Validation study of the Polish version of the Evidence-Based Practice Profile Questionnaire

Instruments measuring evidence-based practice behavior, attitudes, and self-efficacy among healthcare professionals: a systematic review of measurement properties

BACKGROUND

Evidence-based practice (EBP) is well known to most healthcare professionals. Implementing EBP in clinical practice is a complex process that can be challenging and slow. Lack of EBP knowledge, skills, attitudes, self-efficacy, and behavior can be essential barriers that should be measured using valid and reliable instruments for the population in question. Results from previous systematic reviews show that information regarding high-quality instruments that measure EBP attitudes, behavior, and self-efficacy in various healthcare disciplines need to be improved. This systematic review aimed to summarize the measurement properties of existing instruments that measure healthcare professionals' EBP attitudes, behaviors, and self-efficacy.

METHODS

We included studies that reported measurement properties of instruments that measure healthcare professionals' EBP attitudes, behaviors, and self-efficacy. Medline, Embase, PsycINFO, HaPI, AMED via Ovid, and Cinahl via Ebscohost were searched in October 2020. The search was updated in December 2022. The measurement properties extracted included data on the item development process, content validity, structural validity, internal consistency, reliability, and measurement error. The quality assessment, rating of measurement properties, synthesis, and modified grading of the evidence were conducted in accordance with the COSMIN methodology for systematic reviews.

RESULTS

Thirty-four instruments that measure healthcare professionals' EBP attitudes, behaviors or self-efficacy were identified. Seventeen of the 34 were validated in two or more healthcare disciplines. Nurses were most frequently represented (n = 53). Despite the varying quality of instrument development and content validity studies, most instruments received sufficient ( +) ratings on content validity, with the quality of evidence graded as "very low" in most cases. Structural validity and internal consistency were the measurement properties most often assessed, and reliability and measurement error were most rarely assessed. The quality assessment results and overall rating of these measurement properties varied, but the quality of evidence was generally graded higher for these properties than for content validity.

CONCLUSIONS

Based on the summarized results, the constructs, and the population of interest, several instruments can be recommended for use in various healthcare disciplines. However, future studies should strive to use qualitative methods to further develop existing EBP instruments and involve the target population.

TRIAL REGISTRATION

This review is registered in PROSPERO. CRD42020196009. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020196009.

Adaptation and validation of the Evidence-based Practice Profile Questionnaire (EBP2Q) for clinical postgraduates in a Chinese context

BACKGROUND

Evidence-based practice (EBP) is an essential approach of optimizing patient outcomes and driving progress in clinical practice. As an important reserve talent of medical staff and researchers, the clinical postgraduates are expected to become the backbones of supporting the implementation of EBP in clinical units after graduation. The assessment of their EBP learning outcomes is an important issue, yet few tools have been developed specifically in Mainland China. The purpose of this study is to adapt the Evidence-Based Practice Profile Questionnaire (EBP2Q) to Mainland China's cultural context and to evaluate the psychometric properties of the Chinese EBP2Q in clinical postgraduates.

METHODS

Cross-cultural modification, including translating the original EBP2Q into Chinese was implemented according to established guidelines. A pilot study was carried out in Mainland China among 30 clinical postgraduates. A subsequent validation study was conducted among 633 clinical postgraduates majoring in clinical medicine, stomatology and nursing from Mainland China. Construct validity was assessed by exploratory factor analysis (n = 313), together with confirmatory factor analysis (n = 320). Reliability was determined by internal consistency and test-retest reliability.

RESULTS

The Chinese EBP2Q consisted of 40 items. The content validity index of the Chinese EBP2Q achieved 0.938 at an acceptable level. Principal component analysis resulted in a four-factor structure explaining 61.586% of the total variance. All fitting indices satisfied the standard based upon confirmatory factor analyses, indicating that the four-factor structure contributed to an ideal model fit. The internal consistency appeared high for the Chinese EBP2Q, reaching a Cronbach's alpha value of 0.926. Test-retest reliability was 0.868 and the split-half coefficient was 0.925.

CONCLUSION

Chinese version of EBP2Q possesses adequate validity, test-retest reliability and internal consistency. It is a promising questionnaire to be adopted by Chinese medical educators in designing their course and curriculum, or by clinical postgraduates for self-assessment of EBP learning.

