慢性伤口清创换药体验量表的研究  

Development of an experience scale for patients with chronic wound debridement and dressing

作　　者：史妍萍 田凌 刘志飞 张伟[1] 刘天奇 王金娜 姜思明 崔亚楠 李子榕 Shi Yanping;Tian Ling;Liu Zhifei;Zhang Wei;Liu Tianqi;Wang Jinna;Jiang siming;Cui Yanan;Li Zirong(Department of Plastic Surgery,Peking Union Medical College Hospital,Beijing 100140,China)

机构地区：[1]中国医学科学院,北京协和医院整形美容外科,北京100140

出　　处：《中华医学美学美容杂志》2024年第3期213-217,共5页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：北京协和医院课题(XHHLKY202018)。

摘　　要：目的编制适合中国慢性伤口患者清创换药体验的评估工具,并评估其信、效度,为提升患者满意体验提供借鉴。方法2021年1—6月,北京协和医院整形美容外科以美国就医体验调查量表为框架,通过文献复习,对12例慢性伤口患者[男7例、女5例,年龄33~71(58.1±12.3)岁]进行访谈,形成量表初稿;邀请5名专家进行内容效度测定。通过191例慢性伤口患者[男111例、女80例,年龄18~95(53.5±19.1)岁]评估该量表内部一致性信度、折半信度、重测信度及结构效度。结果慢性伤口清创换药体验量表涵盖需求回应、友好沟通、专业信任、流程优化、鼓励患者参与共5个维度、30个子条目,2个综合评估条目。量表总体Cronbachα系数为0.967,各维度Cronbachα系数为0.890~0.962。量表总体重测信度0.940,各维度重测信度0.895~0.940。量表总体折半信度0.923,各维度折半信度0.834~0.935。探索性因子分析提取5个公因子,累计方差贡献率82.061%。结论基于美国就医体验调查量表框架编制的慢性伤口清创换药体验量表具有较高的信、效度,可用于评估慢性伤口患者换药过程体验,对慢性伤口换药有临床指导意义。Objective To develop and evaluate a medical experience assessment scale for debridement and dressing change in chronic wound patients in China,and to provide a reference for improving hospital service quality.Methods Based on the framework of hospital consumer assessment of healthcare providers and systems survey(HCAHPS)in the United States,a preliminary draft of the scale was formed through a literature review and qualitative interviews with 12 chronic wound patients(7 males and 5 females aged 58.1±12.3 years).Five experts were invited for content validity testing,and 191 chronic wound patients(111 males and 80 females aged 53.5±19.1 years)were selected to evaluate the internal consistency reliability,half reliability,retest reliability,and structural validity of the scale.Results The Chronic Wound Patient Debridement and Dressing Experience Scale covered 5 dimensions with 30 sub-items and 2 comprehensive evaluation items,including demand response,good and friendly communication,professional trust,optimization of the medical treatment process,and encouragement of patient participation.The scale Cronbach′sαcoefficient was 0.967 and ranged from 0.890 to 0.962 for each dimension.The overall retest reliability of the scale was 0.940 and ranged from 0.895 to 0.940 for each dimension.The overall half reliability of the scale was 0.923 and ranged from 0.834 to 0.935 for each dimension.5 factors were extracted,with a cumulative variance contribution rate of 82.061%.Conclusions Based on the HCAHPS framework in the United States,the Chronic Wound Debridement and Dressing Experience Scale developed has high reliability and validity,and can be used to evaluate the dressing change experience of patients with chronic wounds.It has clinical practice significance for dressing change in chronic wounds.

关 键 词：外科伤口 调查问卷 慢性伤口 清创换药 量表编制 就医体验调查量表 

分 类 号：R641[医药卫生—外科学]