Hightlight
- •Home-visit nursing plays important roles to support increasing number of CMC.
- •Home-visit nursing quality indicator guidelines exclusive to CMC are needed.
- •Developed Home-visit Nursing Quality Indicators for Children with medical complexity.
Abstract
Purpose
This study aims to examine the reliability and validity of Home-visit Nursing Quality
Indicators for Children (HNQIC) with medical complexity in Japan that will enable
measuring the quality of services provided by home-visit nursing agencies (HNA) for
children with medical complexity (CMC) and their families.
Design and methods
This study employed a model that measures medical quality as proposed by Donabedian
in a conceptual framework. The HNQIC is comprised of a total of 42 items with responses
in 5-point Likert scale: 8 items in “Structure”, 24 items in “Process”, and 10 items
in “Outcome”. A self-rating questionnaire survey was administered and responses from
57 home-visit nursing agencies were analyzed. An exploratory factor analysis was performed
to examine the validity of the construct, and a covariance structure analysis was
performed to examine the structural validity of the model that measures medical quality.
Results
The “Structure” and “Process” sections included 28 items in 5 factors, and the “Outcome”
section included 7 items in 3 factors. The Cronbach's α coefficient for all of the
items of “Structure” and “Process” was 0.93, and that of “Outcome” was 0.76. As a
result of a covariance structure analysis, we obtained following goodness-of-fit indices:
χ2 / df = 1.41, GFI = .897, AGFI = .794, CFI = .926, and for the coefficient of determination
.14 ≤ R2 ≤ .68.
Conclusions
As the statistical validity of the HNQIC was confirmed, we determined the goodness-of-fit
indices of the model to be acceptable.
Practice implications
The findings suggested that the HNQIC can be used as a quality indicator to access
care effects objectively to provide better support.
Keywords
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Article info
Publication history
Published online: December 21, 2021
Accepted:
November 27,
2021
Received in revised form:
November 14,
2021
Received:
August 30,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
