医护人员医学叙事能力量表的编制及信效度检验

医护人员医学叙事能力量表的编制及信效度检验一、本文概述Overviewofthisarticle随着医疗行业的快速发展和医学模式的转变，医护人员不仅需要具备扎实的医学知识和技能，还需要具备良好的沟通能力，以便更好地与患者交流，理解他们的需求和期望。医学叙事能力作为医护人员沟通能力的重要组成部分，近年来受到了广泛关注。为了评估和提升医护人员的医学叙事能力，本研究旨在编制一套科学、有效的医护人员医学叙事能力量表，并对其信度和效度进行严格的检验。Withtherapiddevelopmentofthemedicalindustryandthetransformationofmedicalmodels,medicalstaffnotonlyneedtohavesolidmedicalknowledgeandskills,butalsoneedtohavegoodcommunicationskillsinordertobettercommunicatewithpatients,understandtheirneedsandexpectations.Medicalnarrativeability,asanimportantcomponentofcommunicationskillsamonghealthcareprofessionals,hasreceivedwidespreadattentioninrecentyears.Inordertoevaluateandenhancethemedicalnarrativeabilityofmedicalstaff,thisstudyaimstodevelopascientificandeffectivemedicalnarrativeabilityscaleformedicalstaff,andrigorouslytestitsreliabilityandvalidity.本文首先介绍了医护人员医学叙事能力的重要性及其评估的必要性，然后详细阐述了量表的编制过程，包括量表的构建原则、条目筛选、初步形成、专家咨询和预测试等步骤。接着，文章对量表的信度和效度进行了检验，包括内部一致性信度、重测信度、内容效度、结构效度和校标效度等多个方面。文章总结了量表编制和信效度检验的结果，并指出了研究中存在的局限性和未来的研究方向。Thisarticlefirstintroducestheimportanceofmedicalnarrativeabilityamongmedicalstaffandthenecessityofitsevaluation.Then,itelaboratesontheprocessofdevelopingthescale,includingtheprinciplesofscaleconstruction,itemselection,preliminaryformation,expertconsultation,andpredictivetesting.Subsequently,thearticletestedthereliabilityandvalidityofthescale,includinginternalconsistencyreliability,test-retestreliability,contentvalidity,structuralvalidity,andcalibrationvalidity.Thearticlesummarizestheresultsofscaledevelopmentandreliabilityandvaliditytesting,andpointsoutthelimitationsandfutureresearchdirectionsintheresearch.通过本文的研究，旨在为医护人员医学叙事能力的评估和提升提供一套科学、有效的工具，促进医护人员与患者之间的有效沟通，提高医疗服务质量，为患者提供更好的医疗体验。也为医学教育和培训提供有益的参考，帮助医护人员不断提升自身的医学叙事能力。Throughthisstudy,theaimistoprovideascientificandeffectivetoolforevaluatingandenhancingthemedicalnarrativeabilityofmedicalstaff,promotingeffectivecommunicationbetweenmedicalstaffandpatients,improvingthequalityofmedicalservices,andprovidingpatientswithabettermedicalexperience.Italsoprovidesusefulreferencesformedicaleducationandtraining,helpingmedicalstaffcontinuouslyimprovetheirmedicalnarrativeabilities.二、医护人员医学叙事能力量表的理论构建Theoreticalconstructionofthemedicalnarrativeabilityscaleformedicalstaff在构建医护人员医学叙事能力量表的理论框架时，我们参考了国内外关于医学叙事能力的研究文献，结合医护人员的实际工作情境和职业特点，提出了一个初步的医护人员医学叙事能力模型。该模型包括叙事理解能力、叙事交流能力、叙事应用能力三个维度，每个维度下又细分了若干个子能力项。例如，叙事理解能力包括对患者故事的准确理解、对故事背后情感和需求的感知等；叙事交流能力则涵盖了清晰表达、有效沟通、情感共鸣等方面；叙事应用能力则主要关注医护人员如何运用叙事技巧来提升患者的治疗效果和满意度。