儿童压疮高危风险触发工具形成及信效度检验

Development, reliability and validity of pediatric pressure ulcer trigger tool

目的发展儿童压疮风险触发工具，并检验其信度和效度。方法基于压疮形成的概念框架，结合文献分析及临床实践经验，形成了儿童压疮高危风险触发工具。对193例患儿的274次测量结果进行分析，评价其信度与效度。结果儿童压疮高危风险触发工具共有3个条目，该工具Cronbach α系数为0.826，各条目Cronbach α系数为0.743-0.819，组内相关系数为0.941。儿童压疮风险触发工具的内容效度为0.945，各条目间的相关系数为0.434-0.524，各条目与工具总分间的相关系数为0.703-0.870，均具有统计学意义（P〈0.01）。ROC曲线分析结果显示，以儿童压疮高危风险触发工具总分≥1分为判定压疮风险的临界值，特异度为96.40%、敏感度为100%。定性资料的平行效度检验结果显示，Kappa值为0.819。结论儿童压疮高危风险触发工具具有较好的信度和效度，且以总分≥ 1分为临界值判定是否具有压疮高危风险，可以用于儿童压疮风险的初步筛查。

Objective To develop the Pressure Ulcer trigger tool, and to test the reliability and validity of the tool. Methods The tool was developed based on the conceptual schema of pressure ulcer, literature analysis and nursing practices, the Pressure Ulcer trigger tool was developed totally 274 records from 193 children were used to test the reliability and validity of the Pressure Ulcer trigger tool. Results The Pressure Ulcer trigger tool consisted of 3 items. The Cronbach＇ s a coefficient for the total scale was 0.826, and Cronbach＇s α coefficient of each factor ranged from 0.743 to 0.819. The intra-class correlation coefficient was 0.941. The content validity index was 0.945, the correlation coefficients among each item ranged from 0.434 to 0.524, and the coefficient between each item score and total score ranged from 0.703 to 0.870. Concurrent validity was indicated by high sensitivity （100%） and specificity （96.40%）. Parallel validity test Kappa value was 0.819. Conclusion The Pressure Ulcer trigger tool showed excellent preliminary psychometric performance when used to assess risk of pressure ulcer in pediatric patients, while further researches are merited.