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Article(id=1322924507446518537, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.17.026, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1761926400000, receivedDateStr=2025-11-01, revisedDate=1784044800000, revisedDateStr=2026-07-15, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339381323, onlineDateStr=2026-10-30, pubDate=1788969600000, pubDateStr=2026-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339381323, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339381323, creator=13701087609, updateTime=1793339381323, updator=13701087609, issue=Issue{id=1322924415817757501, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='17', pageStart='2961', pageEnd='3152', issueExtLink='null', onlineDate='null', pubDate='1788969600000', pubDateStr='2026-09-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793339359478, creator='13701087609', updateTime=1793343089343, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940060072542250, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940060072542251, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3128, endPage=3136, ext={EN=ArticleExt(id=1322924509287817994, articleId=1322924507446518537, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Assessment tools for nurses' evidence-based practice competence and their psychometric properties: a scoping review, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To systematically retrieve,analyze,and summarize domestic and international tools for assessing nurses' evidence-based practice competence,and to integrate their psychometric properties,so as to provide references for developing more scientific and practical assessment tools in the future.

Methods

A systematic search was conducted in CNKI, Wanfang Data,VIP,CBM,PubMed,Cochrane Library,EMbase,and Web of Science for literature on nurses' evidence-based practice competence assessment tools from the inception of each database to April 1,2026.The included literature was integrated and analyzed.

Results

A total of 27 articles were included.The assessment content covered nurses' attitudes,knowledge,perceptions,self-efficacy,and critical thinking regarding evidence-based practice;continuous quality improvement,nurse managers' leadership,and compatibility of evidence-based practice with professional work;barriers to and facilitators of searching for and reviewing evidence,barriers to and facilitators of changing practice based on evidence,practices for improvement,and abilities to generate,synthesize,disseminate,and evaluate evidence;and abilities to apply evidence and evaluate outcomes.Psychometric results showed that the included tools had good reliability and validity.

Conclusions

Existing tools for assessing nurses' evidence-based practice competence have comprehensive dimensions and generally good reliability and validity.However,issues remain,including an overemphasis on theoretical content,a lack of unified standards for result interpretation,and insufficient cross-cultural applicability. Further optimization is needed to enhance the scientific rigor,practicality,and comparability of these tools.

, authors=Jiaqi LI, Zhaohao HE, Shuai ZHANG, authorsList=Jiaqi LI, Zhaohao HE, Shuai ZHANG, authorCompany=null, correspAuthors=Shuai ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322924509602390795, articleId=1322924507446518537, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=护士循证实践能力评估工具及其心理测量学特性的范围综述, columnId=1220689485482873504, journalTitle=护理研究, columnName=科研综述, runingTitle=null, highlight=null, articleAbstract=
目的

系统检索、分析并总结国内外用于评估护士循证实践能力的工具，并对其心理测量学特性进行整合，以期为未来构建更具科学性、实用性评估工具提供参考。

方法

系统检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Cochrane Library、EMbase、Web of Science中护士循证实践能力评估工具的相关文献，检索时限为建库至2026年4月1日，对纳入文献进行整合和分析。

结果

纳入27篇文献，评估内容包括护士对循证实践的态度、知识、认知以及自我效能和批判性思维；持续的质量改进，护士长领导力，循证实践与专业工作的兼容性；查找和审查证据的阻碍与促进因素，根据证据改变实践的阻碍与促进因素，改进实践的做法，证据的形成、整合、传播和评估能力；证据的应用能力、结果评估。心理测量学结果显示评估工具具有良好的信效度。

结论

现有护士循证实践能力评估工具评估维度全面、信效度整体良好，但存在评估内容偏重理论、结果解读缺乏统一标准、跨文化适用性不足等问题，仍需进一步优化完善，以提升工具的科学性、实用性与可比性。

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李嘉琪，硕士研究生

, correspAuthorsNote=
张帅，E-mail：
ZHANG Shuai, E-mail:
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articleTitle=心理学中质性研究的方法自洽, refAbstract=null), Reference(id=1322924520000070486, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924507446518537, doi=null, pmid=null, pmcid=null, year=2024, volume=41, issue=5, pageStart=778, pageEnd=784, url=null, language=null, rfNumber=43, rfOrder=42, authorNames=钟思睿, 周玉潇, 林晓, journalName=中国卫生统计, refType=null, unstructuredReference=钟思睿,周玉潇,林晓,等.医学统计学计算机自适应测验算法的模拟研究[J].中国卫生统计,2024,41(5):778-784., articleTitle=医学统计学计算机自适应测验算法的模拟研究, refAbstract=null), Reference(id=1322924520071373655, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924507446518537, doi=null, pmid=null, pmcid=null, year=2024, volume=59, issue=18, pageStart=2290, pageEnd=2296, url=null, language=null, rfNumber=44, rfOrder=43, authorNames=杨福娜, 徐晓霞, 石红英, journalName=中华护理杂志, refType=null, unstructuredReference=杨福娜,徐晓霞,石红英,等.护理领域证据临床实施障碍因素的研究进展[J].中华护理杂志,2024,59(18):2290-2296., articleTitle=护理领域证据临床实施障碍因素的研究进展, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322924509828883212, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924507446518537, xref=1, ext=[AuthorCompanyExt(id=1322924509837271821, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924507446518537, companyId=1322924509828883212, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Hainan General Hospital(Hainan Affiliated Hospital of Hainan Medical University), Hainan 570311 China), AuthorCompanyExt(id=1322924509849854734, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924507446518537, companyId=1322924509828883212, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1海南省人民医院（海南医科大学附属海南医院），海南 570311)])], figs=[ArticleFig(id=1322924511477244712, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924507446518537, language=EN, label=Table 1, caption=