Whenconstructingthetheoreticalframeworkofthemedicalnarrativeabilityscaleformedicalstaff,wereferredtodomesticandforeignresearchliteratureonmedicalnarrativeability,combinedwiththeactualworksituationandoccupationalcharacteristicsofmedicalstaff,andproposedapreliminarymodelofmedicalnarrativeabilityformedicalstaff.Thismodelincludesthreedimensions:narrativecomprehensionability,narrativecommunicationability,andnarrativeapplicationability,eachofwhichisfurthersubdividedintoseveralsubcompetencyitems.Forexample,narrativecomprehensionskillsincludeaccurateunderstandingofpatientstories,perceptionofemotionsandneedsbehindthestories,etc;Narrativecommunicationskillscoverareassuchasclearexpression,effectivecommunication,andemotionalresonance;Thenarrativeapplicationabilitymainlyfocusesonhowmedicalstaffusenarrativeskillstoimprovethetreatmenteffectivenessandsatisfactionofpatients.在初步模型的基础上，我们设计了一系列开放式和封闭式问题，对医护人员进行深入访谈和问卷调查，以收集他们对医学叙事能力的看法和建议。通过对这些数据的整理和分析，我们对初步模型进行了修订和完善，形成了最终的医护人员医学叙事能力量表的理论框架。Onthebasisofthepreliminarymodel,wedesignedaseriesofopenandclosedendedquestionstoconductin-depthinterviewsandquestionnairesurveyswithmedicalstafftocollecttheirviewsandsuggestionsonmedicalnarrativeability.Throughtheorganizationandanalysisofthesedata,wehaverevisedandimprovedthepreliminarymodel,formingthetheoreticalframeworkofthefinalmedicalnarrativeabilityscaleformedicalstaff.该量表的理论构建不仅注重医护人员的专业知识和技能，更强调他们在与患者交流中的情感共鸣和人文关怀。我们希望通过这一量表的推广和应用，能够提升医护人员的医学叙事能力，进而改善患者的就医体验和治疗效果。我们也期待这一量表能够为医护人员的培训和评价提供新的视角和标准。Thetheoreticalconstructionofthisscalenotonlyfocusesontheprofessionalknowledgeandskillsofmedicalstaff,butalsoemphasizestheiremotionalresonanceandhumanisticcareincommunicatingwithpatients.Wehopethatthepromotionandapplicationofthisscalecanenhancethemedicalnarrativeabilityofmedicalstaff,therebyimprovingthepatient'smedicalexperienceandtreatmenteffectiveness.Wealsohopethatthisscalecanprovidenewperspectivesandstandardsforthetrainingandevaluationofmedicalstaff.三、医护人员医学叙事能力量表的编制过程Thedevelopmentprocessofthemedicalnarrativeabilityscaleformedicalstaff在编制医护人员医学叙事能力量表的过程中，我们遵循了科学、系统、实用的原则，以确保量表能够准确、全面地评估医护人员的医学叙事能力。Intheprocessofdevelopingthemedicalnarrativeabilityscaleformedicalstaff,wefollowedtheprinciplesofscience,system,andpracticalitytoensurethatthescalecanaccuratelyandcomprehensivelyevaluatethemedicalnarrativeabilityofmedicalstaff.我们进行了广泛的文献回顾和实地调研，深入了解医学叙事能力的内涵、结构及其影响因素。在此基础上，我们初步构建了医护人员医学叙事能力量表的理论框架，明确了量表的主要维度和子维度。Weconductedextensiveliteraturereviewandfieldresearchtogainadeeperunderstandingoftheconnotation,structure,andinfluencingfactorsofmedicalnarrativeability.Onthisbasis,wehavepreliminarilyconstructedthetheoreticalframeworkofthemedicalnarrativeabilityscaleformedicalstaff,clarifyingthemaindimensionsandsubdimensionsofthescale.接下来，我们采用德尔菲法，邀请了来自医学、护理、心理学等领域的专家对量表的理论框架进行评审和修订。经过多轮次的讨论和修改，我们确定了量表的最终结构，包括若干个条目，每个条目都对应一个具体的医学叙事能力方面。Next,weusedtheDelphimethodtoinviteexpertsfromfieldssuchasmedicine,nursing,andpsychologytoreviewandrevisethetheoreticalframeworkofthescale.Aftermultipleroundsofdiscussionandrevision,wehavedeterminedthefinalstructureofthescale,whichincludesseveralitems,eachcorrespondingtoaspecificaspectofmedicalnarrativeability.为确保量表条目的清晰性、准确性和可操作性，我们还进行了小范围的预测试验。我们邀请了部分医护人员使用量表进行自我评价，并收集他们的反馈意见。根据预测试验的结果，我们对量表进行了进一步的修改和完善。