两种压疮危险因素评估量表在手术患者中信度和效度比较研究

目的比较两种压疮危险因素评估量表(Braden量表和修订版Braden量表)用于手术患者时的信度和效度,为降低术后患者压疮发生率提供有效的压疮危险因素评估工具。方法两名护士分别应用两种量表,同时、独立地对同一患者进行评估,共211例患者接受评估。结果两种量表的评估者间一致性信度Pearson相关系数分别为0.991、0.993;克朗巴赫系数α分别为0.518～0.743,0.307～0.551;Braden量表和修订版中分别去掉“营养状况”、“体型/身高状况”条目后量表的克朗巴赫系数α最高,分别为0.829、0.721;因子分析结果显示两种量表的结构效度与原设想的基本一致;当诊断界值取19分时,修订版Braden量表手术后当天评分的灵敏度和特异度相对较平衡,分别为70.0%、58.1%。结论两种量表具有较好的评估者间一致性信度、区分度和结构效度,在手术患者中的预测效度均不理想,但修订版优于Braden量表,适合中国手术患者人群的压疮危险因素评估工具有待进一步完善。     

Braden量表预测压疮诊断界值及危险因素的研究

目的探讨Braden量表不同分界值的灵敏度、特异度、阳性预测值以及压疮发生的相关危险因素。方法将2011年4月至2013年6月住院的65 926例患者中发生压疮的380例患者应用Braden量表进行压疮风险评估。结果①当Braden量表分界值为14分时,其灵敏度、特异度具有最好的平衡性。②神志、白蛋白、中重度水肿、休克(应用血管活性药物)与压疮发生有关。结论应用Braden量表对住院患者的压疮危险因素进行评估时结合压疮发生的相关危险因素,可以使Braden量表有更好的灵敏性、特异性,从而采取相应措施,有效降低住院患者的压疮发生率。     

Braden压疮危险因素评估量表对基层医院危重病人的适用性研究

[目的]探讨Braden压疮危险因素评估量表对基层医院危重病人压疮评估的预测效力.[方法]采用日常活动能力分类量表、Braden压疮危险因素评估量表对74例危重病人如严重创伤、神经损伤、昏迷、死亡病人进行评估.[结果]日常活动能力分类量表评分3分～5分,Braden压疮危险因素评估量表6个条目平均分为2.36分～3.06分,压疮发生率为8.1%,Braden压疮危险因素评估量表临界值为14分时灵敏度为85.1%、特异度为93.2%、阳性预测值为33.4%、阴性预测值为98.7%.[结论]危重病人病情危重度越高,Braden压疮危险因素评估量表临界值取14分时其灵敏度和特异度较好;Braden压疮危险因素评估量表对我院危重病人的压疮预测效果较好.     

Braden压疮危险因素评估量表对基层医院危重病人的适用性研究

[目的]探讨Braden压疮危险因素评估量表对基层医院危重病人压疮评估的预测效力。[方法]采用日常活动能力分类量表、Braden压疮危险因素评估量表对74例危重病人如严重创伤、神经损伤、昏迷、死亡病人进行评估。[结果]日常活动能力分类量表评分3分～5分,Braden压疮危险因素评估量表6个条目平均分为2.36分～3.06分,压疮发生率为8.1%,Braden压疮危险因素评估量表临界值为14分时灵敏度为85.1%、特异度为93.2%、阳性预测值为33.4%、阴性预测值为98.7%。[结论]危重病人病情危重度越高,Braden压疮危险因素评估量表临界值取14分时其灵敏度和特异度较好;Braden压疮危险因素评估量表对我院危重病人的压疮预测效果较好。     

Braden量表在晚期肿瘤患者压疮防护中的应用

目的评价Braden量表在晚期肿瘤患者压疮预防中的适用性。方法用Braden量表和国内评分法两种量表评价91例晚期肿瘤患者，比较两种量表对压疮发生预测的准确性。结果91例患者中7例发生了压疮，6例为Ⅰ期，1例为Ⅱ期。Braden量表评分≤18分的患者14例，包括了全部6例压疮患者；国内评分法有21例≤25分，包括1例压疮患者。Braden量表预测压疮发生的灵敏度为42．9％（6／14），特异性为98．7％（76／77），国内评分法预测压疮发生的灵敏度为4％（1／25），特异性90．9％（60／66），二者比较差异有统计学意义（P〈0．05）。结论Braden量表能更准确地预测压疮的发生。     

Braden量表评估压疮风险的研究进展及展望

<正>压疮危险因素评估量表(Risk Assessment Scale RAS)可以快速科学评估患者压疮患病风险,具有操作简便、经济、无创的优点,广泛应用于临床护理工作。目前,常见的压疮危险因素评估量表有4种,分别是:Braden量表(Braden Scale)、Braden Q量表(Braden Q Scale)、Norton量表(Norton Scale)和Waterlow量表(Waterlow Scale)。不同量表的适用范围各有侧重。国内外研究表明,Braden Q量表主要适用于儿童压疮风     

Braden量表在神经内科压疮预防中的应用

目的评价Braden量表在神经内科的应用意义。方法将Braden量表应用于2011年8月-10月住院患者,统计其压疮发生的低、中、高、极高危患者,并根据评分结果进行分层管理。结果该期间共评估2435例患者,无危险者1630例（66．94％）,低危者485例（19．92％）,中危者148例（6．08％）,高危者98例（4．02％）,极高危者74例（3．04％）。无院内可避免压疮发生,也未发生由皮肤护理引发的护患纠纷。结论Braden量表的使用提高了护士对发生压疮危险的早期判断能力,工作更有针对性,更利于压疮的分层管理。     

