Development and Psychometric Testing of a Tool to Measure Nursing Care Intensity for Stroke Patients

Area of Science:

• Nursing Science
• Clinical Assessment Tools
• Stroke Care Research

Background:

• Nurses are vital for stroke patient outcomes.
• Stroke nursing care is complex, necessitating tools for monitoring patient dependence and managing care efficiently.
• Existing instruments may not adequately capture the intensity of nursing care required in stroke units.

Purpose of the Study:

• To develop and psychometrically test an instrument to measure nursing care intensity for patients admitted to stroke units.
• To provide stroke care units with a reliable tool for assessing and managing patient care needs.
• To enhance the monitoring of patient dependence throughout their hospital stay.

Main Methods:

• Item generation based on the Roper-Logan-Tierney theory.
• Content validity assessment of initial items.
• Psychometric testing on 1200 stroke patients at admission and discharge, including confirmatory factor analysis, reliability, and validity assessments.

Main Results:

• The final instrument, STROKE-CNA, comprises 8 items with strong structural validity (RMSEA=0.077, CFI=0.99).
• Significant differences in scores between admission and discharge (P<.001, Cohen d=1.42) indicate longitudinal validity.
• The STROKE-CNA demonstrated adequate responsiveness, convergent validity, internal consistency (0.93), and optimal interrater reliability (Kappa 0.61-0.99).

Conclusions:

• The Chart of Nursing Assessment in Stroke (STROKE-CNA) is a valid and reliable instrument.
• It is suitable for assessing the complexity of nursing care for patients in stroke units.
• The STROKE-CNA can aid in monitoring patient dependence and optimizing care management.