COSMIN指导下骨折患儿症状评估量表的开发与信效度检验  

Development of COSMIN-guided symptom assessment scale for children with fracture and its reliability and validity test

作　　者：赵永信 蔡春慧 张娇 陈一朕 顾莺[1] 王达辉[1] ZHAO Yongxin;CAI Chunhui;ZHANG Jiao;CHEN Yizhen;GU Ying;WANG Dahui(Children's Hospital of Fudan University,Shanghai 201102 China)

机构地区：[1]复旦大学附属儿科医院,201102

出　　处：《全科护理》2025年第4期605-609,共5页Chinese General Practice Nursing

基　　金：复旦—复星护理科研基金,编号:FNF202233。

摘　　要：目的:构建骨折患儿症状自评量表并进行信效度检验。方法:遵循基于共识的健康测量工具选择标准(COSMIN)指南意见,通过文献分析、质性访谈及2轮专家函询形成量表初稿。通过临界比值法和相关系数法进行项目分析,综合考虑专家意见与临床意义后决定删减条目,之后再使用探索性因子分析法再次进行条目优化,形成测试量表。从专家视角和患儿视角评价测试量表的内容效度,使用探索性因子分析评价量表的结构效度,通过测量量表各维度和总量表的Cronbach'sα系数评价量表的信度。结果:量表初稿包含16个条目,项目分析中删除1个条目,并在探索性因子分析时提取了神经与心理症状、躯体症状、胃肠道症状3个共同因子。专家视角条目水平的内容效度指数(I-CVI)为0.867~1.000,量表水平内容效度指数的平均值(S-CVI/Ave)为0.967,患儿视角均表示量表中的各条目易于理解。验证性因子分析显示模型拟合良好(χ^(2)/ν=2.626,CFI=0.904,RMSEA=0.095),量表3个维度的Cronbach'sα系数在0.753~0.946,量表总Cronbach'sα系数为0.874。结论:构建的量表具有良好的信效度,可用于评价6~18岁骨折患儿症状情况。Objective:To construct a symptom assessment scale for children with fractures and test its reliability and validity.Methods:Following the COSMIN guidelines,a preliminary draft of the scale was formed through literature analysis,qualitative interviews,and two rounds of expert consultation.The items were analyzed by critical ratio method and correlation coefficient method,and the items were deleted after comprehensive consideration of expert opinions and clinical significance.Afterwards,exploratory factor analysis was used to optimize the items again to form a test scale.Evaluating the content validity of the test scale from the perspectives of experts and children,and using exploratory factor analysis to evaluate the structural validity of the scale.The reliability of the scale was evaluated by measuring the Cronbach's α coefficients of each dimension and the total scale.Results:The first draft of the scale contained 16 items,one item was deleted from the item analysis,and three common factors including neurological and psychological symptoms,somatic symptoms,and gastrointestinal symptoms were extracted during the exploratory factor analysis.From the perspective of expert,the content validity index at the item level(I-CVI) ranges from 0.867 to 1.000,and the average content validity index at the scale level(S-CVI/Ave) was 0.967.From the perspective of pediatric patients,all items in the scale were easy to understand.Confirmatory factor analysis showed that the model fit well(χ^(2)/ν=2.626,CFI=0.904,RMSEA=0.095).Cronbach's α coefficient of the three dimensions of the scale ranged from 0.753 to 0.946,and the total Cronbach's α coefficient of the scale was 0.874.Conclusion:The scale constructed in this study has good reliability and validity,and can be used to evaluate the symptoms of children with fractures aged 6~18 years.

关 键 词：基于共识的健康测量工具选择标准 骨折 症状群 信效度 

分 类 号：R47[医药卫生—护理学]