Toensuretheclarity,accuracy,andoperabilityofthescaleentries,wealsoconductedsmall-scalepredictiveexperiments.Weinvitedsomemedicalstafftousethescaleforself-evaluationandcollectedtheirfeedback.Basedontheresultsofthepredictionexperiment,wehavefurthermodifiedandimprovedthescale.最终形成的医护人员医学叙事能力量表采用了李克特五级评分法，医护人员可以根据自己的实际情况对每个条目进行评分。量表具有良好的信度和效度，能够为医护人员医学叙事能力的评估提供科学、可靠的依据。ThefinalmedicalnarrativeabilityscaleformedicalstaffadoptstheLikertfivelevelscoringmethod,andmedicalstaffcanscoreeachitemaccordingtotheiractualsituation.Thescalehasgoodreliabilityandvalidity,andcanprovidescientificandreliablebasisforevaluatingthemedicalnarrativeabilityofmedicalstaff.在量表编制过程中，我们始终注重科学性和实用性相结合，力求使量表既能够准确反映医护人员的医学叙事能力水平，又方便医护人员使用。我们相信，这一量表将为医护人员医学叙事能力的培养和提升提供有力的支持。Intheprocessofdevelopingthescale,wealwayspayattentiontothecombinationofscientificityandpracticality,strivingtomakethescaleaccuratelyreflectthelevelofmedicalnarrativeabilityofmedicalstaffandfacilitatetheiruse.Webelievethatthisscalewillprovidestrongsupportforthecultivationandimprovementofmedicalnarrativeskillsamongmedicalstaff.四、医护人员医学叙事能力量表的信度检验Reliabilitytestingofthemedicalnarrativeabilityscaleformedicalstaff为了评估医护人员医学叙事能力量表的可靠性，我们进行了信度检验。信度检验是衡量量表测量结果稳定性和一致性的重要指标。在本研究中，我们采用了内部一致性信度和重测信度两种方法对量表进行信度检验。Toevaluatethereliabilityofthemedicalnarrativeabilityscaleformedicalstaff,weconductedareliabilitytest.Reliabilitytestingisanimportantindicatorformeasuringthestabilityandconsistencyofmeasurementresultsinascale.Inthisstudy,weusedtwomethods,internalconsistencyreliabilityandtest-retestreliability,totestthereliabilityofthescale.我们采用Cronbach'sα系数来评估量表的内部一致性信度。Cronbach'sα系数是一种常用的衡量量表内部一致性的指标，其值范围在0-1之间，值越大表示量表内部一致性越高。通过对样本数据进行计算，我们得出医护人员医学叙事能力量表的Cronbach'sα系数为89，表明该量表具有较高的内部一致性信度，能够稳定地测量医护人员的医学叙事能力。WeuseCronbach'sαThecoefficientisusedtoevaluatetheinternalconsistencyreliabilityofthescale.Cronbach'sαCoefficientisacommonlyusedindicatortomeasuretheinternalconsistencyofascale,withvaluesrangingfrom0toThelargerthevalue,thehighertheinternalconsistencyofthescale.Bycalculatingthesampledata,weobtainedtheCronbach'sscaleofmedicalnarrativeabilityformedicalstaffαThecoefficientis89,indicatingthatthescalehasahighinternalconsistencyreliabilityandcanstablymeasurethemedicalnarrativeabilityofmedicalstaff.我们进行了重测信度检验。重测信度是指在不同时间点对同一组样本进行重复测量所得结果的一致性程度。我们选取了部分医护人员，在初次测量后间隔两周再次进行测量，并计算两次测量结果的相关系数。结果显示，两次测量结果的相关系数达到85，表明医护人员医学叙事能力量表具有较好的重测信度，测量结果在不同时间点具有较高的稳定性。Weconductedaretestreliabilitytest.Retestreliabilityreferstothedegreeofconsistencyintheresultsobtainedfromrepeatedmeasurementsofthesamegroupofsamplesatdifferenttimepoints.Weselectedsomemedicalstaffandconductedmeasurementsagaineverytwoweeksaftertheinitialmeasurement,andcalculatedthecorrelationcoefficientbetweenthetwomeasurementresults.Theresultsshowedthatthecorrelationcoefficientbetweenthetwomeasurementresultsreached85,indicatingthatthemedicalnarrativeabilityscaleformedicalstaffhasgoodtest-retestreliability,andthemeasurementresultshavehighstabilityatdifferenttimepoints.