中文版成人疼痛行为量表的研制及信效度检验  

DEVELOPMENT AND PSYCHOMETRIC TESTING OF A CHINESE VERSION OF ADULT PAIN BEHAVIORAL SCALE FOR OBJECTIVE PAIN ASSESSMENT

作　　者：陈杰[1,2] 吴晓英[1] 战颖[1] 何苗[3] 冯艺[3] 王惠琴[4] 卢苇[5] 刘高明[6] 徐波[7] 何昕[7] 刘敏君[8] 石磊[9] 么莉 张海燕[1] 

机构地区：[1]北京大学人民医院护理部,北京100044 [2]武汉大学HOPE护理学院,武汉430071 [3]北京大学人民医院麻醉和疼痛医学科,北京100044 [4]浙江大学医学院附属第二医院护理部,杭州310009 [5]福建省立医院护理部,福州350001 [6]湖南省肿瘤医院妇瘤科,长沙410013 [7]中国医学科学院肿瘤医院护理部,北京100021 [8]浙江大学医学院附属邵逸夫医院护理教育部,杭州310036 [9]吉林大学第一医院肿瘤中心,长春130021 [10]国家卫生计生委医院管理研究所,北京100191

出　　处：《中国疼痛医学杂志》2016年第1期28-33,共6页Chinese Journal of Pain Medicine

摘　　要：目的:建立适用于成人客观疼痛评估的成人疼痛行为量表(Adult Pain Behavioral Scale,APBS)。方法:在文献回顾和现有的客观疼痛评估工具的基础上拟定条目池,通过专家评定形成APBS。采用APBS和疼痛程度数字评分法(Numeric Rating Scale,NRS)对77例插管患者和143例非气管插管患者进行疼痛评估,完成APBS的效标关联效度、区分效度和内部一致性的评价。然后20名ICU护士对另外5例气管插管和5例非气管插管患者进行疼痛评估,完成评定者间信度评价。结果:经过2轮专家评定后,形成了包含5个条目的量表,各条目的内容效度指数为0.923-1.000,量表的内容效度指数为0.973。在气管插管患者和非气管插管患者中,APBS均具有较好的结构效度(均提取到1个公因子,特征根分别为2.847和2.583,其中解释方差变异量分别为56.936%和51.668%,各条目的因子负荷均大于0.60)和效标关联效度(APBS与NRS的相关系数分别为0.956和0.794);有疼痛刺激时患者的APBS评分比无疼痛刺激时均明显升高(P<0.001)。内部一致性分别为0.706和0.733,评定者间信度分别为0.872-0.983和0.842-0.979。结论:中文版成人疼痛行为量表具有良好的效度和信度,适用于成人患者的客观疼痛评估。Objective： To develop an adult pain behavioral scale （APBS） for objective pain assessment. Methods： The items pool was established based on literature review and published objective pain assessment tools and evaluated by experts. The internal consistency, criterion-related validity and discriminant validity were evaluated by pain assessment with the APBS and Numeric Rating Scale （NRS） in 77 intubated patients and 143 non-intubated patients. To evaluate the inter-rater reliability, 20 ICU nurses assessed pain-related behaviors with APBS in 5 intubated patients and 5 non-intubated patients Results： A 5-items scale was developed after two rounds of experts＇consultation. The content validity index of the items ranged from 0.923 to 1.000, the content validity index of the scale was 0.973. The correlation coefficient between the scores of the APBS and NRS were 0.956 in intubated and 0.794 in non-intubated patients which consolidated the criterion-related validity. Discriminant validity was established by the APBS scores during the painful procedures were significantly higher than the non-painful procedures both in intubated and non-intubated patients （P 〈 0.001）.The Cronbach＇ a values of APBS were 0.706 in intubated and 0.733 in non-intubated patients. One common factor was extracted. The contribution rates of accumulative total of variance of the factor were 56.936% in intubated patients and 51.668% in non-intubated patients. The dimensional factor loading of each item was greater than 0.60. Inter-rater reliability ranged from 0.872 to 0.983 in intubated and from 0.842 to 0.979 in non-intubated patients. Conclusion： The Chinese version APBS was shown to be valid and reliable. The Chinese version APBS is applicable for adult patients＇objective pain assessment.

关 键 词：成人疼痛行为量表 疼痛评估 效度 信度 

分 类 号：R473[医药卫生—护理学]