构建适用于我国老年住院病人的新型谵妄筛查量表

Establishment of a new delirium screening scale for elderly inpatients in China

目的 构建适用于我国老年住院病人的谵妄筛查量表。方法 通过查阅文献和专家小组讨论,制定诊断域和备选条目池。经过人群预实验,依照经典测量理论(CTT)方法进行条目删减。结合专家意见,修改量表结构,形成正式谵妄筛查量表中文版(DSI-CV)。结果 预实验共纳入730例病人,量表回收率为100%,条目空缺率为0。量表5个维度中,急性波动性、意识水平、注意力和认知水平的内部一致性系数分别为0.748、1.000、0.666和0.853,精神运动改变由于两个条目互斥的特殊性,不参与内部一致性讨论。经过CTT理论和专家小组讨论删减条目后,最终成型的DSI-CV包含5个维度共14个条目。结论 基于CTT理论构建的DSI-CV在条目设置方面更符合我国文化特点,在使用情景方面充分考虑了老年住院病人的日常活动和与医护人员交互的情况。

Objective To construct a delirium screening scale for elderly inpatients in China.Methods By consulting the literature and expert group discussion,the diagnosis domain and alternative item pool were established.After the preliminary experiment,the entries were deleted according to the classical test theory(CTT)method.Combined with expert opinions and the structure of the scale,the Delirium Screen Instrument of Chinese version(DSI-CV)was established.Results A total of 730 patients were enrolled in the preliminary experiment,and the recovery rate of the scale was 100%,and the item vacancy rate was 0.Among the five dimensions of the scale,the internal consistency coefficients of acute volatility,consciousness level,attention and cognitive level were 0.748,1.000,0.666 and 0.853 respectively.Psychomotor changes did not participate in the internal consistency discussion due to the particularity of their two items.After CTT theory and expert group discussion,the final delirium screening scale of DSI-CV contained 14 items in 5 dimensions.Conclusions The item of DSI-CV is more in line with the cultural characteristics of China,and fully considers the daily activities of elderly hospitalized patients and their interaction with medical staff in terms of usage scenarios.