外科住院患者肌少症评估量表的构建与信效度分析

Construction and Reliability and Validity Analysis of a Scale for Evaluating Sarcopenia in Hospitalized Surgical Patients

【目的】构建外科住院患者肌少症风险评估量表并进行信效度检验,为外科住院患者提供科学,有效的肌少症风险评估工具。【方法】在文献回顾的基础上构建量表的条目池,通过德尔菲法确定量表内容体系,采用层次分析法确定量表条目权重并赋值,形成测试量表。采用测试量表对在湖南省人民医院肝胆外科住院的239例患者进行肌少症风险评估,检验量表的信度和效度。【结果】共对11名专家进行了2轮函询,专家的积极系数均为100%,专家权威系数分别为0.88、0.89,肯德尔和谐系数分别为0.138、0.153(P<0.001)。构建了包括5个一级指标、19个二级指标的外科住院患者肌少症风险评估量表,量表的Cronbach'sα系数为0.829,各条目的内容效度(I-CVI)为0.8~1.0,总内容效度(S-CVI)为0.99。探索性因子分析共提取出6个公因子,累计方差贡献率为63.784%。量表的ROC曲线下面积(AUC)为0.74(95%CI:0.666~0.813,P<0.001),诊断阈值为24分,灵敏度为80%,特异度为61.8%。【结论】构建的外科住院患者肌少症风险评估量表具有一定的科学性、实用性和良好的信效度,可作为临床医护人员评估外科住院患者发生肌少症风险的初筛工具。

【Objective】To construct a risk assessment scale for sarcopenia in surgical inpatients and conduct reliability and validity tests,in order to provide a scientific and effective tool for assessing sarcopenia risk in surgical inpatients.【Methods】On the basis of literature review,a pool of items for the scale was constructed,and the content system of the scale was determined through the Delphi method.The Analytic Hierarchy Process was used to determine the weights of scale items and assign values,forming a test scale.A test scale was used to assess the risk of sarcopenia in 239 patients admitted to the Hepatobiliary Department of Hunan Provincial People's Hospital,and the reliability and validity of the scale were tested.【Results】A total of 11 experts were consulted through 2 rounds of correspondence,and their positive coefficients were all 100%.The authority coefficients of the experts were 0.88 and 0.89,respectively.The Kendall harmony coefficients were 0.138 and 0.153(P<0.001).A surgical inpatient sarcopenia risk assessment scale was constructed,including 5 primary indicators and 19 secondary indicators.The Cronbach'sαcoefficient of the scale was 0.829,and the content validity(I-CVI)of each item was 0.8-1.0,with a total content validity(S-CVI)of 0.99.Exploratory factor analysis extracted a total of 6 common factors,with a cumulative variance contribution rate of 63.784%.The area under the curve(AUC)of the ROC scale was 0.74(95%CI:0.666-0.813,P<0.001),the diagnostic threshold was 24 points,the sensitivity was 80%,and the specificity was 61.8%.【Conclusion】The constructed surgical inpatient sarcopenia risk assessment scale has certain scientific validity,practicality,and good reliability and validity,and can be used as a preliminary screening tool for clinical medical staff to evaluate the risk of sarcopenia in surgical inpatients.