Development and Validation of the Missed Nursing Care Tool for Pre-Operative Patients with Lung Cancer in China

Figures & data

Table 1 Characteristics of Samples

	N (%)
	The First Stage (n=494)	The Second Stage (n=50)	The Third Stage (n=309)
Relationship between you (filler) and the patient
The patient	414 (83.82%)	41 (82.00%)	256 (82.85%)
Patient’s family	80 (16.18%)	9 (18.00%)	53 (17.15%)
Patient Gender
Male	252 (50.81%)	23 (46.00%)	148 (47.89%)
Female	242 (49.19%)	27 (54.00%)	161 (52.10%)
Patient’s Illness Time
<Half year	3 (0.65%)	1 (2.00%)	2 (0.65%)
0.5–1 year	331 (66.99%)	34 (68.00%)	212 (68.61%)
1–3 year	160 (32.36%)	15 (3.00%)	95 (30.74%)
Patient Age
<25	14 (2.59%)	1 (2.00%)	8 (2.59%)
25–34	30 (5.83%)	1 (2.00%)	18 (5.83%)
35–44	119 (23.95%)	11 (22.00%)	71 (22.98%)
45–54	183 (36.89%)	19 (38.00%)	111 (35.92%)
55–64	141 (28.48%)	12 (24.00%)	90 (29.13%)
65–74	7 (2.27%)	6 (12.00%)	12 (3.88%)
Patient’s Marital Status
Single	2 (0.32%)		2 (0.65%)
Married and childless	4 (0.97%)		4 (1.29%)
Married with children	452 (91.59%)	47 (94.00%)	285 (92.23%)
Divorced	23 (4.53%)	3 (6.00%)	14 (4.53%)
Widowed	13 (2.59%)		4 (1.29%)
Patient Residence
Urban area	173 (34.95%)	18 (36.00%)	108 (34.95%)
County/Suburb	249 (50.49%)	26 (52.00%)	160 (51.78%)
Rural	72 (14.56%)	6 (12.00%)	41 (13.27%)
Patient Education Level
(Semi) illiterate	157 (31.72%)	17 (34.00%)	98 (31.72%)
Primary school	13 (2.59%)	1 (2.00%)	8 (2.59%)
Junior high school	23 (4.53%)	2 (4.00%)	14 (4.53%)
High school	80 (16.18%)	7 (14.00%)	53 (17.15%)
College	134 (27.18%)	11 (22.00%)	84 (27.18%)
Undergraduate	79 (16.18%)	8 (16.00%)	50 (16.18%)
Postgraduate	8 (1.62%)	4 (8.00%)	2 (0.65%)
Patient’s Religious Beliefs
None	347 (60.52%)	29 (58.00%)	187 (60.52%)
Buddhism	95 (22.65%)	10 (2.00%)	68 (22.01%)
Christianity	22 (7.12%)	4 (8.00%)	25 (8.09%)
Other	30 (9.71%)	7 (14.00%)	29 (9.39%)
Does the patient smoke
Yes	264 (46.6%)	24 (48.00%)	144 (46.60%)
No	230 (53.4%)	26 (52.00%)	165 (53.40%)
Whether the patient drinks alcohol
Yes	263 (52.75%)	27 (54.00%)	162 (52.43%)
No	231 (47.25%)	23 (46.00%)	147 (47.57%)
Exercise
Exercise regularly	13 (2.59%)	2 (4.00%)	8 (2.59%)
Exercise occasionally	167 (33.66%)	15 (3.00%)	104 (33.66%)
Irregularly exercise	203 (41.1%)	21 (42.00%)	129 (41.75%)
Hardly exercise	111 (22.65%)	12 (24.00%)	68 (22.01%)
Patient’s Current Working Status
Retire	110 (22.33%)	12 (24.00%)	70 (22.65%)
Sick leave	272 (55.02%)	27 (54.00%)	171 (55.34%)
Continue working	87 (17.8%)	8 (16.00%)	55 (17.79%)
Other	15 (4.85%)	3 (6.00%)	12 (3.88%)
Patient Medical Expenses Payment Method
At own expense	21 (4.21%)	3 (6.00%)	13 (4.21%)
Public expense	53 (10.68%)	5 (1.00%)	33 (10.68%)
Medical insurance	415 (84.14%)	40 (8.00%)	260 (84.14%)
NCMS	5 (0.97%)	2 (4.00%)	3 (0.97%)
Payment of Patient’s Family Medical Expenses
Fully able to pay	225 (45.63%)	22 (44.00%)	142 (45.95%)
Barely affordable	255 (51.78%)	27 (54.00%)	160 (51.78%)
Difficulty paying (due to financial hardship)	14 (2.59%)	1 (2.00%)	7 (2.27%)
Patient’s Monthly Family Income (RMB)
≤1999	13 (2.59%)	1 (2.00%)	8 (2.58%)
2000–3999	5 (0.97%)	3 (6.00%)	3 (0.97%)
4000–5999	65 (13.27%)	7 (14.00%)	42 (13.59%)
6000–9999	235 (47.57%)	18 (36.00%)	148 (47.89%)
10,000–14,999	155 (31.39%)	16 (32.00%)	97 (31.39%)
≥15,000	21 (4.21%)	5 (1.00%)	11 (3.56%)
The main accompany of the patient during hospitalization is
Spouse	160 (32.36%)	16 (32.00%)	106 (34.30%)
Child	147 (29.77%)	14 (28.00%)	92 (29.77%)
Parents	2 (0.32%)	1 (2.00%)	1 (0.32%)
Brothers and sisters	14 (2.91%)	1 (2.00%)	9 (2.91%)
Friend	3 (0.65%)	2 (4.00%)	3 (0.97%)
Hire an escort	83 (16.83%)	8 (16.00%)	51 (16.50%)
Unaccompanied	85 (17.15%)	8 (16.00%)	47 (15.21%)
The patient’s relationship with family members
Very happy	189 (38.19%)	18 (36.00%)	116 (37.54%)
More pleasant	166 (33.66%)	17 (34.00%)	104 (33.66%)
A little pleasant	58 (11.65%)	6 (12.00%)	38 (12.29%)
Not very pleasant	54 (11%)	5 (1.00%)	36 (11.65%)
Unhappy	27 (5.5%)	4 (8.00%)	15 (4.85%)

