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[硕士论坛]:中文版行为疼痛量表在气管插管与非气管插管危重症患者中的信效度

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C-秋婵 发表于 2016-9-25 18:14:21 | 显示全部楼层 |阅读模式

Reliability and validity of the Chinese version of the behavioral pain scale in intubated and non-intubated critically ill patients: Two cross-sectional studies
中文版行为疼痛量表在气管插管与非气管插管危重症患者中的信效度:两个横断面研究

摘要
Background: Self-report pain assessment scales may be inappropriate when critically ill patients are incapable of adequate communication because of sedation or mechanical ventilation. The Behavioral Pain Scale (BPS, for intubated patients) and the BPS-non intubated (BPS-NI, for non-intubated patients) measure objective behavioral indicators of pain in non-communicating critically ill patients.
背景:自我主诉疼痛评估量表可能不适于无法充分沟通的危重症患者,因其镇静和机械通气的原因。行为疼痛量表(BPS,用于气管插管患者)和非气管插管BPS(BPS-NI用于非气管插管患者)在无法交流危重症患者中测量疼痛的客观行为指标。

Objectives: To develop a Chinese version of the BPS combining the original version of the BPS and BPS-NI suitable for pain assessment among critically ill patients and to determine its reliability and validity.
目的:为研制中文版BPS,适当结合用于危重症患者疼痛评估的BPS和BPS-NI原始版本,以及确定其信效度。

Design: Two cross-sectional studies.
设计:两个横断面研究

Settings: A 15-bed surgical intensive care unit (ICU) in a teaching hospital in Beijing, China.
场所:中国北京某家配备15张床位的重症监护室(ICU)的教学医院。

Participants: In the first study, 129 patients (53 intubated and 76 non-intubated) were recruited; in the second study, 83 (43 intubated and 40 non-intubated) were recruited.
患者:第1次研究中,129例患者(53例气管插管患者和76例非气管插管患者)被录用;第2次研究中,83例患者(43例插管患者和40 例非插管患者)被录用。

Methods: The Chinese version of the BPS (BPS-C) was developed via rigorous translation methods, including double back-translation and content validation involving 13 clinical experts. Internal consistency, discriminative validity, and criterion-related validity were established using the BPS-C and the Numeric Rating Scale (NRS). The BPS-C and NRS were used to assess pain in 53 intubated and 76 non-intubated post-abdominal surgery patients during low pain exposure and increased pain exposure in the first study. To establish interrater reliability, a researcher and a bedside nurse independently performed 172 paired assessments in 43 intubated patients and 160 paired assessments in 40 non-intubated patients with the BPS-C under the same conditions in the second study.
方法:通过严谨的翻译方法研制中文版BPS(BPS-C),包括13位临床专家的双重回译和内容效度。使用BPS-C和数字评定量表(NRS)建立内部一致性、区分效度和标准相关效度。在第1次研究中,BPS-C和NRS被用于评估53例气管插管和76例非气管插管腹部手术后的患者在低疼痛暴露和增加疼痛暴露期间的疼痛。为建立一致性信度,在第2次研究中,1名研究员和1名床旁护士在同等条件下用BPS-C独立完成43例气管插管患者的172对评估和40例非气管插管患者的160对评估。

Results: The BPS-C achieved conceptual and semantic equivalence with the original tool. Internal consistency was established through Cronbach's alpha (alpha = 0.724-0.743 in intubated patients, alpha = 0.701-0.762 in non-intubated patients). Interrater reliability was confirmed through the intraclass correlation coefficients (ICCs), which ranged from 0.962 to 1.000 in both intubated and non-intubated patients with high agreement percentages (95.3-100.0% in intubated and 95.0-100.0% in non-intubated patients). BPS-C scores during increased exposure to pain were significantly higher than those obtained during low exposure to pain, indicating discriminative validity. Criterion-related validity was confirmed by strong positive correlations between BPS-C and NRS scores (Pearson's correlations r = 0.815-0.937 for intubated patients, Pearson's correlations r = 0.755-0.899 for non-intubated patients).
结果:BPS-C已与原工具达到观念上的和语义上的同等。通过Cronbach系数建立内部一致性(气管插管患者系数=0.724-0.743,非气管插管患者系数=0.701-0.762)。通过组内相关系数(ICCs)确认一致性信度,高比例的气管插管和非气管插管患者的范围从0.962至1.000(气管插管患者95.3-100.0%和非气管插管患者95.0-100.0%)。在疼痛暴露增加期间的BPS-C分数比在低疼痛暴露期间所获得的分数显著增高,表明区分效度。BPS-C和NRS分数之间的强正相关性证实了标准相关效度(气管插管患者的相关分析r =0.815-0.937,非气管插管的相关分析r =0.755-0.899)。

Conclusions: The Chinese version of the BPS (BPS-C) is appropriate for pain assessment among intubated and non-intubated ICU patients. (C) 2016 Elsevier Ltd. All rights reserved.
结论:中文版BPS (BPS-C)适用于ICU气管插管和非气管插管患者的疼痛评估。 (C) 2016 Elsevier 有限公司,版权所有。

      KeyWords:Critical illness; Intubation; Pain measurement; Pain management; Reproducibility of results; Validation studies
     关键词:危重症;气管插管;疼痛测量;疼痛管理;结果再现性;有效研究

作者:Chen, J (Chen, Jie)[ 1,2,3 ] ; Lu, Q (Lu, Qian)[ 2 ] ; Wu, XY (Wu, Xiao-Ying)[ 1,4 ] ; An, YZ (An, You-Zhong)[ 4 ] ; Zhan, YC (Zhan, Yan-Chun)[ 4 ] ; Zhang, HY (Zhang, Hai-Yan)[ 1 ]

INTERNATIONAL JOURNAL OF NURSING STUDIES


卷: 61

页: 63-71


DOI: 10.1016/j.ijnurstu.2016.05.013

出版年: SEP 2016


硕士二教班 陈秋婵 21600240

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