The new version of a patient classification instrument: assessment of psychometric properties

Abstract

P E R R O C A M . G . ( 2 0 1 3 ) The new version of a patient classification instrument: assessment of psychometric properties. AbstractAims. This paper assessed the reliability and construct validity of the new version of a patient classification instrument. Background. In the development of patient classification instruments, monitoring validity and reliability is essential to assure that patient care requirements and nursing staff workload are appropriately measured. Design method. The sample included 194 patients (construct validity test) and 60 patients (inter-rater reliability test) at medical, surgical, and specialized wards of a teaching hospital in the south east of Brazil. The study was conducted in 2009-2010. For analysis purposes, Spearman's correlation and Cronbach's alpha (internal consistency) were used, and weighted kappa (inter-rater reliability), factor analysis with principal axis factoring extraction method (construct validity) and ordinal regression (instrument's predictive ability). Results. A high level of inter-rater agreement was found. The importance of all care areas and their contribution to distinguish patient care needs and category in the new instrument were demonstrated. Results also showed the instrument's high predictive ability (99Á6%). Conclusion. The findings give the evidence that the new scale is a reliable and valid tool to assess patient care needs and care category and that it can be used to guide nursing management practice in determining the nursing staff workload.

Use of patients’ classification instruments: analysis of the brazilian production of knowledge

“…Content validity (2,(7)(8)(9)22) Delphi technic (2,(7)(8)(9)22) Agreement level ≥ 70% (2,(7)(8)(9)22) Neonatology (7) Psychiatry (9) Pediatrics (8,22) Perroca new version (2) 16 areas/ 3 categories (7) ; 11 areas (8) ; 11 areas/3 categories (9) ; 5 categories (22) ; Relevance, clarity and increasing level of complexity (7) Agreement: 86-100% (9) ; 85-100 (21) ; ≥ 90 (structure) and 80-96 (care areas) (2) . Construct validity (10,(20)(21)23) Principal components (21,23) Analysis of Variance (23) Discriminant analysis (21) Pearson (22) Spearman (10) Factor analysis (20) Perroca original (21,23) Psychiatry (10) Perroca new Version (20) First two factors explained 75% of the total variation (23) Discrimination: 89.1 -95.6% (21) Importance of all areas of care (20) Agreement between instruments (24) Spearman and Weighted Kappa …”

“…In the category PPE, the tests performed with the instruments to assess validity and reliability were included in various specialties (n=8): Pediatrics (n=3), Psychiatry (n=2) and Neonatology (n=1) ( Table 1). Inter-rater reliability (8,10,(17)(18)(19)(20) Kappa Coefficient (8,10,(18)(19)(20) Pearson Correlation (17,20) Between nurses (17)(18) Nurses, technician and physician versus Pediatrics PCI (19) Perroca (original) (17)(18) Psychiatry (10) Pediatrics (8,19) Perroca (new version) 20 K = 0.68-0.90 (18) ; 0.17 -0.76 (10) ; 0.69-0.84 (19) ; 0.41-0.74 and ≥ 0.75 (8) r = 0.87-0.95 (17) α = 0.87; CCI= 0.89-0.90 (20) Internal reliability and users' opinions (21) Cronbach' alpha (21) Spearman Correlation (21) Perroca original (21) α= 0.94 ; rs = 0.08 to 0.87 (21) Satisfied users; tendency to underestimate the care category (21) . Content validity (2,(7)(8)(9)22) Delphi technic (2,(7)(8)(9)22) Agreement level ≥ 70% (2,(7)…”

“…The original PCI and its new version were the most subjected to a validation process (2,6,(20)(21)(23)(24) . The psychometric properties of the PCI allows the generation of legitimate and reliable data, allowing its use in clinical practice to measure the workload of the nursing staff and to guide management decisions (20) .…”

“…The researchers used diverse tests to prove reliability and validity of the instruments: inter-rater reliability (8,10,(17)(18)(19)(20) , predictive ability (6,20) , users' opinion (21) , content validity (2,(7)(8)(9)22) and construct validity (10,(20)(21)23) . The original PCI and its new version were the most subjected to a validation process (2,6,(20)(21)(23)(24) .…”

Identification of care needs of patients with and without the use of a classification instrument

“…A Patient Classification Instrument (PCI), developed in Brazil in the late 1990s, has been subjected, over the years, to several tests to evaluate its psychometric properties (9,(12)(13) . Although the results have shown evidence of reliability and validity of the scale and that it can be used to guide management practice in determining the workload of the nursing staff (13) , it becomes important to further investigate this instrument, even though the demand for nursing care for the patient is identified by the perception of nurses.…”