自制住院病人跌倒评估量表与Morse量表的应用比较研究

Comparative study on clinical application of self-made Inpatients' Fall Assessment Scale and Morse Fall Scale

[目的]分析自制住院病人跌倒评估量表的临床应用价值,并与Morse跌倒评估量表(MFS)进行比较。[方法]采用两种量表对广州市某三级甲等医院2 826例病人进行跌倒风险评估,分析自制住院病人跌倒评估量表的信效度、区分度,比较两种量表的跌倒风险预测效果。[结果]住院病人跌倒评估量表的全人群和65岁及以上人群的Cronbach’sα系数分别为0.825、0.759;MFS两种人群的Cronbach’sα系数分别为0.693、0.638。住院病人跌倒评估量表专家内容效度指数(S-CVI)为0.915,各条目得分与量表总分的Spearman相关分析结果均具有统计学意义(P<0.001),量表总分与MFS得分显著相关(r=0.806,P=0.000)。住院病人跌倒评估量表及MFS在不同界值标准下,高分组与低分组的差异均具有统计学意义(P=0.000),两量表全人群的ROC曲线下面积分别为0.717、0.632,两者与参照(0.5)的比较均具有统计学意义(P<0.05),且两者之间的两两比较也具有统计学意义(P<0.05)。[结论]住院病人跌倒评估量表具有较好的信效度、区分度,能较好地预测住院病人的跌倒风险,且效果优于Morse跌倒评估量表。

Objectives： To analyze clinical application value of the self -made Inpatients＇Fall Assessment Scale （IFAS） ,and compare with the Morse Fall Scale. Methods：The two scales were implemented in a third hospital in Guangzhou to assess fall risks of 2 826 patients. Reliability,validity and discrimination of the IFAS were con-ducted,so as to compare the effect of fall risk prediction between IFAS and MFS. Results：The Cronbach＇s a co-efficients of the self - made Inpat ients＇Fall Assessment Scale for the whole population and that for the popula-tion over the age of 65 and above were 0. 825 and 0. 759, respectively. The Cronbach？s a coefficients of the Morse Fall Scale for two populations were 0. 693 and 0. 638, respectively. Experts？ scale content validity index（S- CVI） of IFAS was 0. 915. Spearman correlation analysis showed that scores of all items were statistically signifi-cantly related the whole scale score（IFAS） （P〈C〇 . 001）. Score of IFAS was also statistically significantly related to MFS score（r= 0. 806 , P = 0. 000）. Differences between the high - score and low - score group under different boundary value standards were statistically significant in IFAS and MFS（P = 0. 000）. Areas under the ROC curve of the IFAS and MFS in whole population were 0. 717 and 0. 632 respectively, and there was statistically significant different when compared with the reference（0. 5） ,and the difference between each other was also sta-tistically significant different（P〈C0. 05）. Conclusions： Rel iabi lity, val idity, and discrimination were good in The self - made IFAS,and it could predict fall risks of inpatients bet ter compared with MFS.