Development and Validation of the EBP-Affinity Questionnaire: A Mixed-Method Study.

Background: Implementation of evidence-based practice (EBP) in nursing homes is important to improve quality of care and reduce costs. These facilities primarily employ certified nurse assistants (CNAs) and vocationally-trained registered nurses (VTRNs). Although EBP is scarcely addressed in their education, these caregivers have an important role in EBP. Insight into their affinity with EBP could provide a good starting point for working according to EBP.

Aims: To develop a questionnaire that measures affinity with EBP amongst CNAs and VTRNs in nursing homes. To assess the reliability and validity of the questionnaire.

Design: Mixed-method design according to the COSMIN-checklist.

Methods: Phase 1: the questionnaire was developed in three steps: (1) gathering items from existing questionnaires, occupational profiles and interviews; (2) compression through consensus rounds and (3) a pilot study. Phase 2: psychometric properties were assessed amongst CNAs and VTRNs in nine nursing homes. The factors extracted through principal component analysis were tested for measurement invariance using the one-parameter Rasch model.

Results: Phase 1: all experts interviewed (N = 5) indicated CNAs and VTRNs can play specific and significant roles in EBP. A 26-item questionnaire was created through two consensus rounds with experts (N = 7) and a pilot study (N = 7). Phase 2: Principal component analysis revealed a two-factor structure with good internal reliability (N = 428 questionnaires). All items exhibited good fit with the Rasch model and measurement invariance for CNAs and VTRNs.

Conclusion: CNAs and VTRNs can fulfil important roles in EBP in nursing homes. The 'Evidence-Based Practice-Affinity Questionnaire' is reliable and valid for assessing affinity with EBP amongst CNAs and VTRNs to improve practice and research, and can guide tailored training programs for CNAs and VTRNs, enhancing evidence-based practices in nursing homes.

Impact: The research provides insight into the roles CNAs and VTRNs can play in EBP and how to measure their affinity with EBP, which contributes to implementation of EBP in nursing homes.

Patient Or Public Contribution: No patient or public contribution in the study.