Alarm Fatigue Questionnaire: Turkish Validity and Reliability Study

Öz

Aim: The aim of this study was to determine the validity and reliability of the Turkish version of the Alarm Fatigue Questionnaire.

Method: This study used a methodological design and a sample of 140 nurses working in intensive care units in three hospitals in Istanbul, Turkey. Data were collected with the "Personal Information Form" and the "Alarm Fatigue Scale". The data were analyzed at two stages involving adaptation and confirmation. In the adaptation process, four steps including “translation; back-translation; expert opinion; pilot study” were followed.

In the confirmation process, four steps were followed. In the first step, item analyses were carried out. In the second step, to assess the factorability of the correlation matrix, Kaiser-Meyer-Olkin (KMO) sample adequacy test and Bartlett’s sphericity test were used. Confirmatory factor analysis (CFA) was used to confirm the original construct. The third step involved testing the internal consistency of the scale. At the final stage, test-retest reliability was assessed by using Pearson’s correlation test and paired-samples t-test.

Result: The tool consisted of 13 items and two subscales. Content validity ratings of the scale items were over 0.35. Fit indices were calculated as: χ2/df=1.453, RMSEA=0.059 and CFI=0.91 for the scale. Cronbach's alpha coefficient was 0.71 for scale.

Conclusion: Turkish version of the Alarm Fatigue Questionnaire can be used as a reliable and valid measurement tool for the evaluation of alarm fatigue experienced by nurses working in intensive care units in Turkey.

Anahtar Kelimeler

• Alarm fatigue
• intensive care
• nursing
• psychometric testing
• validity and reliability.

Alarm Yorgunluğu Ölçeği: Türkçe Geçerlik ve Güvenirlik Çalışması

Öz

Amaç: Bu çalışmanın amacı Alarm Yorgunluğu Anketi'nin Türkçe versiyonunun geçerlik ve güvenilirliğini belirlemektir.

Yöntem: Metodolojik tasarımda olan bu çalışmada, İstanbul’daki üç hastanede yoğun bakım ünitelerinde çalışan 140 hemşire örneklemi oluşturmuştur. Veriler “kişisel bilgi formu” ve “Alarm Yorgunluğu Ölçeği” ile toplandı. Verilerin analizinde IBM SPSS Statistics 21 ve AMOS programları kullanıldı. Verilerin analizi uyarlama ve doğrulama süreçlerini içeren iki temel aşamada yapıldı. Uyarlama sürecinde “çeviri; geri çeviri; uzman görüşü ve pilot çalışma ” olmak üzere dört basamak uygulandı. Doğrulama sürecinde dört basamak takip edildi. İlk adımda madde analizleri yapıldı. İkinci adımda, korelasyon matrisinin faktörlenebilirliğini değerlendirmek için Kaiser Meyer Olkin (KMO) örneklem yeterlik ve Bartlett küresellik testi kullanıldı. Orijinal yapıyı doğrulamak için Doğrulayıcı Faktör Analizi (DFA) kullanıldı. Üçüncü adım, alarm yorgunluğu ölçeğinin iç tutarlılığını içermektedir. Son aşamada, test-tekrar test güvenilirliği Pearson korelasyonu ve eşleştirilmiş örneklem t testleri kullanılarak değerlendirilmiştir.

Bulgular: Araç 13 madde ve iki alt ölçekten oluşmaktadır. Ölçek maddelerinin kapsam geçerlilik puanları 0.35'in üzerindedir. Uyum indeksleri ölçek için χ2/df=1,453, RMSEA=0,059 ve CFI=0,91 olarak hesaplanmıştır. Ölçek için Cronbach alfa katsayısı 0.71'dir.

Sonuç: Alarm Yorgunluk Anketinin Türkçe versiyonu Türkiye'de yoğun bakım ünitelerinde çalışan hemşirelerin yaşadığı alarm yorgunluğunun değerlendirilmesinde geçerli ve güvenilir bir ölçüm aracı olarak kullanılabilir.

Anahtar Kelimeler

• Alarm yorgunluğu
• yoğun bakım
• hemşirelik
• psikometrik test
• geçerlilik ve güvenilirlik.

Kaynakça

1. Konkani A, Oakley B. Noise in hospital intensive care unit a critical review of a critical topic. Journal of critical care. 2012; 27(5):522-e1. https://doi.org/10.1016/j.jcrc.2011.09.003.
2. Vreman J, Van Loon LM, Van Den Biggelaar W, Van Der Hoeven JG, Lemson J, Van Den Boogaard M. Contribution of alarm noise to average sound pressure levels in the ICU: An observational cross-sectional study. Intensive and Critical Care Nursing, 2020;102901. https://doi.org/10.1016/j.iccn.2020.102901.
3. Despins LA. Factors influencing when intensive care unit nurses go to the bedside to investigate patient related alarms: A descriptive qualitative study. Intensive and Critical Care Nursing. 2017; 43:101-107. https://doi.org/10.1016/j.iccn.2017.04.003.
4. Clark C, Paunovic K. WHO environmental noise guidelines for the european region: A systematic review on environmental noise and cognition. International journal of environmental research and public health. 2018;15(2):285. https://doi.org/10.3390/ijerph15020285.
5. Casey S, Avalos G, Dowling M. Critical care nurses’ knowledge of alarm fatigue and practices towards alarms: A multicentre study. Intensive and Critical Care Nursing. 2018;48:36-41. https://doi.org/10.1016/j.iccn.2018.05.004.
6. Ergezen FD, Kol E. Nurses’ responses to monitor alarms in an intensive care unit: An observational study. Intensive and Critical Care Nursing. 2020;102845. https://doi.org/10.1016/j.iccn.2020.102845.
7. Ergezen FD, Kol E. Alarm fatigue in critical care nurses and it’s management. Yoğun Bakım Hemşireliği Dergisi. 2019;23(1):43-49.
8. Christensen M, Dodds A, Sauer J, Watts N. Alarm setting for the critically ill patient: A descriptive pilot survey of nurses’ perceptions of current practice in an Australian regional critical care unit. Intensive and Critical Care Nursing. 2014;30(4):204-210. https://doi.org/10.1016/j.iccn.2014.02.003.

