危重患者规范性身体约束评分量表的研制与信效度检验

The development of standard physical restraint assessment scale for critically ill patients and its reliability and validity

目的研制危重患者规范性身体约束评分量表,并对其进行信效度检验,为护士对患者的约束决策提供量性评估工具。方法通过德尔菲法咨询16名危重症领域专家初步拟定量表评估条目,并对贵州医科大学附属医院80例ICU患者进行评估,以检测量表信效度。结果评分量表由3个维度8个评估条目组成:攻击风险(镇静-躁动程度、沟通理解能力、疼痛、攻击行为)、跌倒坠床风险(活动能力、药物数量)及管道危险度(管道高危程度、管道数目)。量表各条目与总分的相关系数为0.61~0.83,探索性因子分析共提取3个公因子,累积贡献率为87.215%。Cronbach′sα系数为0.889,评分者间信度为0.946(P<0.05)。结论危重患者规范性身体约束评分量表能够综合全面地评估患者,且具有良好的信效度,可指导护士形成规范性的约束行为。

Objective To design standard physical restraint assessment scale for critically ill patients and test the reliability and validity,which provide a standard data for the nurses to follow,and help the nurses to regularize their behavior based on this scale.Methods Sixteen experts were consulted by using Delphi method to develop scale evaluation items,and 80 patients in ICU of the Affiliated Hospital of Guizhou Medical University were assessed to examine the reliability and validity.Results Physical restraint assessment scale consisted of 3 dimensions and 8 items：attack risk assessment（sedation agitation degree,communication skills,pain,aggressive behavior）,fall-bed risk（activity ability,the number of drug） and tube risk（tube risk degree,the number of tube）.The correlation coefficients between each item and total score ranged from 0.61 to 0.83.The exploratory factor analysis extracted 3 common factors,and the cumulative contribution rate was 87.215%.Internal consistency reliability Cronbach＇s alpha coefficient was 0.889,and inter rater reliability was 0.946（P〈0.05）.Conclusion Standard physical restraint assessment scale for critically ill patients can be used to assess patients comprehensively,and it has good reliability and validity,which can guide nurses to regularize its restraint behaviors.