Abstract
BackgroundThe use of guidelines has shown to improve clinical practice process and structure of health care, but health care providers don’t always use and keep up-to-date with the new clinical practice guidelines. Nurses’ attitudes towards guidelines have shown to be the most frequently identified factor affecting their actual use of clinical practice guidelines, but no instruments for measuring it are available in China. There are scales validated in the western countries, but there is no information about their validity in Chinese health care. The purpose of this study is to test the validity and reliability of Chinese Attitudes towards guidelines - scale for nurses.MethodsThe study was conducted from April to July 2017. The Attitudes towards guidelines scale was translated into Chinese with forward-backward translation method and a questionnaire survey was conducted. Eight hundred randomly selected nurses (final N = 768) from Geriatrics, Internal medical and Rehabilitation departments of 16 hospitals were drawn in Sichuan province, China. Construct validity was evaluated by exploratory and confirmatory factor analysis, and reliability was assessed by test-retest reliability (represented by intra class correlation) and internal consistency (expressed by Cronbach’s coefficients). The test-retest reliability was examined with a sample of 32 clinical nurses who filled out the questionnaire 14 days after the first survey.ResultsExploratory factor analysis supported a four-factor model for the Chinese version of the scale. Confirmatory factor analysis indicated that the hypothetical four-factor model fitted the data relatively well. The intra class correlation coefficient was 0.85 (95%CI, 0.68–0.93) and the Cronbach’s alpha values for the four subscales ranged from 0.645 to 0.912.ConclusionsThe results support the acceptable level of validity and reliability of the Chinese version of Attitudes towards guidelines scale, which can be used to assess nurses’ attitudes towards guidelines in China. Future testing for the Chinese version of Attitudes towards guidelines scale needs to be carried out to see whether these results are generalizable to other professionals and occupational groups and to be used to revise attitudes towards specific guidelines in China.
Highlights
The use of guidelines has shown to improve clinical practice process and structure of health care, but health care providers don’t always use and keep up-to-date with the new clinical practice guidelines
Clinical practice guidelines are evidence-based tools for standardized treatment programs which can bridge the gap between science and practice and help health care providers conduct evidence-based clinical decisions [1]
There is a lack of validated instruments measuring the attitudes towards guidelines that is suitable for Chinese health care system, there are more than 3.5 million registered nurses in China
Summary
The use of guidelines has shown to improve clinical practice process and structure of health care, but health care providers don’t always use and keep up-to-date with the new clinical practice guidelines. Nurses’ attitudes towards guidelines have shown to be the most frequently identified factor affecting their actual use of clinical practice guidelines, but no instruments for measuring it are available in China. Since nurses are the largest occupational group of health care providers, many studies have done to explore the factors that affect nurses’ use of guidelines [6,7,8,9,10,11,12]. An integrative review of 16 related articles examining the barriers and facilitators of nurses’ use of clinical practice concludes that the most frequently identified barriers and facilitators of nurses’ use of guidelines are their attitudes and perceptions towards guidelines [13]. There is a lack of validated instruments measuring the attitudes towards guidelines that is suitable for Chinese health care system, there are more than 3.5 million registered nurses in China
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