危重患者口腔并发症高危风险评估量表的研制与应用

Development and application of high risk assessment scale for oral complications in critically ill patients

目的制定能够准确、科学进行危重患者口腔并发症高危人群筛选的测评工具。方法基于国外相关口腔并发症评估量表,结合头脑风暴法、专家咨询、临床现状法等确定"危重患者口腔并发症高危风险评估量表"条目池,邀请5名护理专家、2名口腔专家进行内容效度评定,并对50名ICU护士进行测试。随后随机选取100名危重患者,使用"危重患者口腔并发症高危风险评估量表"进行评估,以检验该量表用于筛检口腔并发症患者的准确度。结果最终版"危重患者口腔并发症高危风险评估量表"(包含口腔状况评估7方面内容、口腔p H值测定)Cronbach’s a系数为0.815,量表的内容效度指数(S-CVI/Ave)为0.932,50名护士评估91.2%的量表条目为很重要和重要。该量表对口腔并发症高危患者筛查的灵敏度为97.53%、特异度为94.11%、阳性预测值为98.75%、阴性预测值为88.89%、粗一致性为95.00%。结论 "危重患者口腔并发症高危风险评估量表"具有良好的信效度,筛检试验准确度高,可用于危重患者口腔并发症高危患者的筛选,帮助临床护士快速完成危重患者口腔状况的评估。

Objective To develop an evaluation tool for the screening of high risk population for oral complications in critically ill patients, which can be performed accurately and scientifically. Methods Basing on the related foreign oral assessment scale, combined with the method of brainstorming, expert consultation, method of clinical status and so on, the item pool of the assessment scale was determined. Five nursing experts and two oral experts assessed the content validity and 50 ICU nurses were tested. Then, the screening accuracy of the assessment scale was proved by application in 100 critically ill patients selected randomly. Results The Cronbach＇s a coefficient of final version of the High Risk Assessment Scale for Oral Complications in Critically Ill Patients （including seven parts contents of oral health assessment and oral pH value test） was 0.815, the content validity index （Sr-CVI/Ave） was 0.932. The results of 50 nurses to the 91.2% assessment items of the assessment scale were very important and important. For screening related indicators of oral complications in high-risk patients, the sensitivity of the assessment scale was 97.53%, the specificity was 94.11%, the positive predictive value was 98.75%, the negative predictive value was 88.89%, and the crude agreement was 95%. Conclusion There are good reliability, validity and a high accuracy of screening test in the High Risk Assessment Scale for Oral Complications in Critically Ill Patients. It can be used for screening patients at high risk for oral complications in critically ill patients, and help clinical nurses to complete the oral health status of the critically ill patients quickly.