机械通气患者拔管后吞咽障碍筛查工具的汉化及信效度评价

Reliability and validity of the Chinese version of postextubation dysphagia screening tool for patients with mechanical ventilation

目的:汉化机械通气患者拔管后吞咽障碍筛查工具(postextubation dysphagia screening,PEDS),并检验其信效度及诊断价值。方法:严格遵循Brislin翻译模型对PEDS工具进行汉化,并经专家函询、ICU护士认知性访谈及预试验调适问卷条目,将其应用于100例经口气管插管机械通气患者。问卷内部一致性采用Cronbach’sα系数评估、评定者间信度采用组内相关系数评估;内容效度指数以及探索性因子分析验证效度检验结果;以吞咽障碍评估金标准——纤维内镜吞咽功能检查为参考标准,通过灵敏度、特异度进行诊断价值评价。结果:中文版PEDS工具总的Cronbach’sα系数为0.904;评估者内部信度系数为0.930;各条目内容效度指数为0.84~1.00,总的内容效度指数为0.96;机械通气患者拔管后吞咽障碍的发生率为56%,灵敏度为82.1%,特异度为70.5%。结论:中文版PEDS工具具有良好的信效度,灵敏度高,适用于经口气管插管机械通气患者吞咽障碍的筛查。

Objective:To translate the English version of postextubation dysphagia screening tool(PEDS)into Chinese version and to test its reliability and validity in patients with mechanical ventilation.Methods:According to the Brislin translation model,the English version of postextubation dysphagia screening tool was translated into Chinese version,and then was back-translated and modified for cultural adaptation following the guidelines.Reliability test included Cronbach’sαcoefficient and intra-class correlation coefficients.Validity test included Content Validity Index and exploratory factor analysis.The reliability and validity of the Chinese version of PEDS was tested in 100 patients with mechanical ventilation.As a golden standard for evaluation of dysphagia,flexible endoscopic examination of swallowing test was used to evaluate the sensitivity and specificity of PEDS.Results:The Cronbach’sαcoefficient of the Chinese version of the scale was 0.904 and the intra-class correlation coefficients was 0.93.The Scale-Content Validity Index(S-CVI)was 0.96 and the Item-Content Validity Index(I-CVI)ranged from 0.84 to 1.00.The prevalence of postextubation dysphagia was 56%in 100 eligible patients.The sensitivity of the postextubation dysphagia screening tool was 82.1%and specificity was 70.5%.Conclusion:The Chinese version of PEDS has good reliability and validity,which can effectively evaluate the postextubation dysphagia risk in patients with mechanical ventilation.