Table 2 Expert Scoring Situation (n=6)

Item	Number of Experts With a Score of 3 or 4	I-CVI
Did the nurse instruct you on how to cope with any potential symptoms (pain, cough, etc.)?	6	1
Did the nurse provide you with the essential information and check on you on a regular basis to see if you had mastered the appropriate breathing skills, such as blowing balloons?	6	1
Did the nurse aware of your unusual respiratory issues and provides instructions prior to the procedure?	6	1
Did the nurse go through all of the information you need to know about the operation (such as the process and precautions) with you?	6	1
Did the nurse assess and remind you of high-risk variables related to your disease, as well as providing you with appropriate guidance?	5	0.83
Did you frequently receive disease-related information from your primary nurse?	6	1
Have you been informed of the examination precautions by your primary nurse?	6	1
Did you know who is in charge of looking after you in each class?	6	1
Did the nurse ask if you have any questions, then attentively listen to you and respond appropriately?	6	1
Did the nurse actively tell you when you can communicate next time after the nurse completes the nursing operation and before departing your ward?	5	0.83
Did the nurse demonstrate how to use the ward’s amenities after being admitted to the hospital?	6	1
How long does it generally take for the nurse to respond the calling after you hit the pager?	6	1
How long will it take for the nurse to arrive once they click the stop button on your pager and/or receive a response?	6	1
How long does it take for a nurse to come to your room if you need assistance with toilet needs?	6	1
Did the nurse assist you in washing your hair and / or scrubbing your body when you are unable to care for yourself?	6	1
Did the nurse offer you oral care when you cannot take care of yourself?	6	1
Did the nurse help you or remind you to get out of bed?	6	1

Table 3 Item Analysis

	Cronbach’s α if Item Deleted	Cronbach α
Did the nurse instruct you on how to cope with any potential symptoms (pain, cough, etc.)?	0.930	0.934
Did the nurse provide you with the essential information and check on you on a regular basis to see if you had mastered the appropriate breathing skills, such as blowing balloons?	0.929
Did the nurse aware of your unusual respiratory issues and provides instructions prior to the procedure?	0.929
Did the nurse go through all of the information you need to know about the operation (such as the process and precautions) with you?	0.928
Did the nurse assess and remind you of high-risk variables related to your disease, as well as providing you with appropriate guidance?	0.928
Did you frequently receive disease-related information from your primary nurse?	0.940
Have you been informed of the examination precautions by your primary nurse?	0.938
Did you know who is in charge of looking after you in each class?	0.928
Did the nurse ask if you have any questions, then attentively listen to you and respond appropriately?	0.929
Did the nurse actively tell you when you can communicate next time after the nurse completes the nursing operation and before departing your ward?	0.928
Did the nurse demonstrate how to use the ward’s amenities after being admitted to the hospital?	0.929
How long does it generally take for the nurse to respond the calling after you hit the pager?	0.930
How long will it take for the nurse to arrive once they click the stop button on your pager and/or receive a response?	0.930
How long does it take for a nurse to come to your room if you need assistance with toilet needs?	0.930
Did the nurse assist you in washing your hair and/or scrubbing your body when you are unable to care for yourself?	0.928
Did the nurse offer you oral care when you cannot take care of yourself?	0.928
Did the nurse help you or remind you to get out of bed?	0.928

