连续性记录与评估工具在养老机构老年人中的信度和效度研究

Reliability and validity of the Chinese version of the continuity assessment record and evaluation among the elderly in nursing institutions

目的评价中文版连续性记录与评估工具(CARE)在养老机构老年人中应用的信度和效度。方法对269例养老机构老年人进行面对面评估,采用中文版CARE、简明精神状态量表(MMSE)、老年人抑郁量表(GDS)、视觉模拟疼痛评分(VAS)、巴氏指数(BI)、工具性日常生活活动量表(IADL)和欧洲健康五维量表(EQ-5D)进行数据收集,其中30例老年人于1周后复测中文版CARE,对获得的数据进行信度及效度评价。结果在CARE总量表和各维度水平上,以组内相关系数(ICC)表示的5名评定者间信度、1周后的重测信度分别为0.945~1.000、0.842~1.000,内部一致性信度Cronbach'sα系数分别为0.717~1.000,均具有较好的信度水平。在效标效度方面,CARE量表的相关维度与6个校标量表(MMSE、GDS、VAS、BI、IADL和EQ-5D)的相关系数均较高,分别为0.918、0.802、0.998、0.931、0.924、0.917(均P=0.000)。结论中文版CARE在养老机构老年人中具有良好的信度和效度,可作为一种综合性的老年评估工具供我国养老机构选择及使用。

Objective To evaluate the reliability and validity of the Chinese version of the continuity assessment record and evaluation(CARE)among the elderly in nursing institutions.Methods A total of 269 elders in nursing institutions were face-to-face interviewed.Information was collected with the Chinese version of CARE,the mini mental state examination(MMSE),the geriatric depression scale(GDS),the visual analogue pain score(VAS),the barthel index(BI),the lawton instrumental activities of daily living scale(IADL),and the euroqol five dimensions questionnaire(EQ-5D).A week later,30 of the elderly were re-evaluated with the Chinese version of CARE.Data were analyzed for reliability and validity.Results For both the total score and the score for each dimension of CARE,the interrater reliability and test-retest reliability expressed by the intraclass correlation coefficient(ICC)ranged from 0.945 to 1.000 and 0.842 to 1.000,respectively;the internal consistency expressed by Cronbach'sαranged from 0.717 to 1.000,all reaching good levels of reliability.The criterion-related validity of the relevant dimensions of CARE showed high correlations with MMSE,GDS,VAS,BI,IADL and EQ-5D(0.918,0.802,0.998,0.931,0.924 and 0.917,respectively)(all P=0.000).Conclusions The Chinese version of CARE has good reliability and validity among elders in nursing institutions,and can be used as a comprehensive assessment tool for the elderly in nursing institutions in China.