老年患者出院准备服务需求程度评估表的构建及信效度检验

doi:10.3761/j.issn.0254-1769.2022.02.010

摘要/Abstract

摘要：

目的研制老年患者出院准备服务需求程度评估表并检验其信效度。方法通过文献分析法、专家函询法和层次分析法构建老年患者出院准备服务需求程度评估表初稿,于2020年10月—2021年7月收集北京市某三级甲等医院老年医学科病房收住的242例老年患者的一般资料、出院准备服务需求程度评估资料及出院后31 d内的再入院情况等,检验该评估表的内容效度、评定者间信度及其对患者31 d内非计划性再入院的预测效度。结果该评估表包括9个维度,34个条目;其内容效度指数为0.933;预测患者31 d内非计划性再入院的受试者工作特征曲线下面积为0.975,95%CI为0.958~0.992（P<0.001）,最佳临界值为5.5,对应的灵敏度为0.972,特异度为0.903;评定者间信度为0.951。结论老年患者出院准备服务需求程度评估表的信效度较好,可作为临床快速预测和识别再入院高危老年人的辅助工具。

关键词: 出院准备服务, 老年人, 评估表, 信度, 效度, 护理管理研究

Abstract:

Objective To develop an assessment scale of discharge planning demand for hospitalized elderly patients,and to test its reliability and validity. Methods The assessment scale draft was constructed by the literature analysis method and 2 rounds of Delphi consultations. The data of 242 hospitalized elderly patients was collected from October 2020 to July 2021,and the content validity,inter-rater reliability and predictive validity of the scale for unplanned readmission within 31 days were further tested. Results The scale contains 34 items in 9 dimensions. The content validity index of the scale was 0.933;the area under the ROC curve was 0.975;the confidence interval of 95% was 0.958~0.992（P<0.001）;the optimal critical value was 5.5;the corresponding sensitivity was 0.972 and specificity was 0.903;the inter-rater reliability was 0.951. Conclusion The scale of discharge planning demand for hospitalized elderly patients has good reliability and validity,and it can be used in clinical practice to assist in the identification and prediction of high-risk elderly patients for unplanned readmission.

Key words: Discharge Planning, Aged, Scale, Reliability, Validity, Nursing Administration Research

胡慧秀, 孙超, 张洁, 崔玲玲, 果迪. 老年患者出院准备服务需求程度评估表的构建及信效度检验[J]. 中华护理杂志, 2022, 57(2): 188-192.

HU Huixiu, SUN Chao, ZHANG Jie, CUI Lingling, GUO Di. Development and validation of an assessment scale of discharge planning demand for hospitalized elderly patients[J]. Chinese Journal of Nursing, 2022, 57(2): 188-192.

图/表 3

图1 老年患者出院准备服务需求程度评估表 1）当同一患者同时带有不同管路时,得分累加;2）当同一患者身上留有不同伤口或造口时,得分累加;3）PORT为输液港。

Figure 1 Assessment scale of dishcharge planning demand for hospitalized elderly patients

图2 老年患者出院准备服务需求程度评估预测再入院的ROC曲线

Figure 2 ROC curve of readmission prediction by assessment scale of dishcharge planning demand for hospitalized elderly patients

表1 评定者间信度计算结果

Table 1 Results of inter-rater reliability

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