鼻饲患者误吸风险评估量表的编制及信效度检验

doi:10.3761/j.issn.0254-1769.2022.03.014

摘要/Abstract

摘要：

目的编制鼻饲患者误吸风险评估量表,并检验其信效度,为医护人员提供科学、客观的误吸风险评估工具。方法在文献分析的基础上结合2轮专家咨询构建鼻饲患者误吸风险评估量表。采用便利抽样法,于2020年11月— 2021年3月选取深圳市某三级甲等医院收治的122例鼻饲患者作为调查对象,进行量表条目的筛选及信效度检验。结果鼻饲患者误吸风险评估量表包括3个维度,10个一级条目,22个二级条目;通过探索性因子分析,提取3个公因子,累计方差贡献率为61.699%;各条目的因子载荷值为0.473~0.931。与效标（误吸发生情况）的相关系数为0.739,受试者操作特征曲线下面积为0.961[95%CI（0.929,0.993）,P<0.001];量表水平的内容效度指数为0.953,Cronbach’s α系数为0.739。结论鼻饲患者误吸风险评估量表具有良好的信效度,可作为误吸风险识别与预测的辅助工具。

关键词: 肠内营养, 误吸, 量表, 信度, 效度, 护理

Abstract:

Objective To compile an Assessment Scale of Aspiration Risk for Nasal Feeding Patients,and to test its reliability and validity,aiming to provide a scientific and objective aspiration risk assessment tool for doctors and nurses. Methods The draft of the Assessment Scale of Aspiration Risk for Nasal Feeding Patients was constructed based on the literature analysis and 2 rounds of Delphi consultations. Using convenience sampling,the data of 122 patients with nasal feeding from November 2020 to March 2021 in tertiary A hospital of Shenzhen was collected,and item screening and the test of reliability and validity were carried out. Results The Assessment Scale of Aspiration Risk for Nasal Feeding Patients includes 3 dimensions,10 first-level items and 22 second-level items. The exploratory factor analysis extracts 3 common factors,and the cumulative variance contribution rate is 61.699%. The load value of common factors of each item is between 0.473 to 0.931. The correlation coefficient of the effective standard（whether aspiration occurs） is 0.739;the area under the ROC curve for predicting the risk of aspiration in nasal feeding patients is 0.961,and the confidence interval of 95% is between 0.929 to 0.993（P<0.001）;the content validity is 0.953;the Cronbach’s α coefficient of the scale is 0.739. Conclusion The Assessment Scale of Aspiration Risk for Nasal Feeding Patients has good reliability and validity,and it can be used as a tool in clinical practice to assist in the identification and prediction of aspiration.

Key words: Enteral Nutrition, Aspiration, Scale, Reliability, Validity, Nursing Care

刘璐, 张娟, 张晓瑜, 黄锐娜, 张美红, 晏晓琨. 鼻饲患者误吸风险评估量表的编制及信效度检验[J]. 中华护理杂志, 2022, 57(3): 337-342.

LIU Lu, ZHANG Juan, ZHANG Xiaoyu, HUANG Ruina, ZHANG Meihong, YAN Xiaokun. Development of an Assessment Scale of Aspiration Risk for Nasal Feeding Patients and its test of validity and reliability[J]. Chinese Journal of Nursing, 2022, 57(3): 337-342.

图/表 3

表1 鼻饲患者误吸风险评估量表专家咨询结果（第2轮）

Table 1 Consultation results of the Assessment Scale of Aspiration Risks for Nasal Feeding Patients（the second round）

表2 鼻饲患者误吸风险评估量表各条目因子载荷矩阵

Table 2 Factor load matrix after rotation of the Assessment Scale of Aspiration Risks for Nasal Feeding Patients

图1 鼻饲患者误吸风险评估量表预测误吸发生的受试者操作特征曲线

Figure 1 Receiver operating characteristic curve of aspiration prediction by Assessment Scale of Aspiration Risks for Nasal Feeding Patients

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