The Design and Validation of a Self-Assessment Questionnaire of Critical Appraisal of Medical Literature Skills in Medical Students

INTRODUCTION

Critical appraisal of medical literature is a challenging step of the evidence-based medicine practice. Many assessment questionnaires have been published in the literature, but they have mainly focused on all the evidence-based medicine practice process. The authors aimed to develop and validate a questionnaire assessing the critical appraisal skills of medical students from the same Faculty.

METHODS

The questionnaire was developed by item generation through a review of the literature and an expert committee. The questionnaire was validated in terms of content validity and construct validity. Fitness of data for analysis was checked through Kaiser-Meyer-Olkin (KMO) and Bartlett's sphericity. Construct validity was carried out using a principal axis exploratory factor analysis (EFA) with 'varimax' rotation to study the internal structure of the questionnaire and to extract the test major factors. The questionnaire was administrated to a cohort of under and postgraduate medical students (n=84) to evaluate the test reliability and select the best items. The reliability of the questionnaire was assessed by Cronbach's alpha coefficient to evaluate the internal consistency. The correlations between the self-confidence and satisfaction dimension score, the critical thinking dimension score, the learning style dimension score, the Fresno-adapted test scores and the total score were assessed using the Spearman's correlation test.

RESULTS

The questionnaire consisted of 31 items. A factorial analysis grouped the items into 3 dimensions that consisted of the self-confidence and satisfaction dimension, the critical thinking dimension and the learning style dimension. Cronbach's alpha accounted for 0.95, CI95% [0.9-1] for the entire questionnaire. The factor analysis explained 79.51% of the variance. The external validity assessment based on a Spearman's correlation study highlighted a weak correlation between the total scores and the critical thinking dimension and the self-perception and satisfaction dimension.

CONCLUSION

In spite of the limitations of this study, mainly the small number of the students recruited, the questionnaire seems to measure with adequate reliability the competences of under and postgraduate medical students.

Adaptação transcultural e validação do “health sciences evidence based practice questionnaire” para o português do Brasil

Introdução: o instrumento “Health Sciences Evidence Based Practice Questionnaire” avalia as diferentes dimensões da construção da prática baseada em evidência como um processo para responder às situações decorrentes da prática clínica diária. Objetivos: adaptar culturalmente o instrumento Health Sciences Evidence Based Practice Questionnaire para a língua portuguesa do Brasil e avaliar suas qualidades psicométricas. Método: Estudo metodológico. A primeira etapa compreendeu o processo de tradução e adaptação transcultural. Na segunda etapa, o instrumento Questionário de Prática Baseada em Evidências e Efetividade Clínica foi aplicado para a validação convergente, utilizando-se o índice de correlação de Pearson, nível de significância 0,05 e realizada Análise Fatorial Confirmatória (AFC), de acordo com o modelo de equações estruturais. A confiabilidade foi avaliada pelo teste-reteste, utilizando o coeficiente de correlação r de Pearson. A consistência interna obtida por meio do coeficiente alpha de Cronbach. Resultados: validade de conteúdo obtida na terceira rodada, título final: Questionário HS-EBP- Prática Baseada em Evidência nas Ciências da Saúde, aplicado em 305 profissionais da saúde. A confiabilidade foi verificada por meio do coeficiente alfa de Cronbach (0,970), similar à versão original, e da estabilidade teste-reteste pelo índice de correlação r de Pearson (r = 0,766) que indicou uma correlação forte. Para a validação convergente foi aplicado o índice de correlação de Pearson (r = 0,683) positivo e com correlação moderada entre os instrumentos. Teste Qui-Quadrado foi significativo (<0,001) para todos os modelos obtidos, em todos os modelos testados. Conclusão: o instrumento mostrou-se válido e confiável para reprodutibilidade na versão brasileira.

