ApacheⅡ和简单临床评分在分级护理病情评估中的应用比较  

Comparison of Application of Apache Ⅱ and Simple Clinical Scores in Grading Nursing Care

作　　者：王丹丹 戴新娟[2] 宋玉磊[3] 李英[2] 徐玮[3] 倪冬梅 钟琴 朱静 王迪 柏亚妹[3] WANG Dan-dan;DAI Xin-juan;SONG Yu-lei(Kanda College of Nanjing Medical University,Lianyungang,Jiangsu,222000,China;不详)

机构地区：[1]南京医科大学康达学院,江苏连云港222000 [2]江苏省中医院,江苏南京210029 [3]南京中医药大学护理学院,江苏南京210023 [4]常州市中医院,江苏常州213003

出　　处：《中国医院管理》2020年第11期80-83,共4页Chinese Hospital Management

基　　金：教育部人文社会科学研究青年基金项目(19Z10315006);国家自然科学基金项目(71573140)。

摘　　要：目的比较ApacheⅡ和简单临床评分(SCS)在分级护理病情评估中的应用效果。方法采用多中心分层整群抽样调查法,对全国6家医院的3600例普通成人患者进行问卷调查和工时测量,从信度、效度和可行性等方面对两个量表进行比较。信度采用条目与总分相关系数和Cronbach’sα系数比较;效度中效标效度采用两个量表与标准护理等级、Barthel指数和24 h直接护理工时相关性比较,区分效度采用量表等级得分差异比较;可行性采用问卷回收率、培训时间、测评时间比较。结果信度:APACHEⅡ、SCS条目与总分相关系数分别为0.43~0.76、0.45~0.78,Cronbach’sα系数分别为0.79、0.84。效度:效标效度方面,APACHEⅡ、SCS与标准护理等级、Barthel指数、24 h直接护理工时均明显相关(P<0.01),但SCS与Barthel指数、24 h直接护理工时相关度更高;区分效度方面,APACHEⅡ、SCS均可以区分人群疾病严重程度(P<0.05)。可行性分析:APACHEⅡ、SCS的接受率均为100%,有效回收率分别为97.83%、98.04%,培训课题组成员时间分别为22.6 min和8 min,临床实际测评时间分别为5.2 min和1.8 min。结论SCS的信度、效度和可行性优于APACHEⅡ,更适合作为普通成人病房患者疾病严重程度评估量表。Objective To compare the application effect of Apache Ⅱ and simple clinical scoring(SCS)in grading nursing care.Methods A total of 3600 adult patients from 6 hospitals in China were investigated with a multi center stratified cluster sampling method.The reliability,validity and feasibility were compared.Reliability was compared between item and total score correlation coefficient and Cronbach’s alpha coefficient.In validity,the criterion validity of the scale was compared with the standard nursing level,the Barthel index and the 24 h direct nursing man hour,and the discrimination validity was compared by the scale grade difference of the two scales.The feasibility was compared through questionnaire recovery rate,training time and evaluation time.Results Reliability:the correlation coefficients of APACHE Ⅱ and SCS items were 0.43~0.76 and 0.45~0.78,and the Cronbach’s alpha coefficients were 0.79 and 0.84,respectively.The validity,criterion validity,APACHE Ⅱ,SCS and standard nursing level,Barthel index,24 h direct nursing time were significantly correlated(P<0.01),but the SCS and the Barthel 24 h index,direct nursing time more relevant;in discriminant validity,APACHE Ⅱ and SCS can distinguish the severity of the disease population(P<0.05).The feasibility analysis:APACHE Ⅱ and SCS acceptance rate was 100%,the effective recovery rate were 97.83%and 98.04%.The members of the project group training time were 22.6min and 8min,and the actual clinical evaluation time was 5.2min and 1.8min.Conclusion The reliability,validity and feasibility of SCS are better than that of APACHE Ⅱ,and it is more suitable to be used as an assessment scale for disease severity in general adult ward patients.

关 键 词：急性生理和慢性健康状况评分2 简单临床评分 分级护理 病情评估 

分 类 号：R47[医药卫生—护理学]