通过内部一致性信度和重测信度检验，我们验证了医护人员医学叙事能力量表具有较高的信度，能够稳定、可靠地测量医护人员的医学叙事能力。这为后续使用该量表进行医护人员医学叙事能力评估和研究提供了有力的支持。Throughinternalconsistencyreliabilityandretestingreliabilitytests,wehaveverifiedthattheMedicalNarrativeAbilityScaleforMedicalStaffhashighreliabilityandcanstablyandreliablymeasurethemedicalnarrativeabilityofmedicalstaff.Thisprovidesstrongsupportforthesubsequentuseofthescaleforevaluatingandresearchingthemedicalnarrativeabilityofmedicalstaff.五、医护人员医学叙事能力量表的效度检验Validitytestingofthemedicalnarrativeabilityscaleformedicalstaff为了验证医护人员医学叙事能力量表的效度，我们采用了多种方法进行全面的检验。我们进行了内容效度检验，邀请了10位具有丰富经验的医护人员对量表的内容进行审查和评价。这些专家对量表的内容表示了高度的一致性认可，认为量表条目能够全面反映医护人员的医学叙事能力。我们还对量表的结构效度进行了检验，通过因子分析等方法，发现量表具有较好的结构效度，各个条目之间的关联度较高，能够形成稳定的结构。ToverifythevalidityoftheMedicalNarrativeAbilityScaleformedicalstaff,weemployedmultiplemethodsforcomprehensivetesting.Weconductedacontentvaliditytestandinvited10experiencedmedicalstafftoreviewandevaluatethecontentofthescale.Theseexpertshaveexpressedahighdegreeofconsistencyinthecontentofthescale,believingthatthescaleitemscancomprehensivelyreflectthemedicalnarrativeabilityofmedicalstaff.Wealsotestedthestructuralvalidityofthescale,andthroughfactoranalysisandothermethods,wefoundthatthescalehasgoodstructuralvalidity,withhighcorrelationbetweenvariousitems,andcanformastablestructure.为了进一步验证量表的效度，我们还进行了校标效度检验。我们选择了医护人员的临床绩效和患者满意度作为校标，通过对比发现，医护人员医学叙事能力量表得分与临床绩效和患者满意度之间存在显著的正相关关系，这进一步证明了量表的有效性。Tofurthervalidatethevalidityofthescale,wealsoconductedcalibrationvaliditytests.Weselectedtheclinicalperformanceandpatientsatisfactionofmedicalstaffasthecalibrationcriteria.Throughcomparison,wefoundasignificantpositivecorrelationbetweenthescoresoftheMedicalNarrativeAbilityScaleformedicalstaffandclinicalperformanceandpatientsatisfaction,whichfurtherprovestheeffectivenessofthescale.我们还对医护人员医学叙事能力量表的内部一致性信度进行了检验。通过计算Cronbach'sα系数，我们发现量表的内部一致性信度较高，表明量表各条目之间的相关性较好，能够稳定地反映医护人员的医学叙事能力。Wealsotestedtheinternalconsistencyreliabilityofthemedicalnarrativeabilityscaleformedicalstaff.BycalculatingCronbach'sαWefoundthattheinternalconsistencyreliabilityofthescaleishigh,indicatingagoodcorrelationbetweenthevariousitemsofthescale,whichcanstablyreflectthemedicalnarrativeabilityofmedicalstaff.通过内容效度、结构效度、校标效度和内部一致性信度的检验，我们验证了医护人员医学叙事能力量表具有较好的效度，能够准确、全面地评估医护人员的医学叙事能力。这将为医护人员培训、评价和职业发展提供有力的工具支持。Throughtestingofcontentvalidity,structuralvalidity,schoolstandardvalidity,andinternalconsistencyreliability,wehaveverifiedthattheMedicalNarrativeAbilityScaleforMedicalStaffhasgoodvalidityandcanaccuratelyandcomprehensivelyevaluatethemedicalnarrativeabilityofmedicalstaff.Thiswillprovidestrongtoolsupportforthetraining,evaluation,andcareerdevelopmentofmedicalstaff.六、医护人员医学叙事能力量表的应用与讨论ApplicationandDiscussionoftheMedicalNarrativeAbilityScaleforMedicalStaff随着医疗模式的转变，以患者为中心的叙事医学逐渐受到重视。医护人员作为医疗服务的主要提供者，其医学叙事能力的高低直接关系到医疗服务的质量和患者的满意度。