Evaluation of Reliability and Validity regarding the “Structural Items of Protocol for Percutaneous Endoscopic Gastrostomy Removal for Older People” in Nursing Practice

Abstract

　Purpose:　The purposes of this study were to clarify the reliability and validity of the score of practice using the “Structural Items of Protocol for Percutaneous Endoscopic Gastrostomy Removal for Older People” among the nurses working in long-term institutions and in an acute geriatric hospital.

　Methods:　The subjects analyzed in this study were 372 nurses working in long-term institutions and 339 nurses working in an acute care hospital specialized in the elderly.

　The method was to create and use an index to evaluate the “practical level” of nurses by the “Structural Items of Protocol for Percutaneous Endoscopic Gastrostomy Removal for Older People” (hereafter “Structural Items for Removal of PEG”). This evaluation structural index consists of criteria for 1) initiation of oral administration, 2) face sheet, 3) assessment sheet, and 4) care sheet, and answers to each item were obtained using a 4-point Likert Scale. Furthermore, answers to “Case Management Index of Dysphagia (26 items, a 5-point Likert Scale) ” and “Degree of Case Management for Dysphagic Patients” (hereafter “Case Management for Dysphagic Patients”) by Visual Analogue Scale (VAS, 1 item) were also obtained. Regarding the analysis method, the reliability of this evaluation index was verified by internal consistency, and the validity was verified by criterion-related validity and construct validity. This study was performed with the approval of the ethics review committee of each related institution.

　Results:　The overall score of Cronbach’s coefficient in all items of each sheet of the “Structural Items for Removal of PEG” was 1) 0.916, 2) 0.969, 3) 0.982, and 4) 0.977 in the long-term institutions and 1) 0.921, 2) 0.977, 3) 0.983, and 4) 0.975 in the acute geriatric hospital, respectively. Regarding the validity of both groups, there was a significant correlation between the total score of each major item of the “Structural Items for Removal of PEG” and the score of all items and the “Case Management for Dysphagic Patients,” or the total score of major items of the case management index for dysphagia and the score of all items (p＜0.001).

　Discussion:　As described above, the reliability and validity of the “Structural Items for Removal of PEG” in nursing practice were statistically evaluated.