危重症患者肠内营养治疗管饲依赖评估量表的构建及信效度检验  

Construction and reliability and validity of evaluation scale for tube feeding dependence in critically ill patients receiving enteral nutrition therapy

作　　者：杜金磊 聂臣聪[1] 王红梅 张继权 王兰 张红梅[1] 雷玲[1] 赵洪祥[1] Du Jinlei;Nie Chencong;Wang Hongmei;Zhang Jiquan;Wang Lan;Zhang Hongmei;Lei Ling;Zhao Hongxiang(The Fourth People's Hospital of Zigong City,Zigong Sichuan 643000,China;West China Hospital of Sichuan University,Chengdu 610000,China;Deyang People's Hospital,Deyang Sichuan 618000,China;Sichuan Provincial Maternity and Child Health Care Hospital,Chengdu 610000,China)

机构地区：[1]四川省自贡市第四人民医院,四川自贡643000 [2]四川大学华西医院,成都610000 [3]四川省德阳市人民医院,四川德阳618000 [4]四川省妇幼保健院,成都610000

出　　处：《保健医学研究与实践》2023年第10期83-88,共6页Health Medicine Research and Practice

基　　金：四川省科技厅科技计划项目(2022JDKP003);四川省自贡市卫生健康委员会科研课题(21zd010);四川省自贡市科技局重点科技计划项目(2022ZCYGY30);中华医学会杂志社批准课题(CMAPH-NRD2021053)

摘　　要：目的构建危重症患者肠内营养治疗管饲依赖评估量表并验证其信效度,从而为管饲依赖症状的精准筛查、量化评估提供参考依据。方法于2022年1—5月,采用文献法、质性访谈法以及德尔菲专家函询法拟订初始量表。于2022年6—10月采用便利抽样法于自贡市第四人民医院、四川大学华西医院、德阳市人民医院以及成都市第二人民医院抽取372人展开多中心调查研究,通过项目分析法以及探索性因子分析法形成正式量表,并检验量表的信效度。于2022年11月对量表诊断效能展开评估分析。结果危重症患者肠内营养治疗管饲依赖评估初始量表包含20个条目,经过筛选分析后形成饮食意愿、饮食症状、营养支持3个维度,共计16个条目的最终量表。量表的Cronbach’sα系数为0.929,折半信度为0.864。量表各条目水平的内容效度指数为0.800~1.000,量表水平的内容效度指数为0.894。探索性因子分析共提取3个公因子,累积方差贡献率为67.687%。ROC曲线下面积为0.827(95%CI:0.675~0.979),当诊断界值设为40分时,敏感度为86.7%,特异度为72.4%。结论本研究所编制的危重症患者肠内营养治疗管饲依赖症状评估量表条目简洁、信效度良好,可在我国危重症患者肠内营养治疗后管饲依赖症状评估中推广应用。Objective This paper aims to construct an evaluation scale for tube feeding dependence in critically ill patients treated with enteral nutrition and verify its reliability and validity,to provide evidence for accurate screening and quantitative evaluation of tube feeding dependence symptoms.Methods From January to May 2022,the initial scale was formulated by reviewing literature,qualitative interviews,and Delphi expert correspondence.From June to October 2022,a multicenter survey was conducted among 372 participants selected from the Fourth People's Hospital of Zigong,West China Hospital of Sichuan University,Deyang People's Hospital,and the Second People's Hospital of Chengdu by a convenience sampling method.A formal scale was formed by item analysis and exploratory factor analysis,and the reliability and validity of the scale were tested.The diagnostic efficacy of the scale was assessed and analyzed in November 2022.Results The initial scale of tube feeding dependence assessment for enteral nutrition therapy in critically ill patients included 20 items,and 3 dimensions(dietary willingness,dietary symptoms,and nutritional support)were formed after screening analysis,totaling 16 items of the final scale.The Cronbach's coefficient of the scale was 0.929 and the content validity index was 0.864.The content validity index ranged from 0.800 to 1.000 at each item level of the scale and 0.894 at the scale level.Exploratory factor analysis extracted 3 common factors,and the cumulative variance contribution rate was 67.687%.The area under the ROC curve was 0.827(95%CI,0.675 to 0.979),and when the diagnostic cut-off value was set at 40 points,the sensitivity and specificity were 86.7%and 72.4%,respectively.Conclusion The scale for evaluating the symptoms of feeding dependence after enteral nutrition therapy in critically ill patients developed in this study is simple and reliable,and can be widely used in evaluating the symptoms of feeding dependence after enteral nutrition therapy in these patients in China.

关 键 词：危重症患者 营养治疗 管饲依赖症状 评估 

分 类 号：R473.5[医药卫生—护理学]