Development and psychometric evaluation of the Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND) scale

doi:10.1111/jocn.16350

Review

. 2023 Jun;32(11-12):2684-2699.

doi: 10.1111/jocn.16350. Epub 2022 May 8.

Development and psychometric evaluation of the Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND) scale

Wei Ling Chua¹, Duncan Smith^{2

3}, Li-Phing Clarice Wee⁴, Kit Cheng Ting⁵, Min Li Kimberly Yeo⁶, Siti Zubaidah Mordiffi⁵, Sok Ying Liaw¹

Affiliations

¹ Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.
² School of Health Sciences, City University of London, London, UK.
³ Patient Emergency Response & Resuscitation Team (PERRT), NHS Foundation Trust, University College London Hospitals, London, UK.
⁴ Department of Nursing Administration, Ng Teng Fong General Hospital, National University Health System, Singapore City, Singapore.
⁵ Nursing Department, National University Hospital, National University Health System, Singapore City, Singapore.
⁶ Department of Nursing, Ng Teng Fong General Hospital, National University Health System, Singapore City, Singapore.

PMID: 35527356
DOI: 10.1111/jocn.16350

Review

Development and psychometric evaluation of the Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND) scale

Wei Ling Chua et al. J Clin Nurs. 2023 Jun.

. 2023 Jun;32(11-12):2684-2699.

doi: 10.1111/jocn.16350. Epub 2022 May 8.

Authors

Wei Ling Chua¹, Duncan Smith^{2

3}, Li-Phing Clarice Wee⁴, Kit Cheng Ting⁵, Min Li Kimberly Yeo⁶, Siti Zubaidah Mordiffi⁵, Sok Ying Liaw¹

Affiliations

¹ Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore.
² School of Health Sciences, City University of London, London, UK.
³ Patient Emergency Response & Resuscitation Team (PERRT), NHS Foundation Trust, University College London Hospitals, London, UK.
⁴ Department of Nursing Administration, Ng Teng Fong General Hospital, National University Health System, Singapore City, Singapore.
⁵ Nursing Department, National University Hospital, National University Health System, Singapore City, Singapore.
⁶ Department of Nursing, Ng Teng Fong General Hospital, National University Health System, Singapore City, Singapore.

PMID: 35527356
DOI: 10.1111/jocn.16350

Abstract

Aims and objectives: To develop and evaluate the psychometric properties of an instrument that measures nurses' Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND).

Background: General ward nurses play an important role in recognising patient deterioration. However, their attitudes towards early recognition of clinical deterioration have not been adequately explored due to the lack of a valid and reliable scale.

Design: An instrument development and validation study.

Methods: A three-phase structure that followed the STROBE checklist was used: (1) item generation, (2) content and face validity assessment and (3) psychometric properties evaluation. The scale items were developed based on a comprehensive literature review and content validity assessment by 15 international experts from five countries. The psychometric properties of the ATREND scale were tested on 434 registered nurses, with retest evaluations (n = 100) at two hospitals. Exploratory and confirmatory factor analyses were used to examine the factor structure of the scale. The scale was also evaluated for its internal consistency, test-retest reliability and convergent validity.

Results: The scale's content validity was 0.95. A 3-factor solution was identified from the final 11 items: (1) beliefs about importance of patient observation, (2) use of broader patient assessment skills and (3) confidence in recognising clinical deterioration. The internal consistency reliability of the scale was supported with an acceptable Cronbach's alpha value of 0.745. Test-retest reliability of the scale was excellent, with an intraclass correlation coefficient of 0.825. The ATREND scale shows evidence of good convergent validity.

Conclusion: The final 11-item ATREND scale demonstrates adequate initial evidence of reliability and validity for use in acute ward settings.

Relevance to clinical practice: Nursing educators and clinicians may use this scale to assess ward nurses' attitudes and practices towards early recognition of clinical deterioration and then enhance their competencies and behaviours in the recognition of clinical deterioration.

Keywords: attitudes; clinical deterioration; instrument development; nurses; nursing; patient assessment; reliability; validity.