Basic characteristics of the included assessment tools for nurses' evidence-based practice competence(n=27)

, figureFileSmall=null, figureFileBig=null, tableContent=
工具名称开发者(年)国家研究类型适用对象样本量（人）工具构建方法维度数/条目数/总分结果判读评估内容
EBPQUpton等[21](2006)英国量表开发护士专家人数：33横断面研究：500开放式问卷+焦点小组3/24/168Likert 7级评分法循证实践、态度、知识与技术
DEBPGerrish等[25](2007)英国量表开发+横断面研究护士专家人数：5横断面研究：1 287文献对照+焦点小组5/49/245Likert 5级评分法基础实践知识、查找和审查证据的障碍、根据证据改变实践的障碍、改进实践的做法、寻找和审查证据的技能
OCRSIEPThiel等[35](2008)美国量表开发+横断面研究护士专家人数：3横断面研究：121文献回顾法+Delphi法3/64/320Likert 5级评分法信息需求、知识与技能、文化与态度
EBPB and EBPISMelnyk等[36](2008)美国量表开发+横断面研究护士专家人数：7横断面研究：394文献回顾法+焦点小组2/34/170Likert 5级评分法循证信念、循证实施
SD-EBPAdams等[23](2010)美国量表开发+横断面研究护生专家人数：5横断面研究：386文献对照+Delphi法6/107/385第1部分~第3部分、第5部分采用Likert 5级评分法；第4部分采用Likert 4级评分法循证实践、现行做法、计算机灵活使用、信息来源、循证实践实施障碍、人口统计学资料
EBP2McEvoy等[26](2010)澳大利亚量表开发+横断面研究有/无医学背景专家人数：3横断面研究：106开放式问卷+焦点小组3/58/290Likert 5级评分法相关性、术语、信心
EBNAQRuzafa-Martínez等[27](2011)西班牙量表开发+横断面研究社区护士专家人数：18横断面研究：219文献回顾法+焦点访谈3/25/125Likert 5级评分法认知、情感、行为
EBP-COQRuzafa-Martinez等[16](2013)西班牙量表开发+横断面研究护生（本科生）专家人数：16横断面研究：261文献回顾法+焦点小组3/35/175Likert 5级评分法态度、知识、技能
护士循证护理实践素质及实施水平量表赵梅珍等[34](2013)中国量表开发+横断面研究护士专家人数：7横断面研究：256文献回顾+ Delphi法5/35/105Likert 3级评分法知识、态度、技能、行为
S-EBPQUpton等[11](2016)澳大利亚量表开发护生（本科）横断面研究：244文献对照+开放式问卷4/21/147Likert 7级评分法实践频率、态度、检索/审查证据、分享/应用循证实践
HS-EBPFerna´ndez-DomÍnguez等[13](2016)西班牙量表开发医生；护士；理疗师；心理医生专家人数：32Delphi法5/76/304Likert 4级评分法信念与态度、科学研究结果、专业实践的发展、结果评估、阻碍/促进因素
TPB-EBPWatters等[18](2016)美国量表开发护生专家人数：4文献回顾法+焦点小组4/28/120第1~3部分Likert 4级评分法，第4部分是Likert 5级评分法自我效能、态度、专业网络支持、专业实践
EBNPATLeung等[28](2016)澳大利亚量表开发护士专家人数：4文献回顾法+开放式问卷5/32/-可视化矩阵专业实践、批判性思维、护理的提供与协调、治疗协作
HS-EBPFerna´ndez-DomÍnguez等[19](2017)西班牙量表开发+横断面研究医生；护士；理疗师；心理医生专家人数：32
横断面研究：869		文献回顾法+Delphi法5/72/720Likert 10级评分法信念和态度、科学研究成果、专业实践的发展、评估结果、障碍和促进因素
循证护理能力评定量表王旖磊等[24](2017)中国量表开发+横断面研究护士专家人数：21
横断面研究：303		Delphi法4/24/120Likert 5级评分法证据形成能力、证据整合能力、证据传播与评估能力、证据应用能力
Quick-EBP-VIKConnor等[30] (2017)美国量表开发+横断面研究护士专家人数：6
横断面研究：513		文献回顾法+焦点小组3/25/125Likert 5级评分法价值、实施、知识
护士长EBP量表Shuman等[17] (2018)美国量表开发+横断面研究护士长专家人数：8
横断面研究：83		焦点小组-/16/64Likert 4级评分法护理管理者的循证实践能力
改良Fresno测试Laibhen-Parkes等[10] (2018)美国量表开发儿科护士专家人数：29Delphi法3/11/212Likert分级评分法识别、应用和评估循证实践相关的知识和技能
芬兰EBP评估量表Saunders等[12] (2019)芬兰量表开发护士专家人数：14Delphi法11（条目数）Likert 5级评分法护士循证能力评估
EBP-COQ-ProfRuzafa-Martínez等[29](2020)西班牙量表开发+横断面研究护士专家人数：10
横断面研究：579		Delphi法4/35/175Likert 5级评分法态度、知识、技能、应用
EBE-STAlconero-Camarero等[14](2021)西班牙量表开发+横断面研究护生（四年级）专家人数：3
横断面研究：304		文献回顾+Delphi法8/40/200Likert 5级评分法寻找最佳证据、解释和使用的能力、临床实践、在读期间对 循证护理的了解、专业人员使用循证护理、循证护理和职业因素、职业前途和业绩、循证护理和临床实践
EIDMBelita等[31](2022)加拿大量表开发公共卫生护士横断面研究：201开放式问卷4/24/168Likert 7级评分法知识、技能、态度、信念
MFT-ACNHalm等[15](2023)美国量表开发+横断面研究急诊科护士专家人数：8
横断面研究：90		Delphi法-/14/70Likert 5级评分法循证实践知识和技能
消毒供应中心EBP量表蔡婷婷等[22](2023)中国量表开发+横断面研究消毒供应室护士专家人数：39
横断面研究：183		文献对照+Delphi法3/35/175Likert 5级评分法循证实践知识、信念、实施
多准则决策分析模型Hu等[20](2024)中国矩阵量表开发护生（本科生）专家人数17文献回顾+Delphi法-/6/79矩阵病人为中心的护理、协作和团队精神、循证实践、持续质量改进、安全护理、信息学
ActEBP-nursesParisod等[32](2024)芬兰量表开发+横断面研究护士专家人数：20
横断面研究：1 284		文献回顾法+Delphi法2/10/50Likert 5级评分法个人支持结构、组织支持结构
EBPZ-NLandsverk等[33] (2024)挪威量表开发+横断面研究康复师；护士；医生专家人数：8横断面研究：313文献对照+质性访谈+焦点小组5/58/290Likert 5级评分法价值、循证实践与工作的兼容性、对专业术语的理解、实践、信心
), ArticleFig(id=1322924511569519401, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924507446518537, language=CN, label=表1, caption=

