Validation of a questionnaire of knowledge and attitudes about the subcutaneous venous reservoir in nursing

Raña-Rocha, Roberto; López-de-Ullibarri, Ignacio; Movilla-Fernández, María-Jesús; Carvajal, Carmen Coronado

doi:10.1590/1518-8345.3255.3250

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 28 • 2020 • https://doi.org/10.1590/1518-8345.3255.3250 copy

Validation of a questionnaire of knowledge and attitudes about the subcutaneous venous reservoir in nursing^* * The publication of this article in the Thematic Series “Human Resources in Health and Nursing: Training and Practice in the Americas” is part of Activity 2.2 of Reference Term 2 of the PAHO/WHO Collaborating Center for Nursing Research Development, Brazil. Supported by MINECO MTM2014-52876-R and MTM2017-82724-R, by the Xunta de Galicia (Competitive Reference Groups ED431C-2016-015, ED431C-2018/38 and the Singular Center of Galicia Research ED431G/01), Spain.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

design and validate a questionnaire to evaluate the knowledge and attitudes of nurses about the subcutaneous venous reservoir.

Method:

pilot test: 30 specialized care nurses. Main study: 236 nurses of primary and specialized care. Content validity was evaluated by Lawshe index, reliability by test-retest, internal consistency by Cronbach alpha, and construct validity by exploratory factorial analysis.

Results:

Items with a Lawshe index lower than 0.51 were eliminated. In the test-retest, the intraclass correlation coefficient was higher than 0.75 for all items. The Cronbach alpha of the attitude questionnaire reached 0.865. The Cronbach alpha value for knowledge was 0.750. The exploratory factor analysis identified a set of four dimensions for each part that explain 64% (attitude) to 80% (knowledge) of variability.

Conclusion:

the analysis of the reliability and validity of the questionnaire supports its use as an instrument to assess the knowledge and attitudes of nurses towards the subcutaneous venous reservoir.

Descriptors:
Vascular Access Devices; Surveys and Questionnaires; Reproducibility of Results; Health Knowledge, Attitudes, Practice; Nursing Care; Nursing Clinicians

Attitude Questionnaire				Knowledge Questionnaire
Item	Minimum value	Maximum value	Median value	Minimum value	Maximum value	Median value
1	0.4285	0.5714	0.5356	0.4285	0.7142	0.6070
2	0.4285	0.7142	0.5356	0.4285	1	0.7856
3	0.1428	1	0.5356	0.1428	0.4285^* * Maximum values obtained in the calculation of the Content Validity Index lower than the minimum required (0.51)	0.2856
4	0.4285	0.8571	0.6428	0.5714	0.8571	0.7499
5	0.2857	0.8571	0.5356	1	1	1
6	0.1428	0.7142	0.5356	0.5714	1	0.8214
7	0.2857	0.7142	0.5713	0.7142	1	0.9285
8	0.2857	0.8571	0.5356	0.7142	1	0.8571
9	0.1428	1	0.6428	0.2857	0.5714	0.3928
10	0.2857	0.8571	0.5356	0.4285	0.7142	0.6427
11	0.1428	0.8571	0.5713	0	0.4285^* * Maximum values obtained in the calculation of the Content Validity Index lower than the minimum required (0.51)	0.2499
12	0	1	0.5356	0.1428	1	0.5357
13	-0.8571	0.7152	-0.3571	0.5714	0.8571	0.7499
14	-0.5714	0.5714	-0.1428	0.4285	0.7142	0.6427
15	0.2857	0.8571	0.5356	0.5714	0.8571	0.6785
16	0.1428	0.8571	0.5356

	Attitude Questionnaire			Knowledge Questionnaire
Item	ICC^* * ICC = Intraclass Correlation Coefficient;	IC^† † CI = Confidence Interval 95%		ICC^* * ICC = Intraclass Correlation Coefficient;	CI^† † CI = Confidence Interval 95%
1	0.793	0.610	0.896	0.880	0.763	0.941
2	0.952	0.902	0.977	0.786	0.598	0.892
3	0.901	0.802	0.952	0.896	0.794	0.949
4	0.953	0.904	0.957	0.910	0.820	0.956
5	0.864	0.734	0.933	0.971	0.939	0.986
6	0.954	0.905	0.978	0.921	0.840	0.961
7	0.940	0.878	0.971	0.822	0.659	0.911
8	0.905	0.810	0.953	0.893	0.787	0.947
9	0.860	0.727	0.931	0.902	0.804	0.952
10	0.874	0.753	0.938	0.937	0.871	0.969
11	0.920	0.,839	0.961	0.921	0.841	0.962
12	0.869	0.743	0.935	1	1	1
13	0.925	0.848	0.963	0.843	0.697	0.922
14	0.935	0.868	0.968
15	0.933	0.865	0.968
16	0.885	0.773	0.944

