癌症相关性疼痛病人多维疼痛评估量表的构建及信效度检验

Construction and testing of reliability and validity of multi-dimensional brief test scale for pain in cancer-related pain patients

目的:本研究旨在构建适合癌症相关性疼痛(简称癌痛)病人的疼痛评估量表,并探索评估量表用于癌痛病人的信度和效度,以期为临床癌痛病人的管理提供更加综合全面且简便易行的评估工具。方法:基于国内癌痛领域的指导性规范、临床诊疗指南、专家共识等,本研究构建了癌痛病人评估量表初始条目池,采取德尔菲法选取我国癌痛领域的二十余名专家进行两轮咨询,统计咨询结果,确认纳入的条目,形成最终的多维疼痛评估量表(multi-dimensional brief test scale for pain,BTS)。经过两轮德尔菲法专家咨询,第一轮纳入21位专家,第二轮纳入10位专家,第一轮纳入19个评估维度,选取重要性评分≥4.5分且变异系数≤20%的7个评估维度,进行第二轮专家咨询。这7个评估维度和条目的重要性结果与第一轮一致,由此最终构建的BTS共包含7个评估维度,15个条目。选取2022年7月至2023年2月中国人民解放军北部战区总医院收治的癌痛病人,使用构建的BTS评估量表进行信效度检验。结果:共纳入166例病人,经过数据清洗,最终纳入分析的病人例数为138例。BTS的信度检测Cronbachα系数为0.78,效度检测的KMO值为0.80,具有较好的信度和效度。结论:构建的BTS条目共纳入7个评估维度,15个条目,具有较好的信度和效度,可在临床实践中推广应用于癌痛病人的疼痛评估。

Objective:To construct the pain evaluation scale suitable to cancer-related pain patients,explore its reliability and validity in cancer-related pain patients,and provide more comprehensive,simple and practical tool for management of cancer-related pain patients in clinical practices.Methods:Based on Chinese guidance,consensus,recommendations in cancer-related pain field and discussions from experts in this field,we constructed the initial item pool,and consulted with more than twenty experts in this field according to Delphi methodology.After 2 rounds of consultations from experts,the inclusion of items were confirmed and formed the final multi-dimensional brief test scale for pain(BTS).After 2 rounds of Delphi technique expert consultations,the first round enrolled 21 experts,and the second round enrolled 10 experts.The scale in the first round included 19 dimensions,selected 7 dimensions with importance score≥4.5 and the coefficient of variation≤20%,which advanced in the second round.The final BTS scale was consisted of these 7 dimensions,15 items with the importance score consistent in these two rounds.During July 2022 to February 2023,we enrolled the cancer-related pain patients in General Hospital of Northern Theater Command,Chinese People's Liberation Army,and test the reliability and validity of this scale.Results:We enrolled 166 patients,after final data cleaning,138 patients were included in the final analysis.The reliability and validity of BTS were tested and proven to be good,with Cronbachαcoefficient of 0.78 and KMO value of 0.80.Conclusion:After 2 rounds of Delphi expert consultations,BTS scale includes 7 dimensions and 15 items,with good reliability and validity,and can be popularized to apply in the cancer-related pain patients in clinical practice.