护士循证实践能力评估工具基本特征(n=27)

, figureFileSmall=null, figureFileBig=null, tableContent=
工具名称开发者(年)国家研究类型适用对象样本量（人）工具构建方法维度数/条目数/总分结果判读评估内容
EBPQUpton等[21](2006)英国量表开发护士专家人数：33横断面研究：500开放式问卷+焦点小组3/24/168Likert 7级评分法循证实践、态度、知识与技术
DEBPGerrish等[25](2007)英国量表开发+横断面研究护士专家人数：5横断面研究：1 287文献对照+焦点小组5/49/245Likert 5级评分法基础实践知识、查找和审查证据的障碍、根据证据改变实践的障碍、改进实践的做法、寻找和审查证据的技能
OCRSIEPThiel等[35](2008)美国量表开发+横断面研究护士专家人数：3横断面研究：121文献回顾法+Delphi法3/64/320Likert 5级评分法信息需求、知识与技能、文化与态度
EBPB and EBPISMelnyk等[36](2008)美国量表开发+横断面研究护士专家人数：7横断面研究：394文献回顾法+焦点小组2/34/170Likert 5级评分法循证信念、循证实施
SD-EBPAdams等[23](2010)美国量表开发+横断面研究护生专家人数：5横断面研究：386文献对照+Delphi法6/107/385第1部分~第3部分、第5部分采用Likert 5级评分法；第4部分采用Likert 4级评分法循证实践、现行做法、计算机灵活使用、信息来源、循证实践实施障碍、人口统计学资料
EBP2McEvoy等[26](2010)澳大利亚量表开发+横断面研究有/无医学背景专家人数：3横断面研究：106开放式问卷+焦点小组3/58/290Likert 5级评分法相关性、术语、信心
EBNAQRuzafa-Martínez等[27](2011)西班牙量表开发+横断面研究社区护士专家人数：18横断面研究：219文献回顾法+焦点访谈3/25/125Likert 5级评分法认知、情感、行为
EBP-COQRuzafa-Martinez等[16](2013)西班牙量表开发+横断面研究护生（本科生）专家人数：16横断面研究：261文献回顾法+焦点小组3/35/175Likert 5级评分法态度、知识、技能
护士循证护理实践素质及实施水平量表赵梅珍等[34](2013)中国量表开发+横断面研究护士专家人数：7横断面研究：256文献回顾+ Delphi法5/35/105Likert 3级评分法知识、态度、技能、行为
S-EBPQUpton等[11](2016)澳大利亚量表开发护生（本科）横断面研究：244文献对照+开放式问卷4/21/147Likert 7级评分法实践频率、态度、检索/审查证据、分享/应用循证实践
HS-EBPFerna´ndez-DomÍnguez等[13](2016)西班牙量表开发医生；护士；理疗师；心理医生专家人数：32Delphi法5/76/304Likert 4级评分法信念与态度、科学研究结果、专业实践的发展、结果评估、阻碍/促进因素
TPB-EBPWatters等[18](2016)美国量表开发护生专家人数：4文献回顾法+焦点小组4/28/120第1~3部分Likert 4级评分法，第4部分是Likert 5级评分法自我效能、态度、专业网络支持、专业实践
EBNPATLeung等[28](2016)澳大利亚量表开发护士专家人数：4文献回顾法+开放式问卷5/32/-可视化矩阵专业实践、批判性思维、护理的提供与协调、治疗协作
HS-EBPFerna´ndez-DomÍnguez等[19](2017)西班牙量表开发+横断面研究医生；护士；理疗师；心理医生专家人数：32
横断面研究：869		文献回顾法+Delphi法5/72/720Likert 10级评分法信念和态度、科学研究成果、专业实践的发展、评估结果、障碍和促进因素
循证护理能力评定量表王旖磊等[24](2017)中国量表开发+横断面研究护士专家人数：21
横断面研究：303		Delphi法4/24/120Likert 5级评分法证据形成能力、证据整合能力、证据传播与评估能力、证据应用能力
Quick-EBP-VIKConnor等[30] (2017)美国量表开发+横断面研究护士专家人数：6
横断面研究：513		文献回顾法+焦点小组3/25/125Likert 5级评分法价值、实施、知识
护士长EBP量表Shuman等[17] (2018)美国量表开发+横断面研究护士长专家人数：8
横断面研究：83		焦点小组-/16/64Likert 4级评分法护理管理者的循证实践能力
改良Fresno测试Laibhen-Parkes等[10] (2018)美国量表开发儿科护士专家人数：29Delphi法3/11/212Likert分级评分法识别、应用和评估循证实践相关的知识和技能
芬兰EBP评估量表Saunders等[12] (2019)芬兰量表开发护士专家人数：14Delphi法11（条目数）Likert 5级评分法护士循证能力评估
EBP-COQ-ProfRuzafa-Martínez等[29](2020)西班牙量表开发+横断面研究护士专家人数：10
横断面研究：579		Delphi法4/35/175Likert 5级评分法态度、知识、技能、应用
EBE-STAlconero-Camarero等[14](2021)西班牙量表开发+横断面研究护生（四年级）专家人数：3
横断面研究：304		文献回顾+Delphi法8/40/200Likert 5级评分法寻找最佳证据、解释和使用的能力、临床实践、在读期间对 循证护理的了解、专业人员使用循证护理、循证护理和职业因素、职业前途和业绩、循证护理和临床实践
EIDMBelita等[31](2022)加拿大量表开发公共卫生护士横断面研究：201开放式问卷4/24/168Likert 7级评分法知识、技能、态度、信念
MFT-ACNHalm等[15](2023)美国量表开发+横断面研究急诊科护士专家人数：8
横断面研究：90		Delphi法-/14/70Likert 5级评分法循证实践知识和技能
消毒供应中心EBP量表蔡婷婷等[22](2023)中国量表开发+横断面研究消毒供应室护士专家人数：39
横断面研究：183		文献对照+Delphi法3/35/175Likert 5级评分法循证实践知识、信念、实施
多准则决策分析模型Hu等[20](2024)中国矩阵量表开发护生（本科生）专家人数17文献回顾+Delphi法-/6/79矩阵病人为中心的护理、协作和团队精神、循证实践、持续质量改进、安全护理、信息学
ActEBP-nursesParisod等[32](2024)芬兰量表开发+横断面研究护士专家人数：20
横断面研究：1 284		文献回顾法+Delphi法2/10/50Likert 5级评分法个人支持结构、组织支持结构
EBPZ-NLandsverk等[33] (2024)挪威量表开发+横断面研究康复师；护士；医生专家人数：8横断面研究：313文献对照+质性访谈+焦点小组5/58/290Likert 5级评分法价值、循证实践与工作的兼容性、对专业术语的理解、实践、信心
), ArticleFig(id=1322924511657599786, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924507446518537, language=EN, label=Table 2, caption=

