Validation of Nurse Practitioner Primary Care Organizational Climate Questionnair

政策制定者、卫生保健组织和卫生专业人员呼吁扩大护士人数 初级保健从业者队伍，以确保美国公众及时获得医疗服务。然而，许多人 有效的护士从业者初级保健实践存在障碍，包括组织上的障碍 水平，而且缺乏可靠和有效的工具来衡量组织气氛以确定 从护士从业者的角度来看，这些障碍。初级保健机构中的护理从业人员 气候调查问卷(NP-PCOCQ)是通过文献综述、对现有气候问题的调查而编制的 工具，护士从业人员焦点小组数据，内容验证，和预试。五个领域 建议护士从业者感受到潜在的组织氛围：a)自主性，b) 职业地位、c)赋权、d)联合领导和e)政策。每个NP-PCOCQ分量表测量 一个组织气氛领域，通过询问护士从业者对他们对 4分量表从强烈不同意到强烈同意。这项研究的目的是考察 NP-PCOCQ的心理测量学特征，并进一步完善和验证该调查工具。特定的 目标包括1)检查每个分量表上的项目是否测量符合预期结构的 使用验证性因素分析的护士从业者的数据。2)进一步调查和确定 运用项目反应理论模型构建量表的效度。横断面调查 来自马萨诸塞州健康质量合作伙伴的护士从业人员样本设计 将使用马萨诸塞州提供商数据库。样本将包括执业护士。 马萨诸塞州的初级保健机构(n=713)。每位护士从业者将收到一份邮寄的调查问卷。 附同意见书及同意书，说明研究目的、作为参与者的权利及 他们回复的机密性和匿名性。他们将被要求完成调查并将其返回到 研究团队。将启动明信片提醒和二次邮寄，以提高回复率。 将使用SPSS、LISREL和MULTILOG统计软件进行数据输入和数据分析。各别 将使用验证性因子分析对每个组织气候领域进行模型评估，以 演示每个分量表中的测量如何测量预期的结构。然后用Samejima的 项目反应理论中的分级反应模型每个项目的特征将是 调查过了。这些分析程序将评估判别、收敛和结构效度， 并将产生样本不变参数。NP-PCOCQ可用于各种护理群体 实践者对不同练习地点和组织的气氛进行有意义的比较 各国增加了该文书的效用。

Policy makers, health care organizations, and health professionals are calling for expansion of nurse practitioner workforce in primary care to assure timely access for the American public. However, many obstacles to effective nurse practitioner primary care practice exist, including barriers at the organizational level, and there is lack of reliable and valid instruments to measure organizational climates to identify those barriers from nurse practitioners' perspectives. The Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ) is being developed through literature review, investigation of existing instruments, nurse practitioner focus group data, content validation, and pretesting. Five domains underlying organizational climate perceived by nurse practitioners are proposed: a) autonomy, b) professional status, c) empowerment, d) collegiality, and e) policy. Each NP-PCOCQ subscale measures one organizational climate domain through items asking nurse practitioners to rate their perceptions on a 4-point scale from strongly disagree to strongly agree. The purpose of this study is to examine the psychometric properties of NP-PCOCQ, and further refine and validate this survey instrument. Specific aims include 1) To examine whether the items on each subscale measure the intended construct fitting the data from nurse practitioners utilizing confirmatory factor analysis. 2) To further investigate and establish construct validity of the instrument through using item response theory models. A cross-sectional survey design with a sample of nurse practitioners from the Massachusetts Health Quality Partners Massachusetts Provider Database will be used. The sample will include nurse practitioners practicing in primary care settings in Massachusetts (n=713). Each nurse practitioner will receive a mail survey along with a cover letter and consent form explaining the study purpose, their rights as participants, and the confidentiality and anonymity of their responses. They will be asked to complete the survey and return it to the research team. Post card reminders and second mailing will be initiated to increase the response rate. SPSS, LISREL, and MULTILOG statistical software will be used for data entry and data analysis. Separate models will be estimated using confirmatory factor analysis for each organizational climate domain to demonstrate how the measures in each subscale measure the intended construct. Then using Samejima's Graded Response model in Item Response Theory the characteristics of each individual item will be investigated. These analytical procedures will assess the discriminant, convergent, and construct validity, and will produce sample invariant parameters. NP-PCOCQ may be used with various groups of nurse practitioners for conducting meaningful comparisons of organizational climates across practice sites and states increasing the utility of the instrument.