Validation and Evaluation of the Core Nursing Outcomes Evaluation System for Inpatients with Stroke

To evaluate the reliability, validity, responsiveness, importance, and application level of the Core Nursing Outcomes Evaluation System for inpatients with stroke.

The reliability, validity, responsiveness, importance, and application level were evaluated by expert scoring, clinical measurement, and questionnaire survey.

The scale-level content validity index (S-CVI) and item-level content validity index (I-CVI) were >0.8. The scoring of intraclass coefficient of all indicators was >0.600 (p < .001). There were significant differences in the total scores among patients with different severities (p < .001). Compared with total scores at admission, the total scores at discharge were significantly improved (p < .01). The importance and application level scores of all indexes are >4.5 points.

The system has higher reliability, validity, responsiveness, and importance, but the application of each dimension is disproportionate. Stroke is an acute cerebrovascular disease characterized by cerebral ischemia and hemorrhagic injury. Epidemiological findings revealed that stroke is the second leading cause of death and the leading cause of disability in the world (Feigin et al., 2014). Epidemiological survey of 600,000 people in China showed that the prevalence of stroke has been increasing over the past 30 years (Sun & Wang, 2018). At present, stroke has become the first cause of death among Chinese residents (Wang, 2018; Zhou et al., 2016). In surviving patients with stroke, more than 60% of patients had different degrees of neurological dysfunction (Wang, Liu, Yang, Peng, & Wang, 2018), about 40% of them had severe disabilities (You & Wu, 2016). About 60% of first onset stroke patients were associated with higher risk of recurrence (Wang et al., 2018). With increasing age, the global burden of stroke is becoming heavier and heavier (Johnston, Mendis & Mathers, 2009). In 2015, the cost of stroke treatment in China reached about 29.2 billion RMB, bringing heavy economic burden to families as well as society (Ma, 2018). From the above data, we deduced that stroke has characteristics of high prevalence rate, high disability rate, high mortality rate, and high recurrence rate. It is one of the important causes of death and disability, seriously threatening human health and has become an important public health problem faced by Chinese society currently.