Psychometric properties of the included assessment tools for nurses' evidence-based practice competence(n=27)

, figureFileSmall=null, figureFileBig=null, tableContent=
开发者信度内容效度结构效度区分效度（t检验/Mann-Whitney检验）
整体Cronbach'α（各维度）重测信度评估方式S-CVII-CVIKMO检验累计方差解释率（%）因子载荷拟合优度指数
Upton等[21](2005)0.87(0.91~0.75)专家打分法(n=33)0.861<0.001
Gerrish等[25](2007)0.874(0.730~0.913)专家打分法(n=4)+预测试(n=20）0.087~0.582
Thiel等[35](2008)(0.74~0.93)专家打分法(n=3)+预测试(n=21）
Melnyk等[36](2008)(0.900~0.960)专家打分法(n=8)+预测试(n=15)>0.60
Adams等[23](2010)(0.62~0.89)专家打分法(n=5)+预测试(n=5)0.63~0.890.96~0.56<0.001
McEvoy等[26](2010)0.96(0.76~0.94)0.77~0.94预测试(n=40)>0.32>0.32
Ruzafa-Martínez等[27] (2011)0.853(0.63~0.853)预测试(n=100)0.933
Ruzafa-Martinez等[16](2013)0.888预测试(n=100)0.933
赵梅珍等[34](2013)0.921(0.848~0.898)专家打分法(n=7)0.89359.197>0.5<0.01
Upton等[11](2016)(0.765~0.912)专家打分法(n=32)
Ferna´ndez-DomÍnguez等[13](2016)专家打分法(n=32)
Watters等[18](2016)(0.67~0.86)预测试(n=348)/专家打分法(n=4)
Leung等[28](2016)(0.67~0.77)0.67~0.77专家打分法(n=2)0.950.960.96
Ferna´ndez-DomÍnguez等[19](2017)(0.87~0.92)0.35~0.63预测试(n=211)/专家打分法(n=80）0.9600.989
王旖磊等[24](2017)0.951(0.855~0.916)0.702专家打分法(n=21)0.990.0940.484~0.784
Connor等[30](2017)(0.66~0.84)0.24~0.80专家打分法(n=6)>0.80>0.80<0.05
Shuman等[17](2018)0.95预测试(n=4)0.934>0.5
Laibhen-Parkes等[10](2018)
Saunders等[12](2019)专家打分法(n=7)
Ruzafa-Martínez等[29](2020)0.88(0.817~0.948)0.815~0.966预测试(n=18)0.8900.164~0.9400.932<0.01
Alconero-Camarero等[14](2021)0.882(0.50~0.75)专家打分法(n=3)0.841
Belita等[31](2022)(0.80~0.96)0.8600.46~0.58
Halm[15](2023)0.770.88专家打分法(n=8)0.75~1.000.92<0.01
蔡婷婷等[22](2023)0.956(0.920~0.944)专家打分法(n=30)+预实验(n=30)0.724~1.0000.851~0.9340.826~0.87640.00~76.420.9650.900
Hu等[20](2024)预测试(n=3)
Parisod等[32](2024)预测试(n=8)0.903~0.908<0.01
Landsverk等[33] (2024)(0.82~0.95)预测试(n=40)>0.320.749
), ArticleFig(id=1322924511770845995, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924507446518537, language=CN, label=表2, caption=

