中西医结合病房患者入院护理评估单的研制及信效度检验

doi:10.3761/j.issn.0254-1769.2024.07.005

摘要/Abstract

摘要：

目的设计中西医结合病房患者入院护理评估单并检验其信效度。方法在文献研究的基础上，以中医学的四诊“望、闻、问、切”为基础框架，体质判别为评估结局，融入患者入院一般护理评估要点，设计中西医结合病房患者入院护理评估单初稿，采用德尔菲法对评估单初稿进行函询，修改补充后，于2022年4月选取湖北省某三级甲等综合医院中西医结合科3名临床护理人员对160例入院患者进行评估，采用Fleiss’ Kappa系数和内容效度系数对评估单进行信效度检验。结果共开展2轮专家函询，问卷回收率分别为95.45%、100%。专家权威系数为0.931、0.957，肯德尔和谐系数为0.101、0.106（P<0.01）。第2轮函询专家条目重要性评分为4.13~4.82分，变异系数为0.07~0.19。最终确定的中西医结合病房患者入院护理评估单包含一般人口学资料、四诊评估及体质判别、护理风险评估3个部分，共32项评估内容。评估单的Fleiss’ Kappa系数为0.602（P<0.001），条目水平内容效度指数为0.857~1.000，量表水平内容效度指数为0.920。结论编制的中西医结合病房患者入院护理评估单具有良好的信效度，能体现中医护理的内涵，适用于中西医结合病房患者的入院护理评估。

关键词: 中西医结合, 住院患者, 入院护理评估单, 德尔菲技术, 信度, 效度

Abstract:

Objective To design and test the reliability and validity of patient admission nursing assessment sheet of integrated Chinese and western medicine ward. Methods On the basis of literature research，with traditional Chinese medicine "look，hear，ask and pulse-taking" as the basic framework，physical discrimination as the evaluation outcome，combined with the general nursing evaluation points of patients admitted to hospital，we designed the patient admission nursing assessment sheet of integrated Chinese and western medicine ward，and then we adopted the Delphi method to conduct an inquiry on the draft of the admission sheet. In April 2022，3 clinical nurses were selected to evaluate 160 admitted patients from Integrated Traditional Chinese and Western Medicine Department of a tertiary A comprehensive hospital in Hubei Province，and Fleiss’ Kappa coefficient and content validity coefficient were used to test the reliability and validity. Results The recovery rates of the 2 rounds of expert correspondence questionnaires were 95.45% and 100%. The authority coefficients were 0.931 and 0.957；the Kendall harmony coefficients were 0.101 and 0.106（P<0.01）；the importance scores of articles were 4.13~4.82；the coefficient of variation was 0.07~0.19 in 2nd round of expert correspondence. The final nursing assessment list for inpatients in the integrated Chinese and Western medicine ward included 3 parts：general demographic data assessment，four-Chinese medicine diagnosis assessment/physical discrimination，and nursing risk assessment，and there are 32 evaluation contents in the assessment sheet. The Fleiss’ Kappa coefficient of this assessment sheet was 0.602（P<0.001）；the item content validity index was 0.857~1.000，and the overall content validity index was 0.920. Conclusion The admission nursing assessment sheet for inpatients in integrated Chinese and Western medicine wards has good reliability and validity，and it is suitable for the integrated Chinese and Western medicine wards.

Key words: Integration of Traditional Chinese and Western Medicine, Inpatient, Admission Nursing Assessment Sheet, Delphi Technology, Reliability, Validity

周樊华, 甘霖, 梅艳丽, 杜芬, 严冶, 熊莉娟. 中西医结合病房患者入院护理评估单的研制及信效度检验[J]. 中华护理杂志, 2024, 59(7): 802-807.

ZHOU Fanhua, GAN Lin, MEI Yanli, DU Fen, YAN Ye, XIONG Lijuan. Development and reliability and validity test of patient admission nursing assessment sheet of integrated Chinese and western medicine ward[J]. Chinese Journal of Nursing, 2024, 59(7): 802-807.

图/表 3

图1 中西医结合病房患者入院护理评估单

Figure 1 Admission nursing assessment sheet for inpatients in integrated Chinese and Western medicine ward

表1 应用对象的一般资料[n=160，例（百分比，%）]

Table 1 General Information of application subjects [n=160，cases（percentage，%）]

表2 3名护理人员对160例住院患者入院体质判定结论及一致性检验结果[n=160，例（百分比，%）]

Table 2 Conclusion and consistency test results of 3 nursing staff on admission constitution of 160 hospitalized patients[n=160，cases（percentage，%）]

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