住院癌症患者缓和照护需求筛查工具的汉化及临床验证  

Validity and Applicability of the Chinese Version of the Palliative Care Screening Tool

作　　者：周娅楠 李丽 ZHOU Yanan;LI Li(Department of Nursing,Third Affiliated Hospital of the Naval Medical University,Shanghai 201805,China)

机构地区：[1]海军军医大学第三附属医院护理部,上海市201805

出　　处：《中国全科医学》2022年第22期2804-2810,共7页Chinese General Practice

基　　金：2020年上海市嘉定区第五批医学重点学科(项目)建设(2020-jdyxzdfcxk-01)。

摘　　要：背景缓和照护能够改善癌症患者的生活质量。缓和照护需求筛查相关工具的开发与利用可以帮助医护人员快速、准确、科学地识别有缓和照护需求的癌症患者,并使医护人员能够更加及时地为其提供缓和照护相关服务。目前,国内有关缓和照护需求筛查相关工具开发与利用的文献报道较为少见。目的汉化缓和照护需求筛查工具(PCST),并在住院癌症患者中检验其信效度。方法按照Brislin翻译模型对PCST进行双向翻译,通过专家小组会议和预调查对中文版PCST进行文化调试。于2020年12月至2021年5月,采用便利抽样法,选取入住海军军医大学第三附属医院肿瘤科、生物治疗科、介入科、中西医结合科的173例癌症患者为研究对象,采用一般资料调查表、中文版PCST对其进行调查。采用临界比值法和条目总分相关法进行项目分析,采用专家评分法评价量表的内容效度,通过比较不同特征癌症患者的缓和照护需求筛查结果评价量表的已知族群效度。采用Cronbach'sα系数和Guttman折半系数评价量表内部一致性,采用Pearson相关评价评分者间信度和量表的重测信度。结果中文版PCST包含10个条目,得分范围为0~14分。条目的CR值为0.621~8.820,除条目1、8外,其余条目的CR值均达到显著水平(P<0.05);各条目得分与量表总分的相关系数为0.161~0.795(P<0.05),除条目8外,其余条目得分与量表总分的相关系数均>0.200。量表水平的平均内容效度指数为0.943,条目水平的内容效度指数为0.429~1.000。量表的Cronbachs'α系数为0.612,Guttman折半系数为0.538;评分者间信度系数为0.967(P<0.001),量表的重测信度系数为0.960(P<0.001)。以5分作为缓和照护需求筛查的界值,在完成筛查的173例住院癌症患者中,35.3%(61/173)的患者对缓和照护服务有需求。不同缓和照护需求癌症患者的年龄、子女数、患病时长、癌症症状数量、过去6个月因Background Palliative care improves the quality of life of patients with cancer.The development and utilization of palliative care needs screening tools can help health care providers rapidly,accurately,and scientifically identify cancer patients with palliative care needs and enable health care providers to provide them with palliative care related services in a more timely manner.Currently,the literature on screening tools for palliative care needs in China is less common.Objective To hance the palliative care needs screening tool(PCST)and test its validity in hospitalized cancer patients.Methods The PCST was bidirectionally translated following the Brislin translational model.Cultural commissioning of the Chinese version of PCST through expert panel meetings and pre survey.A total of 173 cancer patients admitted to the Department of oncology,biotherapeutics,interventional,and integrative medicine of the Third Affiliated Hospital of Navy Military Medical University were selected for the study from December 2020 to May 2021 using convenience sampling,and the general information questionnaire,Chinese version of PCST were used for this investigation.The critical ratio method and correlation of the item-total scores were used for item analysis,and the content validity of the scale was assessed by expert scoring.To evaluate the validity of known-groups,the palliative care needs screening results of patients with different characteristics were compared.Cronbach'sαCoefficient and Guttman compromise coefficient were used to evaluate the internal consistency of the scale.Pearson correlation was used to evaluate the inter rater reliability and test-retest reliability of the scale.Results The Chinese version of the PCST includes 10 items,with scores ranging from 0 to 14 points.The CR values of entries ranged from 0.621 to 8.820,and all entries except entries 1 and 8 achieved significant values(P<0.05).The correlation coefficients between the scores of the individual entries and the total score of the scale ranged from 0.

关 键 词：缓和照护 癌症 住院 信度 效度 

分 类 号：R730.56[医药卫生—肿瘤] R739.9[医药卫生—临床医学]