Sociodemographic and Work-Related Variables Affecting Knowledge of, Attitudes toward, and Skills in EBNP of Nurses According to an EBPPQ

(1) This study examines sociodemographic and work-related variables to determine their impact on the knowledge of, attitudes toward, and skills in Evidence-Based Nursing Practice (EBNP). (2) The study included 830 nurses from four voivodships in Poland, Dolnośląskie, Łódzkie, Podlaskie, and Zachodniopomorskie and was conducted by the diagnostic survey method, using the questionnaire technique. The following research tools were applied in the study: an Evidence-Based Practice Profile Questionnaire (EBPPQ) and a survey questionnaire developed by the authors, containing questions on sociodemographic data and work-related variables. (3) Sociodemographic variables with an impact on the knowledge of, attitudes toward, and skills in EBNP include age, marital status, and educational background. Older nurses find it problematic to apply EBNP, and their level of relevant knowledge and skills is lower; whereas, those with university education possess the best EBNP-related skills, and they are also more eager to expand them and apply them in their work. The work-related variables with an impact on the knowledge of, attitudes toward, and skills in EBNP among nurses include work experience, which has a negative effect on applying EBNP and the skills associated with it. The type of school from which the nurses graduated and the nursing specialisation training also have a strong impact on expanding nurses’ competence in EBNP.

Knowledge, behaviours and attitudes towards Evidence-Based Practice amongst physiotherapists in Poland. A nationwide cross-sectional survey and focus group study protocol

Objectives

Evidence-Based Practice, EBP, is recognised, along with team work and patient-centred care, as a core competency in contemporary healthcare. However, dissemination and implementation of EBP remains problematic and is dependent on various external and internal factors, from personal through institutional to systemic, factors, with specific characteristics for different professions, contexts and settings. Knowledge, behaviours, attitudes, as well as facilitators and barriers towards EBP amongst physiotherapists, have been widely explored worldwide, but never in Poland. This study is part of a nationwide project, including dissemination actions addressing EBP in physiotherapists registered in Poland. Our purpose is to explore the issues of knowledge, behaviours, experiences, and attitudes of physiotherapists in Poland towards EBP. Descriptive research studies are warranted before analytical investigations and dissemination activities are conducted.

Methods

We plan to conduct a quantitative, cross-sectional study–an online survey amongst the total population of physiotherapists registered in Poland to assess knowledge, behaviours and use of EBP (Study 1), and a qualitative study to allow physiotherapists to voice their opinions and to explore their experiences and attitudes towards EBP (Study 2). The EBP2 questionnaire, Polish validated translation, will be used for Study 1, in a web-based survey. A focus group approach will be applied for Study 2, with purposive sampling to achieve a representative picture of physiotherapists with respect to setting, specialty, seniority, educational degrees, and age. We will follow an inductive approach, using topics rather than questions.

Results

We will present the results of the studies separately, as typically presented in relevant study types: Study 1 will be reported addressing the domains and items of the EBP2, in relation to the independent variables, and Study 2 will be discussed using the themes and illustrative quotes analyses.

Discussion

We are aware that significant non-response, spin and Hawthorne effect may potentially bias our findings.

Evaluation of evidence-based practice learning among undergraduate nursing students: Relationship between self-reported and objective assessment

BACKGROUND

Self-reported scales and objective measurement tools are used to assess Evidence-based Practice (EBP) learning. An agreement between these measures has not been widely investigated among nursing students.

OBJECTIVE

The aim of the present study was to examine the relationship between EBP competency in undergraduate nursing students, defined as the capability to choose and use an integrated combination of EBP knowledge, skills and attitudes, evaluated with the self-reported EBP-COQ questionnaire and the final test score of an EBP course included in a Nursing Degree Program.

DESIGN

A cross-sectional study was carried out.

SETTINGS

University of Murcia (Spain), Nursing Degree, academic year 2019/2020.

PARTICIPANTS

The study population was comprised by 210 4th-year undergraduate nursing students enrolled in the Clinical Practice and Evidence-based Nursing course. All the students were invited to participate.

METHODS

A validated EBP-COQ questionnaire (1 "lowest score" to 5 "highest score") and an objective test (score from 0 to 10) were used to assess EBP competency. The SPSS 26.0 program was used to perform descriptive, bivariate and multivariate analyses.

