Development and Validation of the Dutch EBPAS-ve and EBPQ-ve for Nursing Assistants and Nurses with a Vocational Education

Abstract

Background: In recent years, there has been an increasing focus on the role of evidence-based practice (EBP) to increase the quality and safety of care. However, EBP implementation research has predominantly taken place in hospitals and hardly in nursing homes or home care. In these care settings, patients are attended by nursing assistants and registered vocationally trained nurses. A good EBP starting point is to assess their current attitude toward and use of EBP. However, current questionnaires are not valid for assistants and nurses with vocational education.

Aims: To adapt the Evidence-Based Practice Attitude Scale (EBPAS) and the Evidence-Based Practice Questionnaire (EBPQ) to a Dutch questionnaire for nursing assistants and registered vocationally trained nurses European Qualification Framework level 3-4 employed in home care or nursing homes.

Methods: Translation, adaptation through cross-cultural validation, pretesting, exploratory factor analysis, and evaluation of psychometric properties among a group of nursing assistants and registered vocationally trained nurses.

Results: Cross-cultural validation led to modified items of EBPQ and EBPAS. The sample comprised 273 nurses. Analysis of both instruments showed a robust factor structure. EBPAS-ve: internal consistency: α = 0.76; intra-rater reliability: ICC = 0.52. EBPQ-ve: α = 0.75; ICC = 0.60. Convergent validity (correlation EBPAS-ve and EBPQ-ve's subscale Attitude): r = .300 (p < .01). Construct validity: significantly higher scores (p < .01) in the group with higher education.

Linking evidence to action: Psychometric qualities of both instruments were satisfactory, although we recommend refinement of EBPAS-ve's subscale Divergence and extra instructions for the EBPQ's subscale Attitude. To our knowledge, this is the first adaptation of an EBP measurement instrument for nursing assistants and registered vocationally trained nurses. The questionnaires appeared to be feasible and showed multiple valid and reliable properties, including a satisfactory intra-rater reliability. Both questionnaires may facilitate the implementation of EBP as they contribute to a richer understanding of the attitude toward and use of EBP in nursing homes and home care.

Keywords: attitude; evidence-based nursing; evidence-based practice; home care; instruments; nurse; nursing homes; nursing staff; validation; vocational training.