护士循证实践能力评估工具的心理测量学特征(n=27)

, figureFileSmall=null, figureFileBig=null, tableContent=
开发者信度内容效度结构效度区分效度（t检验/Mann-Whitney检验）
整体Cronbach'α（各维度）重测信度评估方式S-CVII-CVIKMO检验累计方差解释率（%）因子载荷拟合优度指数
Upton等[21](2005)0.87(0.91~0.75)专家打分法(n=33)0.861<0.001
Gerrish等[25](2007)0.874(0.730~0.913)专家打分法(n=4)+预测试(n=20）0.087~0.582
Thiel等[35](2008)(0.74~0.93)专家打分法(n=3)+预测试(n=21）
Melnyk等[36](2008)(0.900~0.960)专家打分法(n=8)+预测试(n=15)>0.60
Adams等[23](2010)(0.62~0.89)专家打分法(n=5)+预测试(n=5)0.63~0.890.96~0.56<0.001
McEvoy等[26](2010)0.96(0.76~0.94)0.77~0.94预测试(n=40)>0.32>0.32
Ruzafa-Martínez等[27] (2011)0.853(0.63~0.853)预测试(n=100)0.933
Ruzafa-Martinez等[16](2013)0.888预测试(n=100)0.933
赵梅珍等[34](2013)0.921(0.848~0.898)专家打分法(n=7)0.89359.197>0.5<0.01
Upton等[11](2016)(0.765~0.912)专家打分法(n=32)
Ferna´ndez-DomÍnguez等[13](2016)专家打分法(n=32)
Watters等[18](2016)(0.67~0.86)预测试(n=348)/专家打分法(n=4)
Leung等[28](2016)(0.67~0.77)0.67~0.77专家打分法(n=2)0.950.960.96
Ferna´ndez-DomÍnguez等[19](2017)(0.87~0.92)0.35~0.63预测试(n=211)/专家打分法(n=80）0.9600.989
王旖磊等[24](2017)0.951(0.855~0.916)0.702专家打分法(n=21)0.990.0940.484~0.784
Connor等[30](2017)(0.66~0.84)0.24~0.80专家打分法(n=6)>0.80>0.80<0.05
Shuman等[17](2018)0.95预测试(n=4)0.934>0.5
Laibhen-Parkes等[10](2018)
Saunders等[12](2019)专家打分法(n=7)
Ruzafa-Martínez等[29](2020)0.88(0.817~0.948)0.815~0.966预测试(n=18)0.8900.164~0.9400.932<0.01
Alconero-Camarero等[14](2021)0.882(0.50~0.75)专家打分法(n=3)0.841
Belita等[31](2022)(0.80~0.96)0.8600.46~0.58
Halm[15](2023)0.770.88专家打分法(n=8)0.75~1.000.92<0.01
蔡婷婷等[22](2023)0.956(0.920~0.944)专家打分法(n=30)+预实验(n=30)0.724~1.0000.851~0.9340.826~0.87640.00~76.420.9650.900
Hu等[20](2024)预测试(n=3)
Parisod等[32](2024)预测试(n=8)0.903~0.908<0.01
Landsverk等[33] (2024)(0.82~0.95)预测试(n=40)>0.320.749
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护理研究 |科研综述 2026 , 40 (17) : 3128 -3136
护士循证实践能力评估工具及其心理测量学特性的范围综述
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李嘉琪, 何昭好, 张帅*, *, *
作者信息
  • 1海南省人民医院（海南医科大学附属海南医院），海南 570311
通讯作者:
张帅，E-mail：
ZHANG Shuai, E-mail:
作者简介:

李嘉琪，硕士研究生

Assessment tools for nurses' evidence-based practice competence and their psychometric properties: a scoping review
Jiaqi LI, Zhaohao HE, Shuai ZHANG
Affiliations
  • 1Hainan General Hospital(Hainan Affiliated Hospital of Hainan Medical University), Hainan 570311 China
出版时间: 2026-09-10 doi: 10.12102/j.issn.1009-6493.2026.17.026
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摘要
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目的

系统检索、分析并总结国内外用于评估护士循证实践能力的工具，并对其心理测量学特性进行整合，以期为未来构建更具科学性、实用性评估工具提供参考。

方法

系统检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Cochrane Library、EMbase、Web of Science中护士循证实践能力评估工具的相关文献，检索时限为建库至2026年4月1日，对纳入文献进行整合和分析。