RESULTS

152 students participated (response rate 72.4%), the sample was 81.4% female, and the median age was 20 years old; 76.3% attended more than 75% of the class hours. After the EBP course, the students obtained a high overall EBP competency score (mean = 4.21; SD = 0.26). The mean score on the objective test was 6.86 (SD = 1.36). A moderate positive correlation was found between the subjective and objective EBP competency measurements (Pearson's correlation coefficient 0.5; p < 0.0001).

CONCLUSIONS

Our findings contribute with new and significant evidence of the convergent validity of the EBP-COQ questionnaire, which increases the value of this instrument for evaluating the EBP competency of Nursing Degree students.

Health Sciences-Evidence Based Practice Questionnaire (HS-EBP): Normative Data and Differential Profiles in Spanish Osteopathic Professionals

The main goal of this study was to obtain normative data of the scores of the Health-Sciences Evidence Based Practice (HS-EBP) questionnaire, and to analyse evidence-based practice (EBP) among potential clusters of osteopathy professionals in Spain. An online descriptive cross-sectional study has been applied. A total number of 443 Spanish practicing osteopaths answered a survey including the 5 dimensions of the HS-EBP questionnaire and sociodemographic, training, and practice variables using the “LimeSurvey” online platform. Results point out that the median scores for each five HS-EBP questionnaire dimensions were 95.00, 86.00, 78.00, 84.00 and 62.00 considering that the range of possible scores in each of the dimensions was: from 12 to 120 in dimensions 1, 4 and 5; from 14–140 in dimension 2; and from 10–100 in dimension 3. A clustering algorithm extracted 6 different profiles across the five HS-EBP latent dimensions: low scores in all dimensions (cluster 1); low scores in all dimensions but with medium scores in dimension 1 (cluster 2); mixed pattern of scores, low in dimensions 2 and 5 and medium in the rest of the dimensions; medium scores in all dimensions (cluster 4); high scores in all dimensions and low scores in dimension 5 (cluster 5); and high scores in all dimensions (cluster 6). Significant relationship was found among the response patterns in the clusters and: academic degree level, EBP training and training level, and work time invested in healthcare activity, research and teaching activity. These results allow a description of the actual level of EBP and differential profiles of Osteopathy care practice in Spain. Knowledge of normative scores of the HS-EBP questionnaire and identification of different predictors of Spanish osteopaths’ EBP, e.g., academic degree, EBP training and training level, work time invested in healthcare activity, research, and teaching activity, and having a working relationship with an accredited educational centre, enable a comprehensive evaluation of the EBP of osteopathic professionals and can also be useful for developing and implementing formative intervention programs for improving EBP practice in osteopathic practice.

Development and validation of the Chinese version of the evidence-based practice profile questionnaire (EBP2Q)

BACKGROUND

Evidence-based practice (EBP) education or training are considered fundamental to building and strengthening an EBP culture, as well as to encouraging evidence-based academic and clinical practice in the nursing community. However, few valid and reliable instruments are available for the assessment of EBP teaching and learning in clinical nurses in China. Translation, reliability, and validity testing of the English Evidence-Based Practice Profile Questionnaire (EBP²Q), which has strong psychometric properties, may encourage evaluation and promote the implementation of EBP in Mainland China.

METHODS

Based on established guidelines for the development of questionnaires, the English EBP²Q was translated and cross-culturally adapted. The Chinese version of the EBP²Q (EBP²Q-C) was validated using a sample of 543 nurses. Structural validity was evaluated through exploratory factor analysis and confirmatory factor analysis, and the questionnaire was tested for convergent and criterion validity. The internal consistency and test-retest reliability were also evaluated.

RESULTS

The content validity index demonstrated good content validity (≥0.98). An eight-factor structure was obtained in the exploratory factor analysis, and verified by a three-order factor model from the confirmatory factor analysis (χ²/df = 2.001; RMSEA = 0.065; SRMR = 0.077; and CFI = 0.884). The Spearman's rank correlation analysis of the EBP²Q-C with the Evidence-Based Practice Questionnaire showed moderate correlations for Practice (0.58) and Confidence (0.68) and a low correlation for Sympathy (0.32). Criterion validity was demonstrated by significant differences in terms of nurses' highest education, present position, EBP training, involvement in research programs, and level of understanding of English. Both the overall Cronbach's α and the Cronbach's α for the domains exceeded 0.70. The intraclass correlation coefficients for the domains ranged between 0.75 and 0.96, indicating satisfactory repeatability.

