针刺手法操作行为的定量研究

Quantitative research on operation behavior of acupuncture manipulation

目的:探索定量评估针刺手法操作行为的方法,并进一步分析专业针刺手法的行为特征。方法:根据针刺基本手法编制出《针刺基本手法操作行为量表》,经德尔菲法检验内容效度;2名独立评分人运用该量表评估针灸医师和初学者各12人的针刺手法操作行为,计算评判间信度,并比较这两组受试者操作行为总分及消毒、进针、行针及出针各步骤操作行为得分的差异。结果:该量表内容效度满意;评判间信度为0.768;且针灸医师组操作行为总分显著高于初学者组(13.80±1.05vs 11.03±2.14,P<0.01);医师进针及行针得分显著高于初学者(4.28±0.91vs 2.54±1.51,P<0.01;2.56±0.65vs 1.88±0.88,P<0.05);而消毒及出针得分与初学者无差异。结论:该量表可用于定量评估针刺手法操作行为,专业针刺手法的行为特征主要体现在能够完成难度较大且协调性精确性要求较高的进针及行针操作上。

Objective To explore a method of quantitative evaluation on operation behavior of acupuncture ma- nipulation and further analyze behavior features of professional acupuncture manipulation. Methods According to acupuncture basic manipulations, Scales for Operation Behavior of Acupuncture Basic Manipulation was made and Delphi method was adopted to test its validity. Two independent estimators utilized this scale to assess opera- tion behavior of acupuncture manipulate among 12 acupuncturists and 12 acupuncture-novices and calculate inter- rater reliability, also the differences of total score of operation behavior in the two groups as well as single-step score, including sterilization, needle insertion, needle manipulation and needle withdrawal, were compared. Results The validity of this scale was satisfied. The inter-rater reliability was 0. 768. The total score of operation behavior in acupuncturist group was significantly higher than that in the acupuncture-novice group （13.80± 1.05 vs 11.03±2.14, P〈0.01）. The scores of needle insertion and needle manipulation in the acupuncturist group were significantly higher than those in the acupuncture-novice group （4. 28±0. 91 vs 2. 54±1.51, P〈0.01 ;2. 56± 0.65 vs 1.88±0.88, P〈0.05） ; however, the scores of sterilization and needle withdrawal in the acupuncturist group were not different from those in the acupuncture-novice group. Conclusion This scale is suitable for quanti- tative evaluation on operation behavior of acupuncture manipulation. The behavior features of professional acu- puncture manipulation are mainly presented with needle insertion and needle manipulation which has superior diff- culty, high coordination and accuracy.