结果

纳入27篇文献，评估内容包括护士对循证实践的态度、知识、认知以及自我效能和批判性思维；持续的质量改进，护士长领导力，循证实践与专业工作的兼容性；查找和审查证据的阻碍与促进因素，根据证据改变实践的阻碍与促进因素，改进实践的做法，证据的形成、整合、传播和评估能力；证据的应用能力、结果评估。心理测量学结果显示评估工具具有良好的信效度。

结论

现有护士循证实践能力评估工具评估维度全面、信效度整体良好，但存在评估内容偏重理论、结果解读缺乏统一标准、跨文化适用性不足等问题，仍需进一步优化完善，以提升工具的科学性、实用性与可比性。

护理人员  /  循证实践能力  /  评估工具  /  心理测量学  /  范围综述
Objective

To systematically retrieve,analyze,and summarize domestic and international tools for assessing nurses' evidence-based practice competence,and to integrate their psychometric properties,so as to provide references for developing more scientific and practical assessment tools in the future.

Methods

A systematic search was conducted in CNKI, Wanfang Data,VIP,CBM,PubMed,Cochrane Library,EMbase,and Web of Science for literature on nurses' evidence-based practice competence assessment tools from the inception of each database to April 1,2026.The included literature was integrated and analyzed.

Results

A total of 27 articles were included.The assessment content covered nurses' attitudes,knowledge,perceptions,self-efficacy,and critical thinking regarding evidence-based practice;continuous quality improvement,nurse managers' leadership,and compatibility of evidence-based practice with professional work;barriers to and facilitators of searching for and reviewing evidence,barriers to and facilitators of changing practice based on evidence,practices for improvement,and abilities to generate,synthesize,disseminate,and evaluate evidence;and abilities to apply evidence and evaluate outcomes.Psychometric results showed that the included tools had good reliability and validity.

Conclusions

Existing tools for assessing nurses' evidence-based practice competence have comprehensive dimensions and generally good reliability and validity.However,issues remain,including an overemphasis on theoretical content,a lack of unified standards for result interpretation,and insufficient cross-cultural applicability. Further optimization is needed to enhance the scientific rigor,practicality,and comparability of these tools.