CONCLUSIONS

Except for the convergent validity of the Sympathy domain, the EBP²Q-C provided evidence of validity and reliability. Therefore, it can be applied in EBP education or training assessment in Mainland China.

A novel measurement instrument for pressure-injury risk assessment competence: Theoretical procedures, simulation, and psychometric quality

This study developed a measuring instrument of pressure-injury risk assessment competence for nursing education adopting theoretical procedures based on competence structuration to support the psychometric quality. The objective of this study is testing the psychometric properties of the instrument using simulation strategy and to determine the instrument's standardisation and normalisation. A methodological study was designed. The instrument was developed by a content-validated theoretical construct administered to 155 undergraduate nursing students from universities in the northeast and south of Brazil using simulation. The instrument was applied over three phases: before the lecture on pressure-injury risk assessment competence, after scenario of simulation experience, and after debriefing experience. The instrument comprised 32 items. The factorial analysis found that three domains explained 64.6% and 62.18% of the total variance in post-scenario and debriefing cases. The perfect and very high discrimination index of the instrument indicated minimal differences in measured latent trait levels. It also found that reliability was excellent (0.973 and 0.967). Moreover, an equation applicable to instruments using study's theoretical procedure was proposed. The instrument was found to be a valid, accurate, and reliable educational tool for pressure-injury risk assessment competence.

Knowledge, Behaviors, and Attitudes of Polish Nurses As Compared With Evidence-Based Practice in Relation to the Guidelines of the European Resuscitation Council

Background

The emphasis on Evidence-Based Practice (EBP) is taking on new importance as the profession of nursing strives to meet the challenge of defining the direction of health care, promoting optimal outcomes, and ensuring patient safety. Therefore, Evidence-Based Practice has never been more important to nursing than in the current health-care environment.

Objective

The study was designed to assess the knowledge, behaviors, and attitudes of nurses as compared with Evidence-Based Practice in relation to the Guidelines of the European Resuscitation Council.

Methods

The study covered involved a total of 236 nurses who participated in a cardiopulmonary resuscitation course over a period of 12 months. The nurses who qualified for the study followed a complete study registration procedure.

Results

The current findings show that the lowest score was achieved in the domain of attitude toward selected Evidence-Based Practice aspects in professional work. Detailed domain questions concerned nurses’ Evidence-Based Practice and its limitations related to procedures, the lack of equipment and personnel issues, as well as the lack of scientific evidence. Furthermore, nurses saw clinical experience as being more valuable than research findings for practical decision-making than research findings, and, according to the respondents, they presented opinions that the best way to assess the effectiveness of an action was through clinical experience. In addition, the nurses gave low scores and tended to underestimate the critical literature review aspect within the domain, along with its significance for the general professional practice, believing that search for scientific evidence alone does not apply into their professional work.

Conclusions

The validated Polish version of the Evidence-Based Practice profile questionnaire is a reliable instrument. The study demonstrates that nurses are facing a multitude of limitations due to procedures, the lack of equipment, and personnel issues. Currently perceived as very poor, the ability to make critical assessments and synthesize evidence should be improved. According to the nurses, clinical experience cannot be the only and the best way to assess the effectiveness of a given measure.

Validation of self-assessment instrument for the Patient Safety Center

ABSTRACT Objective: To develop and validate an instrument for the self-assessment of the Patient Safety Centers in health care institutions. Method: Non-experimental methodological study. Divided in the following stages: literature review and construction of the preliminary instrument; content validation by nine professionals with experience in Quality Management and patient safety, who contributed to the adequacy of the items in terms of clarity and relevance; finally, 12 PSC coordinators, which conducted the reliability validation of the final instrument, using Cronbach's Alpha. Results: The instrument presented content validity regarding clarity and relevance, evidenced by an agreement level greater than 70%. The internal consistency presented high reliability, with a Cronbach's alpha of 0.857 for the general instrument, 0.825 for the domain Structure, and 0.809 for the domain Process. Conclusion: The instrument presented evidence of content validity and reliability for self-assessment, implementation and evaluation of the PSC in health institutions.