《结直肠手术患者尿管拔除评估量表》的编制与信效度检验  

Reliability and validity test of Urinary Catheter Removal Assessment Scale for Patients with Colorectal Surgery

作　　者：殷燕[1] 张春华[2] 何文斌 段静 李思思[3] 解萧宇 骆曼 孙文 武玲 YIN Yan;ZHANG Chunhua;HE Wenbin;DUAN Jing;LI Sisi;XIE Xiaoyu;LUO Man;SUN Wen;WU Ling(Wound/Stoma Diagnosis and Treatment Center,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Nursing Department,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Colorectal&Anal Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院创面/造口诊疗中心,武汉430071 [2]武汉大学中南医院护理部,武汉430071 [3]武汉大学中南医院结直肠肛门外科,武汉430071

出　　处：《医学新知》2024年第6期665-673,共9页New Medicine

基　　金：国家自然科学基金青年科学基金项目(82202915);武汉大学中南医院护理学科培育项目(HLXKPY202101);武汉大学护理学专项科研培育基金重点类项目(LCHL202304)。

摘　　要：目的在加速康复外科理念的指导下编制《结直肠手术患者尿管拔除评估量表》,并检验其信效度。方法通过文献查阅法、专家访谈法,结合临床实践分析影响结直肠手术患者尿管拔除时机的相关因素,通过2轮德尔菲专家函询,形成初始版量表。采用方便抽样法选取2023年4月至10月在湖北省某三级甲等医院的137例结直肠手术患者进行问卷调查,并进行信效度检验,分析量表的敏感性和特异性,确定最佳阈值。结果该量表包括3个维度,20个条目。累计方差贡献率为83.582%。条目水平的内容效度指数为0.96~1.00,量表水平的内容效度指数为0.91。量表各条目与所属维度的相关系数为0.637~0.852,维度间的相关系数为0.602~0.774,各维度与总量表的相关系数为0.889~0.918。量表各维度的Cronbach'sα系数为0.914~0.957,量表总的Cronbach'sα系数为0.931;各维度的分半信度为0.913~0.942,量表总的分半信度为0.958。量表ROC曲线下面积为0.934[95%CI(0.892,0.975)]。当量表评分为29.5分时,该量表的敏感度、特异度和约登指数最高,分别为0.870、0.912和0.782。评分≤29.5分时,可考虑拔除尿管。结论本研究构建的《结直肠手术患者尿管拔除评估量表》具有较好的信效度,经过临床验证可较准确的判断结直肠手术患者尿管拔除时机。Objective To construct the Urinary Catheter Removal Assessment Scale for Patients with Colorectal Surgery under the guidance of the concept of enhanced recovery after surgery(ERAS),and to test reliability and validity.Methods Under the guidance of the concept of ERAS,the relevant factors affecting the timing of urinary catheter removal in patients with colorectal surgery were analyzed through literature review and expert interview,and combined with clinical practice.The initial scale was formed through 2 rounds of Delphi consultations.A total of 137 patients undergoing colorectal surgery in a grade-III hospital in Hubei province from April to October 2023 were selected by convenience sampling method for questionnaire survey,and the reliability and validity test was conducted to analyze the sensitivity and specificity of the scale and determine the optimal threshold.Results The scale consists of 3 dimensions and 20 items.The cumulative variance contribution rate was 83.582%.The content validity index was 0.96~1.00 at the item level and 0.91 at the scale level.The correlation coefficient between each item and its dimension ranged from 0.637 to 0.852,between the dimensions ranged from 0.602 to 0.774,and between each dimension and the total table ranged from 0.889 to 0.918.The Cronbach’sαcoefficient of each dimension was 0.914~0.957,and of the total scale was 0.931.The partial half-reliability of each dimension was 0.913~0.942,and of the scale was 0.958.The area under the ROC curve of the scale was 0.934[95CI%(0.892,0.975)].When the scale score was 29.5,the sensitivity,specificity and Yoden index of the scale were the highest,which were 0.870,0.912 and 0.782,respectively.When the score is less than 29.5,the urinary catheter could be removed.Conclusion The catheter removal tool constructed in this study has good reliability and validity,and could accurately judge the timing of catheter removal in patients with colorectal surgery through clinical verification.

关 键 词：结直肠 加速康复外科 尿管拔除 量表 信度 效度 

分 类 号：R47[医药卫生—护理学]