重型颅脑损伤患者便秘风险评分量表的编制及信效度检验

Development and reliability and validity test of constipation risk scale for patients with severe craniocerebral injury

目的编制重型颅脑损伤患者便秘风险评分量表,并进行信效度检验,为评估重型颅脑损伤患者的便秘风险程度提供有效简便的评估工具。方法在文献回顾及参照现有风险评估量表的基础上编制量表初始条目池;通过2轮专家函询对条目池进行评定和补充,使条目具有最佳的适宜性,形成量表初稿;进行预调查,对产生歧义的条目予以修改。通过项目分析和探索性因子分析筛选问卷条目。采用便利抽样法,选取2019年1月—12月山西省晋中市某三级乙等医院神经外科收治的108例重型颅脑损伤患者为调查对象进行问卷调查,对评分量表进行信效度检验。结果重型颅脑损伤患者便秘风险评分量表包括肠蠕动功能、神经意识功能障碍、肠道水分子过度转运、患者因素和护理人员因素5个维度,共24个条目,累计方差贡献率为66.347%。该量表的Cronbach’sα系数为0.908,各维度的Cronbach’sα系数为0.830~0.957,重测信度为0.879。结论该研究编制的重型颅脑损伤患者便秘风险评分量表具有良好的信效度,可作为评估重型颅脑损伤患者便秘风险的有效工具。

Objective The constipation score scale for patients with severe craniocerebral injury was developed,and its reliability and validity were tested,providing an intuitive,effective and simple tool for assessing the risk degree of constipation in patients with severe craniocerebral injury.Methods Guided by the framework of the theoretical study on the cause of constipation in patients with severe craniocerebral injury,a systematic literature analysis was conducted on this theme.A preliminary comprehensive pool of items was then formed,evaluated and supplemented through Delphi expert reviews.The preliminary investigation was conducted and the ambiguous items were revised.Finally,project analysis and exploratory factor analysis were employed to identify the best potential structure of the scale.The convenience sampling method was adopted to select 108 patients with severe craniocerebral injury admitted to the Department of Neurosurgery of a tertiary hospital in Jinzhong City,Shanxi Province from January to December 2019 as the research subjects,and a questionnaire survey was conducted to evaluate the reliability and validity of the scale.Results A pre-test questionnaire of 27 items was formed according to the results of expert letter consultation.3 items that did not meet the standard were deleted after item analysis.5 factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 66.347%.The 5 factors were named as intestinal peristalsis function,neuro-conscious dysfunction,excessive transport of intestinal water molecules,patient factor and medical personnel factor.The Cronbach’sαcoefficient of the scoring scale was 0.908;the Cronbach’sαcoefficient of each dimension was 0.830-0.957;the retest reliability was 0.879.Conclusion The constipation risk scale for patients with severe craniocerebral injury developed in this study has good reliability and validity.It can be used as an effective tool to evaluate the risk of constipation in patients with severe brain injury.