nursing staff  /  evidence-based practice competence  /  assessment tool  /  psychometrics  /  scoping review
李嘉琪, 何昭好, 张帅. 护士循证实践能力评估工具及其心理测量学特性的范围综述. 护理研究, 2026 , 40 (17) : 3128 -3136 . DOI: 10.12102/j.issn.1009-6493.2026.17.026
Jiaqi LI, Zhaohao HE, Shuai ZHANG. Assessment tools for nurses' evidence-based practice competence and their psychometric properties: a scoping review[J]. Chinese Nursing Research, 2026 , 40 (17) : 3128 -3136 . DOI: 10.12102/j.issn.1009-6493.2026.17.026
正文
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循证实践(evidence-based practice,EBP)是一种以科学证据为基础的专业决策方法，通过整合现有最佳证据、从业者的专业知识与经验以及病人的价值观和偏好，提升实践的质量和效果[1]。该理念起源于20世纪90年代的医学领域，通过Sackett[2]提出“循证医学”概念得以发展，强调通过系统方法弥合研究与实践的鸿沟，现已广泛应用于临床医学、护理学、心理学、教育学及社会科学等学科领域[3]，缺乏对循证实践的理解以及如何将证据融于实践是一个长期存在的挑战。为评估临床医务人员循证实践的认知及应用能力，现已开发多种循证实践评估工具。早期工具如Fresno test[4]，主要侧重对临床医生批判性思维和循证实践能力的评估。随着时间推移评估工具不断演进，涵盖范围更加广泛，同时评估重点也从狭义的研究评价转向更全面的实践者准备度、信心水平及循证实践的实际应用能力评估。护士作为一线医疗工作者，在将研究成果转化为临床决策、病人护理以及质量改进过程中发挥核心作用，系统性评估循证实践能力可确保护士具备临床实践所需的知识、技能和态度，从而减少护理差异性，确保病人安全，改善成本效益及病人临床结局[5-6]。此外，护理实践常涉及复杂且不断变化的临床环境，针对护士设计的评估工具应当能够收集自我报告的态度、可观察的行为以及适应不同病人群体的能力[7]。因此，评估护士的循证实践能力需要采用针对性的评估工具，用以反映该学科的整体导向及科学严谨性和以病人为中心的双重重心。范围综述是一种知识整合形式，旨在系统性地梳理某一主题相关文献的广义和深度，明确关键概念，识别现有证据中的空白。本研究参考Arksey等[8]提出的范围综述框架，对护士循证实践能力评估工具的内容、特点及心理测量学特性进行整合，为推动评估工具的开发及质量改进提供参考。
1　资料与方法
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本研究遵循PRISMA-ScR(2018)报告规范，已在PROSPERO进行注册(注册号：CRD420251136382)。
1.1　确定研究问题
1）目前国内外涉及护士循证实践能力的评估工具有哪些？2）护士循证实践能力评估工具的心理测量学特性如何？
1.2　检索策略
计算机检索中国知网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Cochrane Library、EMbase、Web of Science。检索时限为建库至2026年4月1日。采用主题词与自由词相结合的方式进行检索，同时通过追溯文献，补充筛选纳入文献的参考文献。中文检索词包括护士/护理/护生、循证实践能力/循证决策、评估工具/量表/模式/框架等；英文检索词包括nurse、evidence-based practice、competence、scale、frame等。以PubMed为例，检索策略如下：
#1 "nurse" OR "nurse practitioners" OR "students,nursing"[MeSH]
#2 "nurs*" OR "medical staff"[Title/Abstract]
#3 #1 AND # 2
#4 "evidence⁃based practice" OR "evidence⁃based nursing" OR "evidence⁃based medicine" [MeSH]
#5 "EBM" OR "EBN" OR "EBM"[Title/Abstract]
#6 #4 AND #5
#7 "clinical competence" OR "professional competence" OR "attitude" OR "knowledge" OR "self⁃efficacy"[MeSH]
#8 "skill" OR "quality" OR "aptitude" OR "ability"[Title/ Abstract]
#9 #7 OR #8
#10 "outcome and process assessment,healthcare"[MeSH]
#11 "assessment" OR "scale" OR "evaluate" OR "prediction"[Title/Abstract]
#12 #10 AND #11
#13 #3 AND #6 AND #9 AND #12
1.3　纳入与排除标准
根据PCC原则[9]确定研究问题。纳入标准：1）研究对象（participants,P）为护士、护理专业学生；2）概念（concept,C）涉及护士循证实践能力评估工具的相关文献，包括工具的开发、验证、修订及应用情况；3）情景（context,C）为护士循证实践能力评估的情景，研究类型包括随机对照试验、横断面研究、病例对照研究、队列研究、工具学研究等。排除标准：无法获得全文、文献内容不全的文献；重复报道的文献；综述、系统综述及其他二次研究；非中文或英文文献。
1.4　文献筛选与数据提取
初步检索数据库后，将文献导入EndNote 20进行去重处理。文献筛选分为标题和摘要筛选、全文筛选。严格执行预先设定的纳入及排除标准，确保与研究问题一致。由2名研究者独立进行评估与筛选，如遇分歧，由第3名研究者进行判定，最大限度减少偏倚。提取文献的主要内容包括工具名称、工具开发者、开发时间、国家、研究类型、适用人群、结果判读方法以及心理测量学相关指标等。
2　结果
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2.1　文献检索结果及基本特征
初检共获取文献3 436篇，剔除重复文献1 944篇后剩余1 492篇；经初筛排除1 293篇（包括主题不符897篇、对象不符274篇、语言不符122篇），余199篇；再复筛剔除172篇（包括内容不符132篇、无法获取全文34篇、重复发表6篇），最终纳入文献27篇。共纳入27种护士循证实践能力评估工具[10-36]，学者来自西班牙（n=6）、美国（n=8）、英国（n=2）、芬兰（n=2）、中国（n=4）、澳大利亚（n=3）、挪威（n=1）等国家，开发于2005—2024年，其中4种评估工具已汉化[19,29,31,36]，并完成信效度检验。纳入文献中，9项研究[10-13,18,20-21,28,31]仅进行了量表开发，18项研究[14-17,19,22-27,29-30,32-36]在量表开发的基础上进行了横断面研究，评估工具构建方法主要包括文献回顾法、Delphi法、焦点小组、开放式问卷、文献对照和定性访谈等，以上方法单一或联合使用。纳入文献的基本特征见表1。
