初次髋关节置换患者术后尿潴留风险评估量表的构建与分析

Development and analysis of a urinary retention risk assessment scale for patients after primary hip arthroplasty

目的 构建初次髋关节置换患者术后尿潴留风险评估量表,并检验其信效度。方法 采用文献回顾法、半结构式访谈法、德尔菲专家函询法和预调查,形成量表条目池。采取便利抽样法,选取重庆市某三级甲等专科医院2021年7-8月住院的27名行初次髋关节置换的患者,进行预调查;2021年8月至2022年6月,选取114名行初次髋关节置换的患者进行条目分析和信效度检验,进一步验证量表结构的稳定性。结果 形成包含3个维度,12个条目的初次髋关节置换患者术后尿潴留风险评估量表。该量表Cronbach’s α系数为0.758,内容效度指数为0.800,重测信度为0.935。ROC曲线结果显示:初次髋关节置换患者术后尿潴留风险评估量表的诊断阈值为17分,AUC为0.704(95%CI 0.578~0.830),敏感度为63.6%,特异度为71.8%。量表分级结果为,17~<22分Ⅰ级;22~<27分Ⅱ级;≥27分Ⅲ级。结论 构建的初次髋关节置换患者术后尿潴留风险评估量表具有良好的信效度,可作为评价髋关节置换术后尿潴留风险的工具。

Objective To construct a urinary retention risk assessment scale for patients after primary hip replacement and test its reliability and validity.Methods The item pool of the scale was formed by combining literature review,semi-structured interview,Delphi expert letter consultation and pre-survey.A total of 27 patients who underwent primary hip replacement in a Class A tertiary specialized hospital in Chongqing from July to August 2021 were subjected with convenience sampling for pre-investigation.Then 114 patients who underwent primary hip replacement from August 2021 to June 2022 were selected for item analysis and reliability and validity test to further verify the stability of the scale structure.Results A risk assessment scale for urinary retention after primary hip replacement was constructed,which included 3 dimensions and 12 items.The content validity index of the scale was 0.800,Cronbach'sαcoefficient was 0.758,and test-retest reliability was 0.935.The results of receiver operating characteristic(ROC)curve analysis showed that the diagnostic threshold of urinary retention risk assessment scale for patients with primary hip replacement was 17,the AUC was 0.704(95%CI 0.578~0.830),the sensitivity was 63.6%,and the specificity was 71.8%.The scale grading results were as follows:17≤total score 22 indicated that the risk grade ofⅠ;22≤total score 27 indicates that the risk grade ofⅡ;A score of 27 or more indicates the grade ofⅢ.Conclusion Our established urinary retention risk assessment scale for patients with primary hip replacement has good reliability and validity,and can be used as a tool to evaluate the risk of urinary retention after hip replacement.