重症患者身体约束评估量表的优化及信效度检验

Optimization of the physical restraint assessment scale for severe patients and its tests of reliability and validity

目的 运用德尔菲法优化重症患者身体约束评估量表并进行信度和效度的检验。方法 参考中华护理学会团体标准《住院患者身体约束护理》的内容,对比相关文献及应用德尔菲法形成量表。选取2022年1-2月入住我院ICU的103例重症患者对量表的信度和效度进行检验。结果 经过2轮专家函询及初级量表的信效度检验后,删除疼痛分级,形成了意识情绪状态、行为分级、上肢肌力分级、管道危险度和管道数目5个一级条目及18个等级条目的重症患者身体约束评估量表。该量表Cronbach′s α系数为0.895;评定者间信度为92.67%;每个条目的内容效度指数为0.80~1.00,总量表的内容效度指数为0.92;探索性因子分析得到1个公因子,总体方差贡献率累计为72.025%。结论 该量表科学合理且信效度良好,可为ICU护士实施身体约束决策提供依据,从而降低患者身体约束率。

Objective To optimize the physical restraint assessment scale for severe patients by Delphi method and test its reliability and validity.Methods Referring to the content of the Chinese Nursing Society group standard"Physical Restraint Nursing for Inpatients",comparison of the relevant literature and application of Delphi method finally formed the scale.The reliability and validity of the scale were tested in 103 clinically severe patients admitted to ICU of a Grade A hospital in Putian from January to February 2022.Results After two rounds of expert letter inquiry and reliability validity test of the primary scale,the pain grading was deleted,and the physical restraint assessment scale for severe patients including 5 first-level items of conscious and emotional state,behavior grading,upper limb muscle strength grading,risk degree and number of pipelines and 18 grade items was formed.The Cronbach's coefficient of the scale was 0.895,the inter-rater reliability was 92.67%,the content validity index of each item ranged from 0.80 to 1.00,and the content validity index of the total scale was 0.92.Exploratory factor analysis obtained a common factor,and the cumulative contribution rate of the total variance was 72.025%.Conclusion This scale is scientific and reasonable and has good credit validity,which can provide a basis for ICU nurses to implement physical restraint decisions and reduce the physical restraint rate of patients.