2.2　护士循证实践能力评估工具内容及评分标准
纳入文献中，24项研究使用Likert评分法，其中22项研究[10-19,21-22,24,26-27,29,31-36]使用正向计分法，1项研究[23]使用Likert正反向结合进行计分。2项研究[20,28]以矩阵形式对结果进行展示。7项研究[10,20,23,26-27,31,36]显示量表评估所需时间为9~40 min。内容主要包括：1)个人层面，护士对循证实践的态度、知识、认知以及自我效能和批判性思维；2)组织层面，持续的质量改进、护士长领导力、循证实践与专业工作的兼容性；3)过程，查找和审查证据的阻碍与促进因素，根据证据改变实践的阻碍与促进因素，改进实践的做法，证据的形成、整合、传播和评估能力；4)结果，证据的应用能力、结果评估。
2.3　护士循证实践能力评估工具的心理测量学特征
基于COSMIN共识[37]分析护士循证实践评估工具质量。纳入评估工具的心理测量学指标主要包括信度（Cronbach'α系数、重测信度）、内容效度（专家打分法、预测试）；结构效度（KOM值、累计方差解释率、因子载荷、拟合优度指数）、区分效度（t检验、Mann-Whitney检验）。具体评估结果见表2。
3　讨论
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3.1　心理测量学特性分析的重要性及必要性
心理测量学评估是评估开发、验证和完善评估工具的关键环节，以确保这些工具的有效性和可靠性，达到测量目标准确无误以及评估结果在不同场景和人群中均具备可信度的目的。可靠性是指评估工具的一致性，即在相似条件下反复使用时能否产生相同结果[38]。在循证实践背景下，不可靠的评估工具会导致对医疗专业人员的不一致评价，难以判断是个人技能水平的提升还是评估过程本身存在缺陷。本研究最常用的Cronbach's α系数检验内部一致性或计算相关系数重新评估重测信度，能确保工具能够持续、有效地衡量循证实践能力。研究结果显示，纳入评估工具的均具有良好的信度，可用于研究。效度是确保评估工具能准确测量其设计目标，本研究中即护理人员循证实践能力的真实水平。在问卷研究中，内容效度通常作为第一个被评估的指标，以确保测量工具能够准确反映所需构念，从而提高研究的可信性[38]。仅使用数字和百分比来报告专家间一致性不足以证明内容效度，这并没有考虑归因于偶然性的一致性。纳入评估工具中，11项研究使用单一的专家打分法，2项研究未对内容效度进行描述，表明评估工具的可行性存疑。常见的统计学方法中，Cohen'k和组内相关系数被认为是分析专家间一致性程度的严格方法，但目前并没有一种方法被确定为通用标准[39]。在护理相关量表领域，CVI已被广泛用于量化量表的内容效度。然而，也存在一定局限性，他的计算过程放弃了四点顺序标度相应，改为两点的二分类名义标度，这降低了它区分专家间不同一致性和调节能力[40]。
循证实践能力评估工具的目标不仅在于评估特定时刻的知识水平，更在于追踪能力随时间的变化，例如在培训项目或干预措施后，评估工具必须能监测到护士循证实践能力的提升。反应灵敏度是衡量评估工具在干预后或随时间推移中捕捉真实能力变化的精准度，捕捉临床决策、批判性思维和研究整合能力中的细微提升，同时通过心理测量学验证跨场景与人群的普适性，确保评估工具不受特定情境因素（如机构资源或区域医疗实践）的偏倚影响，能准确衡量不同医疗场景中的循证实践能力。本研究中使用结构效度间接反映灵敏度，但报道此指标的文献较少。未来研究可将反应灵敏度作为文献质量评价的一部分，提高评估工具的应用效率。
3.2　护士循证实践能力评估工具的局限性及对未来的启示
护士循证实践能力评估是衡量护士在循证护理实践中综合能力的重要手段，但其由于发展时间较短，仍存在一定局限性。1）评估内容：多数循证实践评估工具侧重知识与态度评估，而非实际行为或真实场景应用，常考察理论知识，但真正的考察在于能否在临床环境中运用实践[41]。建议评估工具融入更多的临床真实场景，如模拟训练或案例分析，考察医护人员在日常生活中实施循证实践的能力，可通过设置患者案例，要求参与者展示其评估研究，批判性评价证据及做出明智决策的能力。2）数据收集：大多数工具依赖于护士的自我报告，可能无法捕捉到强烈影响循证实践实施的组织因素，例如工作量、资源、领导支持[14,17]。过度强调量化指标可能无法全面反映专业人员的循证能力。此类工具可能忽视沟通能力，批判性思维及将证据应用于病人个体情景等软技能[42]。建议通过定性研究对定量研究进行补充，可采用结构化访谈、同行评议及自我反思等形式，探讨如何在实践中应用循证医学以及如何引导病人参与决策的过程。3）结果解读：现有评估工具种类繁多且缺乏统一标准，不同机构或地区间的评估结果难以比较，降低了循证实践能力评估的可靠性。建议建立实践评估的标准化框架，鼓励机构间共享最佳实践和循证实践能力评估工具，有助于建立更统一的循证实践能力评估体系。4）评估过程：耗时性强，部分循证实践能力评估工具需投入大量的时间精力，建议开发更简短高效的评估工具，或采取自适应测验[43]，即根据受试者回答调整测试难度，提供实时反馈的在线平台也能简化流程，减轻时间负担。5）文化背景差异：循证实践能力评估工具可能未能充分考虑实践中的文化与情景差异，如果没有进行本土化和验证，可能无法完全适用于不同的文化或医疗保健系统。同时，由于资源、病人群体及医疗群体的差异，某一地区或医疗系统视为最佳实践的方法，在其他地区可能并不适用。建议工具应具备足够的灵活性以适应不同文化与情景背景，将本地指南、资源及病人人口统计学纳入评估，可提升结果的适用性和可操作性。6）变革阻力：医疗工作者（尤其是经验丰富的从业者）可能抵制使用新工具或改变实践方式。若循证实践能力评估工具未获得广泛认可或被视为无关紧要，其实施效果将会大打折扣。建议在开发和实施初期就让医疗专业人员参与进来，确保工具实用、相关且易于使用，提供培训、支持和激励措施可帮助克服抵触情绪[44]。7）反馈与支持不足，循证实践评估工具常提供有限反馈，导致医疗专业人员难以识别发展短板或提升能力。建议在工具中嵌入详细反馈机制，指导个体如何提升循证实践技能，包括相关文献推荐、导师指导机会或继续教育通道。运用电子学习平台及虚拟模拟技术可优化循证实践能力评估。这些技术更具互动性、动态性和时效性的评估方式，同时为改进提供反馈与资源支持。通过解决现存局限性，可提升循证实践能力评估工具的有效性，最终达到医疗服务质量的提升与病人预后改善。
4　小结
收起
本研究通过范围综述的方法对护士循证实践能力评估工具及其心理测量学特性进行整合和分析，结果显示现有护士循证实践能力评估工具种类丰富，评估内容涵盖广泛，在监测和改善临床护士循证实践能力方面具有积极作用。但现有评估工具仍具有一定的局限性，如评估方式和结果评估具有较大异质性以及不同工具间存在较大的文化差异。未来可借鉴国内外相关研究的共性部分，结合国情构建更符合本研究单位的护士循证实践能力评估工具。

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doi: 10.12102/j.issn.1009-6493.2026.17.026
  • 接收时间：2025-11-01
  • 首发时间：2026-10-30
  • 出版时间：2026-09-10
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  • 收稿日期：2025-11-01
  • 修回日期：2026-07-15
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    1海南省人民医院（海南医科大学附属海南医院），海南 570311

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