title: The new version of a patient classification instrument: assessment of psychometric properties.
abstract: OBJECTIVE
  This paper assessed the reliability and construct validity of the new version of a patient classification instrument.
  
  
  BACKGROUND
  In the development of patient classification instruments, monitoring validity and reliability is essential to assure that patient care requirements and nursing staff workload are appropriately measured.
  
  
  METHODS
  The sample included 194 patients (construct validity test) and 60 patients (inter-rater reliability test) at medical, surgical, and specialized wards of a teaching hospital in the south east of Brazil. The study was conducted in 2009-2010. For analysis purposes, Spearman's correlation and Cronbach's alpha (internal consistency) were used, and weighted kappa (inter-rater reliability), factor analysis with principal axis factoring extraction method (construct validity) and ordinal regression (instrument's predictive ability).
  
  
  RESULTS
  A high level of inter-rater agreement was found. The importance of all care areas and their contribution to distinguish patient care needs and category in the new instrument were demonstrated. Results also showed the instrument's high predictive ability (99·6%).
  
  
  CONCLUSIONS
  The findings give the evidence that the new scale is a reliable and valid tool to assess patient care needs and care category and that it can be used to guide nursing management practice in determining the nursing staff workload.
authors.affiliation: Department of Specialized Nursing, Undergraduate Nursing Program, Faculty of Medicine of São José do Rio Preto (FAMERP), Brazil. marcia.perroca@famerp.br
authors.forename: Marcia Galan
authors.initials: MG
authors.lastname: Perroca
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010346:Patient Care Management / Q000379:methods*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D025341:Principal Component Analysis; D011594:Psychometrics; D012044:Regression Analysis; D015203:Reproducibility of Results; D016526:Workload