They certainly were the greatest relationship between residuals compared to leftover correlations (every less than )

They certainly were the greatest relationship between residuals compared to leftover correlations (every less than )

The latest CFI was 0.953, above the necessary 0.95 important to have an excellent match. The fresh new TLI try 0.945, beneath the required 0.95 important to own an excellent complement. not, CFI and you can TLI are usually thought appropriate whenever more than 0.90, while the TLI property value 0.945 was felt adequate. Ergo, the fresh new hypothesized a couple-grounds Peplau model put a reasonable to great fit on data.

IOM design

In contrast to the acceptable fit of the Peplau model, the nine-factor IOM model performed extremely well. As with the Peplau model, all items loaded onto their anticipated latent factors, and no outliers were identified (Cook’s Ds < 1.00; range = 0.0-0.16). In contrast to the mediocre to good score ranges found in the Peplau model, overall indicators of the nine-factor model fit were excellent. The RMSEA was 0.027, 90% CI (0.024, 0.028), well below the cutoff of 0.05 for a good model fit. The calculated probability that the true RMSEA value was <0.05 was 1.00, confirming the strong fit of the model. The CFI was 0.995, which was above the recommended 0.95 standard for excellent. The TLI was 0.993, also above the recommended 0.95 standard for excellent.

Authoritative model comparison

The BIC, which accounts for the number of items in a model, can be used to compare the relative fit of two models to the exact same data-as was the case in the current study. The BIC for the Peplau model, 276,596, was slightly larger than the BIC for the IOM-based model, 270,482, suggesting that the IOM-based model fit these data better than the Peplau-based model. The two models were also compared using log likelihood, which further supported the better fit of the IOM-based model (? 2 = , df = 20, p < .0001).

Supplementary Analyses

From inside the light of them results and you will influence Peplau’s new about three-phase design in mind, amendment indicator (MIs) was indeed inspected to identify changes on a few-basis Peplau-established design who raise its complement. In particular, correlations between items’ residual variances was basically thought when commercially associated. A relationship between your recurring variances (MI = ) are found involving the ways to HCAHPS Items step 1 (“During this hospital sit, how frequently performed nurses get rid of your with as a consequence of and value?”) and you will Product dos (“In this health remain, how often performed nurses tune in meticulously for you?”). Which relationship is actually consistent with the direction phase in Peplau’s () amazing three-stage concept. It absolutely was therefore considered that the new in the first place hypothesized two-foundation model is lack of and this the brand new orientation stage is actually a stand-alone phase that will not subsumed by the most other a couple stages.

The two-factor Peplau-based model was therefore modified to include a third latent factor (orientation), and a CFA was run on this new model (see Figure 3 ). The three-factor model resulted in an improved fit (RMSEA = 0.068 [CI 0.066, 0.069; probability of RMSEA ? .05 = 1.00], CFI/TLI 0.958/0.950, ? 2 = 5,, df = 101, p < .0001).

The three-factor model’s MIs were then inspected to identify adjustments to the three-factor model that would improve the fit. Inspection of the MIs revealed relevant relationships between six items’ residual variances: (a) items 13 and 14 (MI = 3,) (pain management), (b) items 16 and 17 (MI = ) (medication teaching), and (c) items 2 and 3 (MI = ) (nurses listening carefully and explaining). The inclusion of these relationships further improved the fit of the three-phase Peplau model (RMSEA = 0.039 [CI 0.038, 0.041; probability of RMSEA ? .05 ? 1.00], CFI/TLI = 0.986/0.983, ? 2 = 1,, df = 98, p < .0001). As noted previously, a RMSEA score of 0.01 is considered excellent, 0.05 good, and 0.08 mediocre. The RMSEA score of 0.039 for the three-factor model is within the excellent to good score range of 0.01 to 0.05.

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