流行病学伤害即“伤且害”界定标准的构建与评价

Construction and evaluation of the epidemiological injury criteria based on the combination of 'Hurt' and 'Harm'

目的构建流行病学"伤且害"的伤害界定标准,评价其合理性,为科学合理的研究流行病学伤害提供理论依据。方法采用文献分析及专家咨询等方法构建流行病学"伤且害"的伤害界定标准,应用Delphi法评价"伤且害"伤害界定标准的合理性。结果流行病学伤害是指"有伤且有害",即"伤且害",其中"伤"是临床医学意义的损伤或受伤,"害"是公共卫生意义的损害或危害;Delphi法两轮咨询专家的积极系数都为100%,权威程度分别为0.88和0.87,协调系数分别为0.39,0.55(P均<0.05);"伤"的界定、"害"的界定、"伤害"即伤且害、伤害需分级、伤害可根据时间划分等级的合理性得分均>3分,除"伤害应根据时间划分等级"外其余各指标的变异系数均低于0.25。结论流行病学伤害中关于"伤"、"害"、"伤害即伤且害"的界定、"伤害需要分为轻、中、重等不同级别"以及"伤害可根据时间划分等级"是合理的,但"伤害可根据时间划分等级"存在一定程度的分歧。

Objective To construct and evaluate the criteria of injury based on the theoretical model that ＇Injury＇ is the combination of ＇Hurt＇ and ＇Harm＇, in order to provide theoretical basis for scientific and rational research on injury in future epidemiological survey. Methods The criteria of epidemiological injury was consected by analyzing documents and consulting experts, then Delphi method was used to evaluate its rationality. Results The epidemiological definition for＇Injury＇is the combination of ＇Hurt＇ and ＇Harm＇. ＇Hurt＇ means the wound in clinical medicine, while ＇Harm＇ means the damage from the views of public health. The active coefficients of two rounds Delphi Method were both 100%. The authority coefficients of two rounds were 0.88 and 0.87, respectively. The coordination coefficients were 0.44 and 0.62（P〈0.05）,respectively. After two rounds consulting, all scores of rationality for definition of ＇Hurt＇, definition of ＇Harm＇, ＇Injury＇ being the combination of ＇hurt＇ and ＇harm＇, ＇Injury＇ should be graded, Graded based on the ＇Injured＇ time were above 3, and all values of CV for those index were below 0.25 except Graded based on the ＇Injured＇ time. Conclusion The rationality of Definition of＇Hurt＇, Definition of ＇Harm＇, ＇Injury＇ being the combination of ＇hurt＇ and ＇harm＇, ＇Injury＇ should be graded and Graded based on the ＇Injured＇ time is good. There is still a certain degree of divergence about Graded based on the ＇Injured＇ time.