中文版Braden-QD与Braden-Q量表在小儿重症监护室患儿压力性损伤风险评估中的比较

Comparison of Chinese version Braden-QD scale and Braden-Q scale in assessing the risk assessment of pressure injury for patients in pediatric intensive care unit

目的比较Braden-QD量表和Braden-Q量表在评估小儿重症监护室(pediatric intensive care unit,PICU)患儿压力性损伤发生风险中的应用效果。方法采用方便抽样方法,选取2021年12月至2022年9月连云港市第一人民医院PICU收治的205例患儿作为研究对象,采用Braden-QD量表和Braden-Q量表评估压力性损伤的风险。使用SPSS 25.0和Python 2.7进行数据统计分析。量表的评定者间信度采用组内相关系数(intraclass correlation coefficient,ICC)评价,内部一致性采用Cronbach'sα评价,预测能力比较采用受试者工作特征曲线(receiver operator characteristic curve,ROC)、阳性预测值、阴性预测值、灵敏度、特异度和ROC曲线下面积(area under the ROC curve,AUC)。结果(1)205例患儿中有24例(11.7%)发生压力性损伤,以1期为主(20例,83.3%)。(2)Braden-QD量表和Braden-Q量表的ICC分别为0.890、0.862,Cronbach'sα分别为0.891、0.710。(3)Braden-QD量表的AUC为0.936,最佳诊断截断值为9.5分,此时约登指数、灵敏度、特异度、阳性预测值、阴性预测值分别为0.765、0.875、0.890、0.512、0.982;Braden-Q量表的AUC为0.881,最佳诊断截断值为18.5分,约登指数、灵敏度、特异度、阳性预测值、阴性预测值分别为0.626、0.792、0.834、0.388、0.968。结论Braden-QD量表更适用于PICU患儿压力性损伤发生风险的评估。

Objective To compare the application value of the Braden-QD scale and the Braden-Q scale in assessing the risk of pressure injuries in pediatric intensive care unit(PICU)patients.Methods A convenient sampling method was used to select 205 pediatric patients admitted to the First People’s Hospital of Lianyungang from December 2021 to September 2022 as the research subjects.The Braden-QD scale and the Braden-Q scale were used to evaluate the risk of pressure injuries.SPSS 25.0 and Python 2.7 softwares were used for statistical analysis.Inter-rater reliability of the scales was evaluated using intraclass correlation coefficient(ICC),internal consistency was evaluated using Cronbach'sα,and the predictive power was compared using receiver operator characteristic curve(ROC),positive predictive value,negative predictive value,sensitivity,specificity and area under the ROC curve(AUC).Results(1)A total of 24(11.7%)out of 205 patients had pressure injury,predominantly in stage 1(20 cases,83.3%).(2)The ICC of Braden-QD scale and Braden-Q scale were 0.890 and 0.862,while the Cronbach'sαwere 0.891 and 0.710.(3)The AUC of the Braden-QD scale was 0.936.The optimal diagnostic cutoff value was 9.5,with a Youden index,sensitivity,specificity,positive predictive value and negative predictive value of 0.765,0.875,0.890,0.512,0.982,respectively.The AUC of the Braden-Q scale was 0.881.The optimal diagnostic cutoff value was 18.5,with a Youden index,sensitivity,specificity,positive predictive value,and negative predictive value of 0.626,0.792,0.834,0.388,0.968,respectively.Conclusion Compared with the Braden-Q scale,the Braden-QD scale is more suitable for assessing the risk of pressure injuries in PICU children.