以患者安全为导向的延续护理测评工具系统评价

Systematic evaluation of patient safety-oriented transitional care assessment tools based on COSMIN

目的:系统评价以患者安全为导向的延续护理测评工具的测量属性和方法学质量,为医疗卫生保健专业人员选择最佳的测评工具提供借鉴。方法:检索中、英文数据库中有关延续护理测评工具的文献,检索时限为建库至2022年10月27日。由两位研究者采用COSMIN独立测评,对纳入的测评工具的内容效度、结构效度、内部一致性、稳定性、假设检验等进行详细分析。结果:共纳入27篇文献,9种测评工具。内容效度方面,1种工具评价结果为“充分”,8种工具质量评价为“不确定”或“未提及”。结构效度方面,1种工具评价为“充分”,8种工具评价为“不确定”。就内部一致性而言,1种工具评价为“不充分”,1种工具评价为“不确定”,7种工具评价为“充分”。稳定性方面,1种工具评价为“不充分”,1种工具评价为“不确定”,7种工具为“未提及”。假设检验方面,4种工具评价为“充分”,5种工具评价为“不确定”或“未提及”。结论:鉴于评价结果及证据分级,延续护理测评量表被评为A类工具,其余8种量表被评为B类工具,无C类工具。因此推荐延续护理测评量表,其具有较好的信度、效度,但是否能够在国内得到广泛应用,还需要进一步研究。

Objective:The psychometric properties and methodological quality of patient safety-oriented tools measuring transitional care were systematically evaluated to provide reference for medical health care professionals to select the best assessment tools.Methods:Databases were searched to collect studies on the instruments of measuring transitional care from their inception to October 27,2022.COSMIN was used by 2 researchers independently to screen the literature and extract the data.In this paper,the content validity,structure validity,internal consistency,stability and hypothesis testing were analyzed in detail.Results:A total of 27 studies were included involving 9 measurement tools for transitional care.In terms of content validity,1 tool was evaluated as“sufficient”,8 tools were evaluated as“uncertain”or“not mentioned”.As to structure validity,1 tool was evaluated as“sufficient”,8 tools were considered as“uncertain”.In terms of internal consistency,1 tool was evaluated as“insufficient”,1 tool was evaluated as“uncertain”,7 tools were evaluated as“sufficient”.When it comes to stability,1 tool was classified as“insufficient”,1 tool was classified as“uncertain”,7 tools were classified as“not mentioned”.On the aspect of hypothesis testing,4 tools were evaluated as“sufficient”,5 tools were evaluated as“uncertain”or“not mentioned”.Conclusion:In view of evaluation results and grading of evidence,the recommended rating of the Care Transition Measure was grade A,the other 8 tools was grade B.No tool was grade C.Therefore,it can be temporarily recommended for use.It has good reliability and validity,but whether it can be widely used in China still needs further research.