Developing and testing instruments to measure client outcomes at the Comox Valley Nursing Center

Area of Science:

• Nursing Practice
• Primary Health Care
• Health Outcomes Assessment

Background:

• A Canadian Nursing Centre aimed to showcase primary health care nursing outside traditional agency constraints.
• A multimethod evaluation was conducted, necessitating a client questionnaire to capture the center's impact.
• Existing instruments were inadequate for the center's diverse clients and varied outcomes.

Purpose of the Study:

• To develop and validate a client questionnaire to assess the impact of a nursing center and nurses' work.
• To measure client outcomes across physical, emotional, situational, and community dimensions.
• To evaluate client satisfaction and overall health status.

Main Methods:

• Minimally structured client interviews informed the development of a new instrument.
• Qualitative feedback assessed the validity and reliability of selected instruments for the client population.
• A five-instrument questionnaire, including the developed Nurses' Work and Client Outcomes Questionnaire (NWCOQ), was piloted and administered to all clients over seven months.

Main Results:

• The NWCOQ effectively captured the nature of nursing work and client changes in physical, emotional, and community health.
• Clients reported high satisfaction with the nursing center and experienced numerous positive health outcomes.
• The NWCOQ demonstrated content validity and internal consistency reliability.

Conclusions:

• Qualitative methods are highly recommended for developing and refining quantitative instruments for diverse populations.
• This approach is feasible even with limited timeframes for outcome measurement.
• The developed questionnaire provides valuable insights into nursing practice and client health outcomes in primary care.