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References

REFERENCES

1. Ajzen, I., & Fishbein, M. (1977). Attitude-behavior relations: A theoretical analysis and review of empirical research. Psychological Bulletin, 84(5), 888-918. https://doi.org/10.1037/0033-2909.84.5.888
1. Ajzen, I., & Fishbein, M. (2000). Attitudes and the attitude-behavior relation: Reasoned and automatic processes. European Review of Social Psychology, 11(1), 1-33. https://doi.org/10.1080/14792779943000116
1. Allen, G. (2020). Barriers to non-critical care nurses identifying and responding to early signs of clinical deterioration in acute care facilities. MedSurg Nursing, 29(1), 43-52.
1. Al-Moteri, M., Plummer, V., Cooper, S., & Symmons, M. (2019). Clinical deterioration of ward patients in the presence of antecedents: A systematic review and narrative synthesis. Australian Critical Care, 32(5), 411-420. https://doi.org/10.1016/j.aucc.2018.06.004
1. Andersen, L. W., Kim, W. Y., Chase, M., Berg, K.-M., Mortensen, S. J., Moskowitz, A., Novack, V., Cocchi, M. N., & Donnino, M. W. (2016). The prevalence and significance of abnormal vital signs prior to in-hospital cardiac arrest. Resuscitation, 98, 112-117. https://doi.org/10.1016/j.resuscitation.2015.08.016

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NUHSRO/2020/025/T1/Seed-Aug/09/Singapore Ministry of Education's Academic Research Fund Tier 1: National University Health System Seed Fund Grant

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[1] Ajzen, I., & Fishbein, M. (1977). Attitude-behavior relations: A theoretical analysis and review of empirical research. Psychological Bulletin, 84(5), 888-918. https://doi.org/10.1037/0033-2909.84.5.888

[2] Ajzen, I., & Fishbein, M. (1977). Attitude-behavior relations: A theoretical analysis and review of empirical research. Psychological Bulletin, 84(5), 888-918. https://doi.org/10.1037/0033-2909.84.5.888

[3] Ajzen, I., & Fishbein, M. (2000). Attitudes and the attitude-behavior relation: Reasoned and automatic processes. European Review of Social Psychology, 11(1), 1-33. https://doi.org/10.1080/14792779943000116

[4] Ajzen, I., & Fishbein, M. (2000). Attitudes and the attitude-behavior relation: Reasoned and automatic processes. European Review of Social Psychology, 11(1), 1-33. https://doi.org/10.1080/14792779943000116

[5] Allen, G. (2020). Barriers to non-critical care nurses identifying and responding to early signs of clinical deterioration in acute care facilities. MedSurg Nursing, 29(1), 43-52.

[6] Allen, G. (2020). Barriers to non-critical care nurses identifying and responding to early signs of clinical deterioration in acute care facilities. MedSurg Nursing, 29(1), 43-52.

[7] Al-Moteri, M., Plummer, V., Cooper, S., & Symmons, M. (2019). Clinical deterioration of ward patients in the presence of antecedents: A systematic review and narrative synthesis. Australian Critical Care, 32(5), 411-420. https://doi.org/10.1016/j.aucc.2018.06.004

[8] Al-Moteri, M., Plummer, V., Cooper, S., & Symmons, M. (2019). Clinical deterioration of ward patients in the presence of antecedents: A systematic review and narrative synthesis. Australian Critical Care, 32(5), 411-420. https://doi.org/10.1016/j.aucc.2018.06.004

[9] Andersen, L. W., Kim, W. Y., Chase, M., Berg, K.-M., Mortensen, S. J., Moskowitz, A., Novack, V., Cocchi, M. N., & Donnino, M. W. (2016). The prevalence and significance of abnormal vital signs prior to in-hospital cardiac arrest. Resuscitation, 98, 112-117. https://doi.org/10.1016/j.resuscitation.2015.08.016

[10] Andersen, L. W., Kim, W. Y., Chase, M., Berg, K.-M., Mortensen, S. J., Moskowitz, A., Novack, V., Cocchi, M. N., & Donnino, M. W. (2016). The prevalence and significance of abnormal vital signs prior to in-hospital cardiac arrest. Resuscitation, 98, 112-117. https://doi.org/10.1016/j.resuscitation.2015.08.016

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Development and psychometric evaluation of the Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND) scale

Affiliations

Development and psychometric evaluation of the Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND) scale

Authors

Affiliations

Abstract

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References

REFERENCES

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MeSH terms

Grants and funding

LinkOut - more resources

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