Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Reliability and Validity of an Instrument Assessing Advance Directives for Nurse

간호사의 사전의사결정 태도측정 도구의 신뢰도 및 타당도 검증

  • Cheon, Hojung (Palliative Care Unit, Pusan National University Hospital) ;
  • Kim, Eunha (College of Nursing, Catholic University of Pusan)
  • 천호정 (부산대학교병원 호스피스병동) ;
  • 김은하 (부산가톨릭대학교 간호학과)
  • Received : 2019.04.18
  • Accepted : 2019.08.13
  • Published : 2019.09.01
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Abstract

Purpose: This methodological study was conducted to test the reliability and validity of an instrument that measures attitudes of advance directives (ADs) among nurses. Methods: 1) Sixteen items related to attitudes in the English version of the Knowledge, Attitudinal, and Experiential Survey on Advance Directives (KAESAD) were forward/backward translated into Korean. 2) The content was validated by an expert panel (three nursing professors and eight hospice nursing specialists). 3) The preliminary 12 items were selected as a tool to assess the Korean version of Nurses' Attitudes towards Advance Directives (NAAD-K). 4) The instrument was validated by a survey (n=216). 5) It was confirmed to use the 12 items for the final version of the instrument. Results: NAAD-K was shown to be valid in terms of factors, items and content. The three factors extracted from the factor analysis were named as follows: Caring for patients with an AD (factor 1), nurses' role in informing patients (factor 2) and patient right (factor 3). The three factors explained total variance 57.796%. Factor loadings of the 12 items ranged from 0.47 to 0.93. For the 12 items, Cronbach's alpha was 0.81, and Guttman split-half coefficient was 0.78. Conclusion: This instrument was identified to be applicable with satisfactory reliability and validity for further use in measuring nurses' attitudes towards ADs in hospice and palliative care.

목적: 사전의사결정에 관한 간호사의 태도를 측정하기 위한 도구의 신뢰도와 타당도를 검증하기 위해 수행하였다. 방법: 본 연구는 1) KAESAD 도구 중에서 사전의사결정 태도를 측정하는 문항을 우리나라 실정에 맞게 한국어로 번안, 2) 예비문항의 작성, 3) 내용타당도 검증, 4) 신뢰도와 타당도 검증, 5) 최종문항 선정과정에 따른 방법론적 연구이다. 결과: 요인분석을 통해 추출된 3개의 요인은 다음과 같이 명명하였다. 요인 1은 '환자 돌봄의 원칙', 요인 2는 '환자 권리의 보호', 요인 3은 '환자 의견의 존중' 이었다. 이 요인들은 총 변량의 57.79%를 설명하였고, Cronbach's ${\alpha}=0.81$, Guttman 반분 신뢰도 계수는 0.78로 나타났다. 결론: 본 도구의 신뢰도와 타당도는 체계적인 방법으로 적합성이 검증되었으므로 호스피스 완화의료 분야에서 사전의사결정에 관한 간호사의 태도를 평가하는 다른 연구에 활용 가능할 것이다.

Keywords

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