野生蕈中毒神经精神症状病情评价量表编制  

Development of the neuropsychiatric symptoms of wild mushroom poisoning evaluation scale

作　　者：符阳山 何利平 李娅[1] 兰言馨 杜兆伦 刘林[1] 郑粉双 Fu Yangshan;He Liping;Li Ya;Lan Yanxin;Du Zhaolun;Liu Lin;Zheng Fenshuang(Department of Emergency Medicine,the Affiliated Hospital of Yunnan University,Kunming 650021,China)

机构地区：[1]云南大学附属医院急诊医学部,云南昆明650021 [2]昆明医科大学公共卫生学院流行病与卫生统计学系,云南昆明650500

出　　处：《中国急救医学》2023年第9期679-684,共6页Chinese Journal of Critical Care Medicine

基　　金：云南省科技计划重点项目:兰茂牛肝菌致幻机制及中毒诊断体系应用基础研究(202301AS070037);云南省于学忠专家工作站项目(202105AF150026)。

摘　　要：目的编制野生蕈中毒神经精神症状病情评价量表(NSWMPES),探讨临床使用方案。方法在经典测量理论(CTT)框架的指导下,通过回顾性收集分析病历资料、查阅书籍和文献、参照现有评分系统量表、访谈等方式收集、整理形成条目池,依据德尔菲法(Delphi)原则通过两轮专家咨询形成初测量表。对初测量表进行临床适用性初步评价,以临床典型病例情景模拟方式收集不同年资、不同专业背景的使用者对初测量表使用情况的访谈结果。抽样选取2023年6月至8月就诊于云南大学附属医院急诊医学部内科的野生蕈中毒神经精神型患者使用初测量表进行测评,并记录不同使用者测评的情况。相关测评访谈结果通过专家小组讨论,在不改变大体结构的基础上对条目进一步修订,探讨修订后量表的临床使用方案。结果通过两轮专家咨询、专家小组讨论、临床适用性初步评价访谈后修订形成的《野生蕈中毒神经精神症状病情评价量表(V2.4.9)》包含两大部分,评价量表条目项目14个,症状描述用词48个,各条目的严重程度分为5个级别。量表目标使用对象为从事野生蕈中毒救治的急诊科医师,访谈结果显示,目标使用者对量表的接受度较好,实际使用情况及评分结果存在个人差异。初步临床使用中发现,因患者和家属配合度,对疾病的认识和理解程度等客观因素,使用者经验等客观差异,测评结果存在一定误差。结论野生蕈中毒神经精神症状病情评价量表编制有一定临床实际使用价值,测量学检验需进一步收集临床使用数据,从而提高量表的科学性、准确性与适用性。Objective To develop the neuropsychiatric symptoms of wild mushroom poisoning evaluation scale(NSWMPES)and to explore clinical application plans.Methods Under the guidance of the classic test theory(CTT)framework,the entry pool of items was collected and organized by retrospective collection and analysis of medical records,consulting books and literatures,referring to existing scales,interviews,and other methods.The initial measurement table was formed through two rounds of expert consultation according to the principle of Delphi method.The clinical applicability of the preliminary scale was evaluated preliminary,and interview results on the use of the preliminary scale were collected from the users of different seniority and medical professional backgrounds through clinical scenario simulation.Sampling method:wild mushroom poisoning patients with neuropsychiatric symptoms who had been hospitalized in the Department of Emergency Medicine,the Affiliated Hospital of Yunnan University from June to August 2023 and accepted the scale for evaluation were selected,and the evaluation results of different users were recorded.Based on the interview results of the relevant evaluation,further revisions of the items were made according to expert group discussions without changing the overall structure,and the clinical application plan of the revised scale was explored.Results The revised《neuropsychiatric symptoms of wild mushroom poisoning evaluation scale(V2.4.9)》after two rounds of expert consultation,expert group discussion,and preliminary clinical applicability evaluation interviews consisted of two major parts,with 14 evaluation scale items,48 symptom description words.The severity of each item was divided into 5 levels.The target users of the scale was emergency physicians engaged in the treatment of wild mushroom poisoning.The interview results showed that the target user had a good acceptance of the scale,but there were personal differences in actual use and scoring results.In preliminary clinical use,it was found

关 键 词：野生蕈 中毒 神经精神症状 量表编制 

分 类 号：R595.6[医药卫生—内科学]