ICU患者身体约束评估量表的构建及信效度检测  

Construction of physical restraint assessment scale for ICU patients and analysis of its reliability and validity

作　　者：崔念奇 甘秀妮[1] 周世群[1] 张传来[2] 唐锡飞 Cui Nianqi;Gan Xiuni;Zhou Shiqun;Zhang Chuanlai;Tang Xifei(Department of Nursing;Department of Critical Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China)

机构地区：[1]重庆医科大学附属第二医院护理部,重庆400010 [2]重庆医科大学附属第二医院重症医学科,重庆400010

出　　处：《中华危重症医学杂志（电子版）》2018年第2期94-99,共6页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：重庆市卫生和计划生育委员会医学科研项目(2017MSXM036)

摘　　要：目的初步构建ICU患者身体约束评估工具。方法参考国外相关评估工具,结合文献回顾、德尔菲法与层次分析法构建量表,并进行信效度检测。结果第1轮和第2轮专家函询专家的积极系数分别为95.4%和100%,权威系数分别为0.91和0.92,专家协调程度均为0.359。最终形成了包含行为等级、治疗等级、肌力等级3个维度8个条目的 ICU患者身体约束评估量表,三个维度的权重分别为0.718、0.191、0.091。量表的信度效度检测结果为:评估量表总分的Cronbach’sα系数为0.704,评定者组内相关系数为0.948(P<0.001);量表条目水平的内容效度指数为0.957 5,量表水平的内容效度指数为0.958 3。评估阈值取25分时,敏感度为0.532,特异度为0.833,约登指数为0.365,受试者操作特征曲线下面积为0.759[95%CI(0.667,0.852),P<0.001]。结论该量表具有良好的信效度,可以作为ICU患者身体约束评估的工具。Objective To construct an instrument for physical restraint assessment of ICU patients. Method The scale was constructed based on related instruments abroad, literature review, the Delphi method and analytic hierarchy process, and its reliability and validity were verified. Results The positive coefficients, authoritative coefficients and Kendall’s coefficients of concordance W of expert questionnaires in two rounds were 95.4% and 100%, 0.91 and 0.92,0.359 and 0.359, respectively. The final physical restraint assessment scale for ICU patients included 3 dimensions（the behavior level, treatment level and myodynamia level） in 8 items.The weight of three levels were 0.718, 0.191, and 0.091. Its reliability and validity test showed the Cronbach’s α coefficient was 0.704. The correlation coefficient among raters was 0.948（P 〈0.001）. The item-level content validity index was 0.957 5, and the scale-level content validity index was 0.958 3. When the evaluation threshold was 25 scores, the sensitivity was 0.532, the specificity was 0.833, the Youden index was 0.365, and the area under receiver operating characteristic curve was 0.759 [95%CI（0.667, 0.852）, P 〈 0.001]. Conclusion The scale has satisfactory reliability and validity and it can be used as a tool for physical restraint assessment of patients in ICU.

关 键 词：重症监护病房 约束 身体的 信度 效度 

分 类 号：R47[医药卫生—护理学]