Development of a Questionnaire for Measuring Trauma-Informed Care of Nurses Working with Traumatically Injured Patients

Figures & data

Figure 1 The process of questionnaire development.

Table 1 Kaiser–Meyer–Olkin (KMO) and Bartlett’s Test of Sphericity

Kaiser-Meyer-Olkin Measure of Sampling		0.918
Bartlett’s test of sphericity	Approx. Chi-Square	9055.549
	Sig.	0.000

Table 2 Factor Analysis of the Items

Items	Description	Factors
		1	2	3
K1	Traumatic injured events can affect an individual’s emotional regulation, such as uncontrollable crying, anger, fear, numbness, etc.			0.771
K2	Traumatic injured events can affect individual’s behavior, such as temper tantrums, impulsiveness, compulsivity, social withdrawal, etc.			0.854
K3	Traumatic injured events can affect cognitive function, such as memory loss, lack of concentration, confusion, negative self-concept, and inability to make decisions.			0.754
K4	Traumatic injured events can affect individual values, such as the prioritization of life’s important events.			0.769
K5	Severe traumatic injured events can trigger acute stress response, manifesting as psychomotor arousal (eg, intense fearful experiences) or psychomotor inhibition (eg, stupor).			0.806
K6	The symptoms of acute stress response are often short-lived, usually resolving within a few days or a week, and have a good prognosis, which are normal individual response to stress events.			0.838
K7	A severe traumatic injured event may trigger a traumatic stress disorder (PTSD) characterized by persistent flashbacks, avoidance, persistent anxiety, and hyper-vigilance. Some individuals may also have addictive behaviors, aggressive behavior, self-harm, or suicide attempts.			0.729
K8	After traumatic injured events, some individuals can quickly recover their psychosocial functioning or even achieve post-traumatic growth, but some individuals may experience long-term adverse effects on their psychosocial functioning.			0.736
A1	I should care for traumatic injured patients, relieve their mental stress, and help them to gain a sense of psychological security.		0.781
A2	I should respect the cultural needs, ethnicity, gender, age, religious beliefs, and values of traumatic injured patients.		0.766
A3	I should have the trauma information as much as possible so as to provide the appropriate medical care for the traumatic injured patient.		0.78
A4	For the psychological problems of traumatic injured patients, I believe it need the collaboration of nurses, doctors, psychiatrists, counsellors, social workers and family members.		0.786
A5	Hospital needs to provide nurses training or education related to trauma-informed care for traumatically injured patients.		0.774
A6	I want to learn and master the psychological trauma assessment and screening tools for traumatically injured patients.		0.825
A7	I want to get the latest evidence and researches related to the trauma-informed care for traumatically injured patients.		0.856
A8	I believe that the traumatically injured patients have the potential to cope with the traumatic event.		0.869
A9	I want to master psychological trauma interventions for traumatically injured patients.		0.865
A10	I understand the traumatically injured patients’ emotional reactions.		0.751
P1	I learn from patients or families about their trauma experiences in a respectful and professional manner without re-traumatizing them.	0.777
P2	I assess whether the traumatically injured patient has the past trauma history, mental disease, substance abuse, or other potential risk factors for post-traumatic stress disorder (PTSD).	0.83
P3	After the traumatic injury, I assess the patient’s psychological state by observation, talking or psychological scales to access the psychological impact.	0.816
P4	As taking care of traumatically injured patients with psychological trauma, I avoid irritate them with inappropriate words and behaviors.	0.807
P5	In a propriate time, I instruct the traumatically injured patients or their family members how to seek professional services such as psychiatric consultation, psychotherapy, psychological counselling, etc.	0.798
P6	I help traumatically injured patients to get peer support (face-to-face, internet, symposium).	0.824
P7	I teach traumatically injured patients relaxation techniques to relieve their negative emotions (eg, deep breathing, muscle relaxation, meditation).	0.836
P8	I give instructions for the traumatically injured patients or their family about the symptoms and recovery process of traumatic stress reactions.	0.905
P9	I assess the cultural needs of traumatically injured patients and provide culturally sensitive care.	0.746
P10	I avoid denying or blaming the traumatically injured patient’s emotions.	0.829
P11	I explore and acknowledge the positive resources of the traumatically injured patients, such as important person in life, will to survive, strong character traits, resilient character, hobbies, etc.	0.855
P12	I collaborate with professionals, such as counselors, psychiatrists, social workers, and help provide necessary referrals for traumatically injured patients as needed.	0.871

Notes: K=TIC knowledge, A=TIC attitude, P=TIC practice.

Figure 2 Scree plot.

Table 3 Internal Consistency: Cronbach’s Alpha Coefficients

Dimensions	Numbers of Expression	Cronbach’s Alpha Coefficients
The first factor (TIC knowledge)	8	0.918
The second factor (TIC attitude)	10	0.948
The third factor (TIC practice)	12	0.962
Total score	30	0.939

Table 4 Split-Half Reliability

Variable	Numbers of Expression	Split-Half Reliability
The first part	15	0.942
The second part	15	0.94
Guttman’s half coefficient	/	0.655