HIV感染者继发口咽念珠菌病风险评估量表的编制及信效度检验

doi:10.3761/j.issn.0254-1769.2025.06.013

摘要/Abstract

摘要：

目的编制HIV感染者继发口咽念珠菌病风险评估量表并验证其信效度。方法通过文献分析法、德尔菲专家函询法和层次分析法形成量表初稿，采用便利抽样法，选取2023年10月—2024年1月杭州市某三级甲等综合医院收治的231例HIV感染者进行问卷调查，检测量表的信效度。结果该量表包含一般因素、HIV相关因素和口腔相关因素3个维度，12个一级条目和21个二级条目。量表总的Cronbach’s α系数为0.813，内容效度指数为0.98，各维度的相关性为0.574~0.733（P<0.05）。验证性因子分析显示，量表模型适配度各检验量均在可接受范围，模型拟合良好。利用受试者操作特征曲线确定量表的临界值为30.5分，该曲线下面积为0.909，灵敏度和特异度分别为0.962和0.697。结论 HIV感染者继发口咽念珠菌病风险评估量表具有良好的信效度，可作为口咽念珠菌病风险有效识别和预测的辅助工具。

关键词: 人类免疫缺陷病毒, 念珠菌病, 风险评估, 量表, 信度, 效度, 护理

Abstract:

Objective To develop an assessment scale of oropharyngeal candidiasis risks in HIV-infected patients，and to test its reliability and validity. Methods The draft of the assessment scale was constructed by the literature analysis method，Delphi consultations and analytic hierarchy process. Totally 231 HIV-infected patients in a tertiary A hospital of Hangzhou were recruited for questionnaire survey in October 2023 to January 2024. Results The scale includes 3 dimensions，including general factors，HIV related factors and oral related factors，12 first-level items and 21 second-level items. The Cronbach’s α coefficient of the scale was 0.813；the content validity index was 0.98；the correlation of each dimension was 0.574~0.733（P<0.05）. Confirmatory factor analysis showed that the 3 factor models fitted the data well. The critical value（30.5 points） of the scale was determined by ROC curve；the area under the curve was 0.909；the sensitivity of index system was 0.962，and specificity was 0.697. Conclusion The assessment scale of oropharyngeal candidiasis risks in HIV-infected patients has good reliability and validity，and it can be used as an auxiliary tool for effective identification and prediction of oropharyngeal candidiasis risk.

Key words: Human Immunodeficiency Virus, Candidiasis, Risk Assessment, Scale, Reliability, Validity, Nursing Care

孙丹萍, 王华芬, 黄莺, 邵丽芳, 鲁慧琴, 詹晓琴. HIV感染者继发口咽念珠菌病风险评估量表的编制及信效度检验[J]. 中华护理杂志, 2025, 60(6): 723-728.

SUN Danping, WANG Huafen, HUANG Ying, SHAO Lifang, LU Huiqin, ZHAN Xiaoqin. Development of an Assessment Scale of Oropharyngeal Candidiasis Risks in HIV-infected Patients and its test of validity and reliability[J]. Chinese Journal of Nursing, 2025, 60(6): 723-728.

