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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References
- Prevalence and risk factors for postoperative delirium in a cardiovascular intensive care unit.Am J Crit Care. 2008; 17: 567-575
- Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU).JAMA. 2001; 286: 2703-2710
- Prevalence of delirium in hospitalized patients from an internal medicine service.Medwave. 2015; 15e6311
- Occurrence of delirium is severely underestimated in the ICU during daily care.Intensive Care Med. 2009; 35: 1276-1280
- Pathophysiology of delirium in the intensive care unit.Crit Care Clin. 2008; 24: 45-65
- Intensive care unit delirium and intensive care unit–related posttraumatic stress disorder.Surg Clin North Am. 2017; 97: 1215-1235
- Long-term outcome of delirium during intensive care unit stay in survivors of critical illness: a prospective cohort study.Crit Care. 2014; 18: R125
- Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU.Crit Care Med. 2018; 46: e826-e873
- ICU delirium: a survey into nursing and medical staff knowledge of current practices and perceived barriers towards ICU delirium in the intensive care unit.Intensive Crit Care Nurs. 2014; 30: 333-338
- A questionnaire to determine nurses' knowledge of delirium and its risk factors.Contemp Nurse. 2008; 29: 23-31
- Barriers to delirium assessment in the intensive care unit: a literature review.Intensive Crit Care Nurs. 2018; 44: 99-104
- Review of nurses' knowledge of delirium, dementia and depressions (3Ds): systematic literature review.Open J Nurs. 2016; 6: 193-203
- Intensive care nurses' experiences and perceptions of delirium and delirium care.Intensive Crit Care Nurs. 2017; 40: 94-100
- Understanding terminology of delirium and long term cognitive impairment in critically ill patients.Best Pract Res Clin Anaesthesiol. 2012; 26: 267-278
- Long-term cognitive impairment after critical illness.N Engl J Med. 2013; 369: 1306-1316
- An exploratory study of staff nurses' knowledge of delirium in the medical ICU: an Asian perspective.Intensive Crit Care Nurs. 2014; 30: 54-60https://doi.org/10.1016/j.iccn.2013.08.004
- Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit.Crit Care Med. 2013; 41: 263-306
- The CAM-ICU-7 Delirium Severity Scale: a novel delirium severity instrument for use in the intensive care unit.Crit Care Med. 2017; 45: 851-857
- Concept analysis of self-efficacy.J Prof Nurs. 2000; 2: 1-7
- Social cognitive theory: an agentic perspective.Annu Rev Psychol. 2001; 52: 1-26
- Self-efficacy: toward a unifying theory of behavioral change.Psychol Rev. 1977; 84: 191-215
- The relationship between clinical competence and clinical self-efficacy among nursing and midwifery students.Int J Pediatr. 2015; 3: 1117-1125
- Self-efficacy and self-regulated learning in clinical performance of nursing students: a qualitative research.IJMS. 2008; 8: 33-41
- The effects of an interactive nursing skills mobile application on nursing students' knowledge, self-efficacy, and skills performance: a randomized controlled trial.Asian Nurs Res. 2018; 12: 17-25
- A handbook of test construction (psychology revivals): introduction to psychometric design.Taylor & Francis, London2015
- Determination and quantification of content validity.Nurs Res. 1986; 35: 382-385
- Measurement in nursing and health research.Springer Publishing Company, New York, NY2010
- Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures.Health Qual Life Outcomes. 2014; 12: 176
- Psychological testing.7th ed. Prentice-Hall, Upper Saddle River, NJ1997
- Statistics for social data analysis.3rd ed. F.E. Peacock, Itasca, IL1994
- Multivariate data analysis: a global perspective.Pearson Prentice Hall, NJ2010
- Exploratory factor analysis and principal component analysis in clinical studies: which one should you use?.J Adv Nurs. 2020; 76: 1886-1889
- The partial least squares approach to structural equation modelling.in: Marcoulides G.A. Modern methods for business research. Erlbaum, Mahwah, NJ1998: 295-336
- Measurement in health behaviour: methods for research and evaluation.John Wiley & Sons, San Francisco, CA2005
- Using multivariate statistics.5th ed. Allyn & Bacon/Pearson Education, California State University, Northridge2007
- A first course in factor analysis.2nd ed. Lawrence Erlbaum Associates, Hillsdale, NJ1992
- Intensive care delirium screening checklist: evaluation of a new screening tool.Intensive Care Med. 2001; 27: 859-864
- Measurement of perceived self-efficacy: psychometric scales for cross-cultural research.Freie University, Berlin1993
- Measuring optimistic self-beliefs: a Chinese adaptation of the general self-efficacy scale.Psychologia. 1995; 38: 174-181
- Assessment of optimistic self-beliefs: further validation of the Chinese version of the General Self Efficacy Scale.Psychol Rep. 1999; 85: 1221-1224
- Foundations of clinical research: applications to practice.3rd ed. Prentice-Hall, New Jersey2007
- Psychometric theory.McGraw-Hill, New York, NY1994
- Statistical data analysis with standard statistical programs.2nd ed. Kaan Publishing, Eskisehir, Turkey1999
- Development and validation of the nursing profession self-efficacy scale.Int Nurs Rev. 2016 Sep; 63: 455-464
- A multi-phase study for the development of a self-efficacy measuring scale for ostomy care nursing management.J Adv Nurs. 2020; 76: 409-419
- Factors associated with nurses' self-efficacy in clinical setting in Iran, 2013.Iran J Nurs Midwifery Res. 2015; 20: 226-231
- Examining relationships between socio-demographics and self-efficacy among registered nurses in Australia.Collegian. 2018; 25: 57-63
- Interprofessional education for delirium care: a systematic review.J Interprof Care. 2014; 28: 345-351
- Frontline nurse managers' confidence and self-efficacy.J Nurs Manag. 2016; 24: 533-539
Article info
Publication history
Published online: September 19, 2022
Accepted:
August 6,
2022
Received in revised form:
July 13,
2022
Received:
February 19,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.