Table 4 Exploratory Factor Loadings

	Factor Load Coefficient				Communality
	Specific Care	Communicative Care	Timely Care	Basic Care
Did the nurse instruct you on how to cope with any potential symptoms (pain, cough, etc.)?	0.789	0.184	0.112	0.198	0.707
Did the nurse provide you with the essential information and check on you on a regular basis to see if you had mastered the appropriate breathing skills, such as blowing balloons?	0.805	0.168	0.221	0.239	0.781
Before the surgery, did the nurse notice your unusual breathing condition and give instructions?	0.815	0.289	0.183	0.133	0.8
Did the nurse check with you all you needed to know about the operation, including the steps and matters needing attention?	0.765	0.29	0.301	0.152	0.783
Did the nurse assess and remind you of high-risk variables related to your disease, as well as providing you with appropriate guidance?	0.805	0.225	0.218	0.257	0.812
Did you know who is in charge of looking after you in each class?	0.265	0.82	0.199	0.244	0.841
Did the nurse ask if you have any questions, then attentively listen to you and respond appropriately?	0.22	0.852	0.202	0.193	0.853
Did the nurse actively tell you when you can communicate next time after the nurse completes the nursing operation and before departing your ward?	0.239	0.828	0.183	0.276	0.853
Did the nurse demonstrate how to use the ward’s amenities after being admitted to the hospital?	0.268	0.853	0.132	0.187	0.852
How long does it generally take for the nurse to respond the calling after you hit the pager?	0.298	0.181	0.806	0.239	0.829
How long will it take for the nurse to arrive once they click the stop button on your pager and/or receive a response?	0.299	0.155	0.824	0.177	0.824
How long does it take for a nurse to come to your room if you need assistance with toilet needs?	0.143	0.258	0.828	0.266	0.843
Did the nurse assist you in washing your hair and/or scrubbing your body when you are unable to care for yourself?	0.272	0.26	0.224	0.817	0.86
Did the nurse offer you oral care when you cannot take care of yourself?	0.229	0.366	0.284	0.76	0.844
Did the nurse help you or remind you to get out of bed?	0.299	0.25	0.27	0.788	0.846
Eigenvalue	3.829	3.481	2.583	2.487
Variance explained	25.53%	48.73%	65.95%	82.20%
KMO	0.932
P	0.000

Table 5 Correlation Analysis

Item					The Corresponding Dimensions
Between each item and the corresponding dimensions
Did the nurse instruct you on how to cope with any potential symptoms (pain, cough, etc.)?					0.684**
Did the nurse provide you with the essential information and check on you on a regular basis to see if you had mastered the appropriate breathing skills, such as blowing balloons?					0.749**
Before the surgery, did the nurse notice your unusual breathing condition and give instructions?					0.756**
Did the nurse check with you all you needed to know about the operation, including the steps and matters needing attention?					0.788**
Did the nurse assess and remind you of high-risk variables related to your disease, as well as providing you with appropriate guidance?					0.787**
Did you know who is in charge of looking after you in each class?					0.784**
Did the nurse ask if you have any questions, then attentively listen to you and respond appropriately?					0.755**
Did the nurse actively tell you when you can communicate next time after the nurse completes the nursing operation and before departing your ward?					0.782**
Did the nurse demonstrate how to use the ward’s amenities after being admitted to the hospital?					0.751**
How long does it generally take for the nurse to respond the calling after you hit the pager?					0.731**
How long will it take for the nurse to arrive once they click the stop button on your pager and/or receive a response?					0.698**
How long does it take for a nurse to come to your room if you need assistance with toilet needs?					0.706**
Did the nurse assist you in washing your hair and/or scrubbing your body when you are unable to care for yourself?					0.754**
Did the nurse offer you oral care when you cannot take care of yourself?					0.784**
Did the nurse help you or remind you to get out of bed?					0.770**
Between dimensions and total score
	Average value	Standard deviation	Specific care	Communicative care	Timely care	Basic care	Total score
Specific care	17.879	5.750	1
Communicative care	14.261	5.152	0.585**	1
Timely care	20.844	6.924	0.656**	0.634**	1
Basic care	10.488	3.875	0.604**	0.631**	0.900**	1
Total score	52.984	15.482	0.859**	0.834**	0.902**	0.837**	1

Note: *p<0.05 **p<0.01.

Table 6 The Indices of the Convergent and Discriminant Validity

Factors	AVE	CR
Specific care	0.555	0.861
Communicative care	0.703	0.904
Timely care	0.717	0.883
Basic care	0.684	0.867

Abbreviations: CR, composite reliability; AVE, average variance extracted.

Table 7 Model Fit

Indicators	GFI	AGFI	χ^2/df	RMSEA	CFI	NFI	IFI
Criteria	>0.9	>0.9	<3	<0.10	>0.9	>0.9	>0.9
Value	0.962	0.945	1.138	0.021	0.996	0.967	0.996

Note: Default Model: χ² (105)=2857.637, p=1.000.

Table 8 Reliability Test

	Number of Items	Cronbach’s α	Spearman-Brown Coefficient	Retest
Total	15	0.945	0.866	0.824
Specific care	5	0.925	0.916
Comunicative Care	4	0.940	0.942
Timely Care	3	0.894	0.896
Basic care	3	0.909	0.906