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参考文献 19

[1]	Stoopler ET, Villa A, Bindakhil M, et al. Common oral conditions:a review[J]. JAMA, 2024, 331(12):1045-1054. DOI PMID
[2]	Chadwick DR, Sutherland RK, Raffe S, et al. British HIV Association guidelines on the management of opportunistic infection in people living with HIV:the clinical management of gastrointestinal opportunistic infections 2020[J]. HIV Med, 2020, 21(Suppl 5):1-19.
[3]	Vila T, Sultan AS, Montelongo-Jauregui D, et al. Oral candidiasis:a disease of opportunity[J]. J Fungi, 2020, 6(1):15.
[4]	Eilers J, Berger AM, Petersen MC. Development,testing,and application of the oral assessment guide[J]. Oncol Nurs Forum, 1988, 15(3):325-330. PMID
[5]	Sonis ST, Eilers JP, Epstein JB, et al. Validation of a new scoring system for the assessment of clinical trial research of oral mucositis induced by radiation or chemotherapy[J]. Cancer, 1999, 85(10):2103-2113. DOI PMID
[6]	Jaroneski LA. The importance of assessment rating scales for chemotherapy-induced oral mucositis[J]. Oncol Nurs Forum, 2006, 33(6):1085-1093. DOI PMID
[7]	Fidan Ö, Arslan S. Development and validation of the oral mucositis risk assessment scale in hematology patients[J]. Semin Oncol Nurs, 2021, 37(3):151159.
[8]	浙江省性病艾滋病防治协会艾滋病临床治疗专业委员会, 浙江省性病艾滋病防治协会艾滋病护理和关怀专业委员会. HIV感染者口咽念珠菌病管理专家共识[J]. 中华临床感染病杂志, 2023, 16(2):108-112.
	AIDS Clinical Treatment Committee of Zhejiang STD/AIDS Prevention and Control Association,AIDS Nursing and Care Committee of Zhejiang STD/AIDS Prevention and Control Association. Expert consensus on the management of oropharyngeal candidiasis in HIV infected patients[J]. Chin J Clin Infect Dis, 2023, 16(2):108-112.
[9]	Brouwers MC, Browman GP, Burgers JS, et al. Appraisal of guidelines for research & evaluation Ⅱ[EB/OL]. (2017-12)[2024-02-10]. http://www.agreetrust.org.
[10]	胡雁, 郝玉芳. 循证护理学[M]. 2版. 北京: 人民卫生出版社, 2018.
	Hu Y,Hao YF. Evidence-based nursing[M]. 2nd ed. Beijing: People’s Medical Publishing House,2018.
[11]	张翠萍, 李笃武, 胡善菊. 层次分析法在护理人员绩效评价指标体系构建中的应用[J]. 护理学杂志, 2010, 25(13):14-16.
	Zhang CP, Li DW, Hu SJ. Application of analytic hierarchy process in constructing a nurse performance appraisal system[J]. J Nurs Sci, 2010, 25(13):14-16.
[12]	杨柳, 李智慧, 孔燕, 等. 婴幼儿照顾者的口腔健康照护能力评估量表的编制及信效度检验[J]. 中华护理杂志, 2024, 59(10):1218-1225. DOI
	Yang L, Li ZH, Kong Y, et al. Development and reliability and validity tests of Oral Health Caring Ability Assessment Scale for Caregivers of Infants and Young Children[J]. Chin J Nurs, 2024, 59(10):1218-1225. DOI
[13]	中华医学会感染病学分会艾滋病丙型肝炎学组,中国疾病预防控制中心. 中国艾滋病诊疗指南(2024年版)[J]. 中华传染病杂志, 2024, 17(3):161-190.
	Acquired Immunodeficiency Syndrome and Hepatitis C Professional Group,Society of Infectious Diseases;Chinese Medical Association,Chinese Center for Disease Control and Prevention. Chinese guidelines for diagnosis and treatment of human immunodeficiency virus infection/acquired immunodeficiency syndrome(2024 edition)[J]. Chin J Infect Dis, 2024, 17(3):161-190.
[14]	王凯选, 李培宇, 王文远, 等. 心力衰竭患者照顾者自我护理贡献量表的汉化及信效度检验[J]. 中华护理杂志, 2022, 57(13):1585-1590. DOI
	Wang KX, Li PY, Wang WY, et al. The sinicization of the European Heart Failure Self-care Behaviour Scale for Caregivers and the test of its reliability and validity[J]. Chin J Nurs, 2022, 57(13):1585-1590.
[15]	孙昕霙. 健康调查问卷:设计原理与实践[M]. 北京: 北京大学医学出版社, 2020.
	Sun XY. Design principle and practice of health questionnaire[M]. Beijing: Peking University Medical Press, 2020.
[16]	Leal JE. AHP-express:a simplified version of the analytical hie-rarchy process method[J]. MethodsX, 2020, 7:100748.
[17]	吴明隆. 问卷统计分析实务:SPSS操作与应用[M]. 重庆: 重庆大学出版社, 2010.
	Wu ML. Questionnaire statistical analysis practice:SPSS opera-tion and application[M]. Chongqing: Chongqing University Press, 2010.
[18]	Reise SP, Widaman KF, Pugh RH. Confirmatory factor analysis and item response theory:two approaches for exploring measurement invariance[J]. Psychol Bull, 1993, 114(3):552-566.
[19]	高兴莲, 郭莉. 术中获得性压力性损伤危险因素评估量表的编制及信效度检验[J]. 中华护理杂志, 2021, 56(4):556-560. DOI
	Gao XL, Guo L. Development and reliability and validity test of the risk factor assessment scale for intraoperative acquired pressure injury[J]. Chin J Nurs, 2021, 56(4):556-560. DOI