3种压疮危险评估量表在神经外科ICU病人中的应用研究  

Application research on three kinds of pressure sore risk assessment scale for patients in ICU in department of neurosurgery

作　　者：陈晓艳[1] 

机构地区：[1]南通大学附属医院

出　　处：《护理研究（下旬版）》2016年第3期1081-1083,共3页Chinese Nursing Researsh

摘　　要：[目的]研究Braden量表、Norton量表和Waterlow压疮危险评估量表在神经外科监护病房病人应用中的信效度情况。[方法]选择南通大学附属医院神经外科ICU入科前未发生压疮的病人121例,由两名研究者运用3种量表对病人发生压疮的风险进行评估,连续评估病人发生压疮的危险,采用Cronbach’sα系数评价量表的内部一致性信度、采用组内相关系数评价量表的评定者间的信度,采用灵敏度、特异度、ROC曲线下面积(AUC)评价量表的预测效度。[结果]Braden量表、Norton量表和Waterlow量表Cronbach’sα系数分别为0.459,0.397,0.311,ICC分别为0.79,0.89,0.78。Braden量表的AUC为0.365,高低危人群的分界诊断界值在10.5分时,灵敏度为36.4%,特异度为47.5%。Norton量表的AUC为0.475,高低危人群的分界诊断界值在10.5分时,灵敏度为59.1%,特异度为38.4%。Waterlow量表的AUC为0.468,高低危人群的分界诊断界值在20.5分时,灵敏度为54.5%,特异度为47.5%。[结论]Braden量表、Norton量表和Waterlow量表评定者间信度较好,内部一致性信度较差,与其他两个量表相比,Waterlow量表的预测效度较佳,提示进一步研究可对Waterlow量表的条目进行修订,研究更为准确且适合神经外科ICU病人的压疮预测工具。Objective:In order to study the reliability and validity of Braden scale,Norton scale and Waterlow pressure sore risk assessment scale in ICU patients in Department of neurosurgery.Methods:A total of 121 cases of patients without pressure sore before admission were selected in ICU in department of neurosurgery in affiliated hospital of Nantong university.Two researchers used 3kinds of scales to assess their risk of pressure sores.Cronbach,s alpha coefficient was used to evaluate the internal consistency reliability of the scales.The intraclass correlation coefficient was used to evaluate the reliability of scales.The sensitivity,specificity and the area under the ROC curve(AUC)were used to assess the predictive validity of scales.Results:Cronbach's alpha coefficient of Braden scale,Norton scale and Waterlow scale were respectively 0.459,0.397 and 0.311.ICC were respectively 0.79,0.89 and 0.78.AUC of the Braden scale was 0.365.When the boundary diagnostic values of the high and low risk population was 10.5,the sensitivity was 36.4% and the specificity was 47.5%.AUC of the Norton scale was 0.475.When the boundary diagnostic values of the high and low risk population was 10.5,the sensitivity was 59.1%,specificity was 38.4%.AUC of the Waterlow scale was 0.468.When the boundary diagnostic values of the high and low risk population was 20.5,the sensitivity was 54.5% and the specificity was47.5%.Conclusion:Braden scale,Norton scale and Waterlow scale had better reliability among raters and poor internal consistency reliability.Compared with the other two scales,t he predictive validity of Waterlow scale was better.In order to study the pressure ulcer prediction tool for patients in ICU in department of neurosurgery more accuratedly and suitablly,it suggested that further study to revise the entries of Waterlow scale.

关 键 词：压疮 BRADEN量表 Norton量表 Waterlow量表 神经外科 ICU 

分 类 号：R472[医药卫生—护理学]