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The Swedish version of the Normalization Process Theory Measure S-NoMAD: translation, adaptation, and pilot testing
School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
Luleå University of Technology, Department of Health Sciences, Nursing Care.
Department of Statistics, Uppsala University, Uppsala, Sweden.
Department of Nursing, Midwifery & Health, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK. .
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2018 (English)In: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 13, no 1, article id 146Article in journal (Refereed) Published
Abstract [en]

Background

The original British instrument the Normalization Process Theory Measure (NoMAD) is based on the four core constructs of the Normalization Process Theory: Coherence, Cognitive Participation, Collective Action, and Reflexive Monitoring. They represent ways of thinking about implementation and are focused on how interventions can become part of everyday practice.

Aim

To translate and adapt the original NoMAD into the Swedish version S-NoMAD and to evaluate its psychometric properties based on a pilot test in a health care context including in-hospital, primary, and community care contexts.

Methods

A systematic approach with a four-step process was utilized, including forward and backward translation and expert reviews for the test and improvement of content validity of the S-NoMAD in different stages of development. The final S-NoMAD version was then used for process evaluation in a pilot study aimed at the implementation of a new working method for individualized care planning. The pilot was executed in two hospitals, four health care centres, and two municipalities in a region in northern Sweden. The S-NoMAD pilot results were analysed for validity using confirmatory factor analysis, i.e. a one-factor model fitted for each of the four constructs of the S-NoMAD. Cronbach’s alpha was used to ascertain the internal consistency reliability.

Results

In the pilot, S-NoMAD data were collected from 144 individuals who were different health care professionals or managers. The initial factor analysis model showed good fit for two of the constructs (Coherence and Cognitive Participation) and unsatisfactory fit for the remaining two (Collective Action and Reflexive Monitoring) based on three items. Deleting those items from the model yielded a good fit and good internal consistency (alphas between 0.78 and 0.83). However, the estimation of correlations between the factors showed that the factor Reflexive Monitoring was highly correlated (around 0.9) with the factors Coherence and Collective Action.

Conclusions

The results show initial satisfactory psychometric properties for the translation and first validation of the S-NoMAD. However, development of a highly valid and reliable instrument is an iterative process, requiring more extensive validation in various settings and populations. Thus, in order to establish the validity and reliability of the S-NoMAD, additional psychometric testing is needed.

Place, publisher, year, edition, pages
Springer, 2018. Vol. 13, no 1, article id 146
Keywords [en]
Normalization process theory, NPT, Implementation, Questionnaire, Instrument development, Psychometric properties, Pilot study, Validation, Content validity index
National Category
Nursing
Research subject
Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-72491DOI: 10.1186/s13012-018-0835-5ISI: 000452047200001PubMedID: 30509289Scopus ID: 2-s2.0-85057810011OAI: oai:DiVA.org:ltu-72491DiVA, id: diva2:1276375
Note

Validerad;2019;Nivå 2;2019-01-08 (johcin) 

Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-01-31Bibliographically approved

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Nordmark, Sofi

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