9. Sendelbach S. Alarm fatigue. Nurs Clin North Am. 2012;47(3):375–82. https://doi.org/10.1016/j.cnur.2012.05.009.
10. Lewandowska K, Weisbrot M, Cieloszyk A, Mędrzycka-Dąbrowska W, Krupa S, Ozga D. Impact of Alarm Fatigue on the work of nurses in an intensive care environment-A systematic review. International Journal of Environmental Research and Public Health. 2020;17(22):8409. https://doi.org/10.3390/ijerph17228409.
11. Paine CW, Goel VV, Ely E, Stave CD, Stemler S, Zander M, Bonafide CP. Systematic review of physiologic monitor alarm characteristics and pragmatic interventions to reduce alarm frequency. Journal of Hospital Medicine. 2016;11(2):136-144. https://doi.org/10.1002/jhm.2520.
12. Hannibal GB. Monitor alarms and alarm fatigue. AACN Adv Crit Care. 2011;22(4):418–20. https://doi.org/10.4037/NCI.0b013e318232ed55.
13. Nix M. Combating alarm fatigue. Am J Nurs. 2015;115(2):16. doi: 10.1097/01.NAJ.0000460671.80285.6b.
14. The Joint Commission. National patient safety goals: 2014 national patient safety goals. Chicago. 2013. http://www.jointcommission.org/standards_information/npsgs.aspx.
15. Torabizadeh C, Yousefinya A, Zand F, Rakhshan M, Fararooei M. A nurses’ alarm fatigue questionnaire: Development and psychometric properties. Journal of Clinical Monitoring and Computing. 2017;31(6):1305-1312. https://doi.org/10.1007/s10877-016-9958-x.
16. Bi J, Yin X, Li H, Gao R, et al. Effects of monitor alarm management training on nurses’ alarm fatigue: A randomised controlled trial. Journal of Clinical Nursing. 2020;29(21-22):4203-4216. https://doi.org/10.1111/jocn.15452.
17. Graham KC, Cvach M. Monitor alarm fatigue: Standardizing use of physiological monitors and decreasing nuisance alarms. American Journal of Critical Care. 2010;19(1):28-34. https://doi.org/10.4037/ajcc2010651.
18. Baillargeon E. Alarm fatigue: A Risk Assessment. [master’s thesis]. US: Rhode Island College; 2013.
19. Funk M, Clark JT, Bauld TJ, Ott JC, Coss P. Attitudes and practices related to clinical alarms. Am J Crit Care. 2014;23(3):9–18. https://doi.org/10.4037/ajcc2014315.
20. Cho OM, Kim H, Lee YW, Cho I. Clinical alarms in intensive care units: Perceived obstacles in alarm management and alarm fatigue in nurses. Healthc Inform Res. 2016;22(1):46–53. https://doi.org/10.4258/hir.2016.22.1.46.
21. Tavşancıl E. Measuring Attitudes and data Analysis with SPSS. 5th edition. Ankara: Nobel Akademik Yayıncılık Eğitim Danışmanlık Tic. Ltd.Şti; 2014.
22. Capik C, Gozum S, Aksayan S. Intercultural scale adaptation stages, language and culture adaptation: updated guideline. Florence Nightingale J.Nurs. 2018;26:199–210. Doi: 10.26650/fnjn397481.
23. International Test Commission. The ITC guidelines for translating and adapting tests. International Test Commission. https://www.intestcom.org/files/guideline_test_adaptation_2ed.pdf. Published 2017. Accessed Date 18 July 2020.
24. World Health Organization. Process of translation and adaptation of instruments. https://www.who.int/substance_abuse/research_tools/translation/en/. Published 2019. Accessed 17 July 2020.
25. Polit DF, Beck CT. Nursing Research: Principles and Methods. Philadelphia: Lippincott Williams &Wilkins; 2012.
26. Simsek ÖF. Introduction to Structural Equation Modeling, Fundamental Principles and LISREL Applications. Ankara: Ekinoks Pres; 2007.
27. Davis LL. Instrument review: Getting the most from a panel of experts. Applied Nursing Research. 1992;5(4):194-197. https://doi.org/10.1016/S0897-1897(05)80008-4.
28. Bayer N, Baykal Ü. Improving Quality Perception Scale of Health Workers. Journal of Health and Nursing Management. 2018;5(2):86-99. doi:10.5222/SHYD.2018.086.
29. Kline P. An Easy Guide to Factor Analysis. 1. ed. New York: Taylor & Francis Group; 1994.