducted with a panel of five experts in delirium. A group of nurses were recruited by convenience sampling from intensive care units (N = 299) for item analysis of the questionnaire, assessment of validity, and reliability of the scale. Nurse participants were recruited from nine adult critical care units affiliated with a hospital in Taiwan. Data were collected from August 2020 to July 2021.

      Results

      Content validity index was 0.98 for the initial 26 items, indicating good validity. The critical ratio for item discrimination was 14.47–19.29, and item-to-total correlations ranged from 0.67 to 0.81. Principal component analysis reduced items to 13 and extracted two factors, confidence in delirium assessment and confidence in delirium management, which explained 66.82% of the total variance. Cronbach's alpha for internal consistency was 0.94 with good test–retest reliability (r = 0.92). High scale scores among participants were significantly associated with age (≥40 years), work experience in an intensive care unit (≥10 years), delirium education, and willingness to use delirium assessment tools.

      Conclusions

      The newly developed Delirium Care Self-Efficacy Scale demonstrated acceptable reliability and validity as a measure of confidence for intensive care nurses caring for and managing patients with delirium in the intensive care unit.

      Keywords

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