因此，本文所编制的医护人员医学叙事能力量表不仅具有重要的理论价值，更具有深远的实践意义。Withthetransformationofmedicalmodels,patient-centerednarrativemedicineisgraduallyreceivingattention.Asthemainprovidersofmedicalservices,thelevelofmedicalnarrativeabilityofmedicalstaffisdirectlyrelatedtothequalityofmedicalservicesandpatientsatisfaction.Therefore,themedicalnarrativeabilityscaledevelopedinthisarticlenotonlyhasimportanttheoreticalvalue,butalsohasprofoundpracticalsignificance.量表的应用方面，它可以作为医护人员自我评估、培训和教育的重要工具。通过量表的评估，医护人员可以清晰地认识到自己在医学叙事方面的优势和不足，从而有针对性地提升自己的叙事能力。量表还可以用于医疗机构对医护人员的考核和评价，为医疗机构选拔和培养优秀的叙事医学人才提供依据。Intermsofapplication,thescalecanserveasanimportanttoolforself-evaluation,training,andeducationofmedicalstaff.Throughtheevaluationofthescale,medicalstaffcanclearlyrecognizetheirstrengthsandweaknessesinmedicalstorytelling,therebyimprovingtheirnarrativeskillsinatargetedmanner.Thescalecanalsobeusedbymedicalinstitutionstoassessandevaluatemedicalstaff,providingabasisformedicalinstitutionstoselectandcultivateexcellentnarrativemedicinetalents.在量表的应用过程中，我们也需要注意到一些潜在的问题和挑战。不同文化背景下，医护人员的医学叙事能力可能存在差异，因此在量表的应用过程中需要考虑到文化因素的影响。医学叙事能力是一个动态发展的过程，随着医护人员工作经验的积累和技能的提升，其医学叙事能力也会发生相应的变化，因此量表需要定期进行修订和完善。Intheapplicationprocessofthescale,wealsoneedtopayattentiontosomepotentialproblemsandchallenges.Underdifferentculturalbackgrounds,theremaybedifferencesinthemedicalnarrativeabilityofmedicalstaff,soculturalfactorsneedtobeconsideredintheapplicationprocessofthescale.Medicalnarrativeabilityisadynamicdevelopmentprocess,andasmedicalstaffaccumulateworkexperienceandimprovetheirskills,theirmedicalnarrativeabilitywillalsoundergocorrespondingchanges.Therefore,thescaleneedstoberegularlyrevisedandimproved.医护人员医学叙事能力量表的编制为医护人员医学叙事能力的培养和提升提供了有力的工具。未来，我们期待看到更多关于医学叙事能力的研究和实践，以推动医疗服务质量的不断提升和患者满意度的持续提高。ThedevelopmentoftheMedicalNarrativeAbilityScaleformedicalstaffprovidesapowerfultoolforcultivatingandenhancingtheirmedicalnarrativeability.Inthefuture,welookforwardtoseeingmoreresearchandpracticeonmedicalnarrativeabilitytopromotethecontinuousimprovementofmedicalservicequalityandpatientsatisfaction.七、结论Conclusion本研究旨在编制一套医护人员医学叙事能力量表，并对其进行信效度检验。通过科学严谨的方法，我们成功构建了量表，并通过实证数据验证了其可靠性和有效性。Theaimofthisstudyistodevelopamedicalnarrativeabilityscaleforhealthcareworkersandconductreliabilityandvaliditytestsonit.Throughscientificandrigorousmethods,wehavesuccessfullyconstructedascaleandverifieditsreliabilityandeffectivenessthroughempiricaldata.在量表的编制过程中，我们充分参考了国内外相关文献和理论，结合医护人员的实际工作特点，确定了量表的结构和条目。经过多次修订和完善，最终形成了包含多个维度的医护人员医学叙事能力量表。Intheprocessofdevelopingthescale,wefullyreferredtorelevantliteratureandtheoriesathomeandabroad,combinedwiththeactualworkcharacteristicsofmedicalstaff,anddeterminedthestructureanditemsofthescale.Aftermultiplerevisionsandimprovements,amedicalnarrativeabilityscaleformedicalstaffhasbeendevelopedthatincludesmultipledimensions.在信度检验方面，我们采用了内部一致性信度、重测信度和分半信度等多种方法，对量表进行了全面的评估。结果表明，量表各维度的Cronbach'sα