Item	Factor 1^* * Factor 1 = Training in the management of the subcutaneous venous reservoir ;	Factor 2^† † Factor 2 = Theoretical framework of subcutaneous venous reservoir management;	Factor 3^‡ ‡ Factor 3 = Influence of infrequent situations;	Factor 4^§ § Factor 4 = Nursing skills ;	Communality
Is the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; a device that is used in patients who need long-lasting venous access?	0.05	0.84^¶ ¶ Burdens that characterize each factor	0.04	0.24	0.87
Is the administration of anti-tumour drugs the most prominent application of SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; ?	-0.04	0.95^¶ ¶ Burdens that characterize each factor	0.05	-0.14	0.88
Is it possible to draw blood repeatedly using the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; ?	0.87^¶ ¶ Burdens that characterize each factor	-0.13	0.12	0.15	0.83
Is it necessary to wash the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; after administering blood products?	0.87^¶ ¶ Burdens that characterize each factor	-0.01	0.11	0.12	0.89
Is it necessary to perform heparinization on a regular basis even if the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; is not being used?	0.84^¶ ¶ Burdens that characterize each factor	0.11	-0.15	-0.04	0.75
Is it always necessary to insert the needle into the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; using a sterile technique?	0.65^¶ ¶ Burdens that characterize each factor	0.30	0.06	-0.44	0.69
Is it possible to fix the needle in the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; for 12 hours if it is not going to be used in this time?	0.06	0.06	0.94^¶ ¶ Burdens that characterize each factor	0.08	0.95
Is swimming contraindicated in patients with SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; ?	-0.03	0.00	0.98^¶ ¶ Burdens that characterize each factor	-0.10	0.95
Are the electromagnetic waves emitted by the microwave detrimental to the proper functioning of the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; ?	-0.04	0.51^¶ ¶ Burdens that characterize each factor	0.26	0.22	0.43
Is body image disorder a nursing diagnosis frequently suffered by SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; users?	0.09	0.11	-0.07	0.85^¶ ¶ Burdens that characterize each factor	0.82
Do I consider the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; of exclusive use of onco-haematological units?	0.43	0.04	0.17	0.58^¶ ¶ Burdens that characterize each factor	0.78
Do I have training on the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; ?	0.45	0.50^¶ ¶ Burdens that characterize each factor	-0.19	0.15	0.73
Do I consider that it is necessary to have training for the management of the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; ?

Item	Factor 1^* * Factor 1 = Unsafe management of the subcutaneous venous reservoir;	Factor 2^† † Factor 2 = Loss of decision-making autonomy ;	Factor 3^‡ ‡ Factor 3 = Arousal of conflicts in the working environment ;	Factor 4^§ § Factor 4 = Bonding to the workplace;	Communality
I am allowed to use/management of the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; in my unit.	-0.69^¶ ¶ Burdens that characterize each factor	0.23	-0.15	0.14	0.56
If I have a patient with SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; , I check with the patient's responsible doctor to see if I can use it.	0.08	0.71^¶ ¶ Burdens that characterize each factor	0.09	-0.03	0.60
In my unit or work center, I have the adequate material resources for the management of the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; .	-0.09	0.02	0.04	0.75^¶ ¶ Burdens that characterize each factor	0.58
The protocol for the use and handling of the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; is available to me in my unit or work center.	0.07	-0.01	-0.02	0.76^¶ ¶ Burdens that characterize each factor	0.59
I use a peripheral pathway if the patient's attending doctor considers that I should not use the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; for a purpose different from the one that caused the indication.	0.00	0.79\|^¶ ¶ Burdens that characterize each factor	0.07	0.02	0.66
In case I need to use the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; , I advise a nurse who is accustomed to handling this type of device to help me.	0.62^¶ ¶ Burdens that characterize each factor	0.38	-0.07	0.01	0.63
I consider that only personnel accustomed to operate this type of device may operate it.	0.47^¶ ¶ Burdens that characterize each factor	0.46	0.02	0.06	0.59
The fear of damaging the device is one of the reasons why I would not use the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; .	0.46^¶ ¶ Burdens that characterize each factor	0.45	0.11	-0.03	0.66
I consider it safer for the patient to use a central pathway in front of the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; .	0.77^¶ ¶ Burdens that characterize each factor	-0.02	0.14	0.14	0.75
I'd rather use a peripheral pathway than handle the SVRS^\|\| \|\| SVR = Subcutaneous Venous Reservoir; .	0.69^¶ ¶ Burdens that characterize each factor	0.14	0.12	-0.08	0.68
I had a patient with SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; who didn't allow me to operate the device.	0.06	0.19	0.58^¶ ¶ Burdens that characterize each factor	-0.06	0.48
I have worked in teams where the doctor responsible for the patient has not allowed me to use the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; .	-0.11	0.30	0.75^¶ ¶ Burdens that characterize each factor	-0.02	0.66
I have worked in teams where my own colleagues have not allowed me to use the SVR^\|\| \|\| SVR = Subcutaneous Venous Reservoir; .	0.22	-0.20	0.81^¶ ¶ Burdens that characterize each factor	0.08	0.87

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Carmen Coronado Carvajal E-mail: carmen.coronado@udc.es https://orcid.org/0000-0002-4824-6902