Paper
Friday, July 23, 2004
Validity and Reliabilty of the Factorial Survey for Assessing Nurse Decision-Making
Ruth Ludwick, PhD, RNC1, Susan Jones, PhD, RN1, and Rich Zeller, PhD2. (1) College of Nursing, Kent State University, Kent, OH, USA, (2) College of Nursing, Kent State U, Kent, OH, USA
| Learning Objective #1: Examine the use of the factorial survey method for nursing research |
| Learning Objective #2: Discuss the use of the factorial survey method in nurse decision-making about acute confusion |
Objective: The aim was to evaluate the validity and reliability of the factorial survey method. Design: This experimental design combines advantages of factorial experiments with sample survey procedures using randomly generated vignettes as the central design element. A recent case survey, a test-retest of vignettes, and semi-structured interviews supplemented the basic design. Sample: In 2003, 226 nurses (randomly selected nursing homes in a 7 county region participated in this study. Concept: The design was tested using nurses' judgment about acute resident confusion and subsequent clinical decision-making about restraint use. Methods: A 3-part survey was used: a) open ended questions about recent experience with confused residents, b) 3 vignettes, and c) demographic information. A retest of vignettes and semi-structured interviews were conducted with 10 % of the sample. Multiple regression was used for vignette analysis. Descriptive statistics were used to summarize the findings from the subjects' most recent case for comparison of the similarities and differences. A Repeated Measures Within Subjects ANOVA was used to evaluate the reliability over time of vignette responses. Independent analysts categorized the semi-structured most recent case data. Findings: This study showed there is considerable consensus among nurses on when to report and document resident confusion and when to use (or not) restraints. The similarity of the emergent categories revealed the degree to which multiple analysts share common interpretations of the meanings inferred from the qualitative data used to describe subjects' most recent cases and demonstrate. Conclusions: The factorial survey is a valid and reliable measure to assess judgments and decision-making of nurses. Implications: Nurses can use the factorial survey to gain the strengths of survey research and the robustness of the experiment from factorial designs and the design can be used across settings (e. g. nursing homes and across practices like LPNs and RNs).
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