Braden量表评估准确性对压疮风险预警的影响

[目的]探讨临床护士应用Braden量表评估准确性对压疮风险预警的影响。[方法]对骨科压疮高危者的Braden量表124份进行分析,比较培训前后临床护士应用Braden量表评估准确性。[结果]临床护士应用Braden量表评估准确性高于培训前,临床护士培训前后对感知、营养、摩擦/剪切力3个方面比较,差异有统计学意义。[结论]加强对临床护士相关知识培训能提高护士应用Braden量表的准确性,提高对压疮风险评估的认识,有效起到压疮风险预警的作用。     

3种压疮危险评估量表在老年患者中应用的信效度研究

目的 比较和评价Norton、Braden和Waterlow 3种压疮危险评估量表在老年患者中应用的信效度.方法 选取某三级甲等医院老年患者271例,运用3种量表连续评估患者的压疮危险,以Cronbach's α系数、内容效度指数、因子分析、ROC曲线等方法评价和比较各量表的信效度.结果Norton、Braden、Watedow量表的内部一致性信度分别为0.71、0.79、0.32;内容效度指数分别为0.85、0.91、0.87;因子分析得到的方差累计贡献率分别为71.73%、70.34%、65.76%;灵敏度和特异度分别为(0.75、0.62)、(0.74、0.59)、(0.86、0.59).结论 Waterlow量表的内部一致性信度低,但预测能力最好;Braden量表的信效度均高,但预测能力偏低.     

Braden压疮风险评估量表在ICU病人压疮管理中的应用

[目的]探讨Braden压疮风险评估量表在重症监护室(ICU)病人压疮预防中的应用.[方法]将2009年1月-12月ICU收治的1086例病人作为对照组,采取2h翻身1次、气垫床减压等护理措施;将2010年1月-12月ICU收治的1165例病人作为干预组,根据Braden压疮风险评估量表评分结果制定压疮预防与治疗方案.比较两组病人住院期间压疮的发生率.[结果]对照组压疮发生率为1.10％,干预组为0.26％,两组发生率比较,差异有统计学意义(P＜0.05).[结论]ICU病人护理中应用Braden压疮风险评估量表,并根据评估结果实施干预能提高预防压疮的有效性.     

Assessing predictive validity of the modified Braden scale for prediction of pressure ulcer risk of orthopaedic patients in an acute care setting

Aims and objectives. To assess and compare the predictive validity of the modified Braden and Braden scales and to identify which of the modified Braden subscales are predictive in assessing pressure ulcer risk among orthopaedic patients in an acute care setting. Background. Although the Braden scale has better predictive validity, literature has suggested that it can be used in conjunction with other pressure ulcer risk calculators or that some other subscales be added. To increase the predictive power of the Braden scale, a modified Braden scale by adding body build for height and skin type and excluding nutrition was developed. Design. A prospective cohort study. Method. A total of 197 subjects in a 106‐bed orthopaedic department of an acute care hospital in Hong Kong were assessed for their risk for pressure ulcer development by the modified Braden and Braden scales. Subsequently, daily skin assessment was performed to detect pressure ulcers. Cases were closed when pressure ulcers were detected. Results. Out of 197 subjects, 18 patients (9·1%) developed pressure ulcers. The area under the receiver operating characteristic curve for the modified Braden scale was 0·736 and for the Braden scale was 0·648. The modified Braden cut‐off score of 19 showed the best balance of sensitivity (89%) and specificity (62%). Sensory perception (Beta = ?1·544, OR=0·214, p = 0·016), body build for height (Beta = ?0·755, OR = 0·470, p = 0·030) and skin type (Beta = ?1·527, OR = 0·217, p = 0·002) were significantly predictive of pressure ulcer development. Conclusion. The modified Braden scale is more predictive of pressure ulcer development than the Braden scale. Relevance to clinical practice. The modified Braden scale can be adopted for predicting pressure ulcer development among orthopaedic patients in an acute care setting. Specific nursing interventions should be provided, with special attention paid to orthopaedic patients with impaired sensory perception, poor skin type and abnormal body build for height.     

Assessing reliability and validity of the Chinese version of the stroke scale: scale development

BACKGROUND: The National Institutes of Health Stroke Scale (NIHSS) is a systematic, 15-point evaluation tool, designed to assess neurological deficit in acute stroke patients and written in English. It is used to support important medical and nursing decisions. OBJECTIVES: To translate the NIHSS into Chinese and establish its psychometric properties using Chinese evaluators. DESIGN: Methodological research design. SETTING: One medical centre. Participants: Using convenience sampling, 48 subjects admitted with acute ischemic stroke were selected. METHODS: In this study, six clinicians from the Department of Neurology (3 nurses, 3 doctors) assessed the 48 patients using the C-NIHSS, the Glasgow Coma Scale and the Barthel index. RESULTS: The C-NIHSS content validity index reached 1.00, and the Cronbach's alpha coefficient for internal consistency was 0.92. Of the 15 scale items, two (facial palsy and limb ataxia) had low inter-rater values (k values below 0.39). Kappa (kappa) values were substantial (over 0.60) for all other items. The C-NIHSS has a significantly negative correlation with both Glasgow Coma Scale (r = -0.824, p < 0.01), and Barthel index (r = -0.683, p < 0.01) scores. CONCLUSIONS: The C-NIHSS is a reliable and valid scale for the clinical assessment of neurological deficit in acute stroke patients.     

护理组织氛围量表的编制及其信度、效度检验

目的编制护理组织氛围量表,并检验其信度和效度。方法运用访谈及查阅文献的方法编制护理组织氛围量表,并采用整群分层随机抽样的方法,调查哈尔滨市4所三级甲等医院的720名注册护士,考察量表的信度和效度。结果经过专业调适和修订的护理组织氛围量表包括4个维度,因子累积贡献率为53．73％,因素负荷为0．452～0．735;量表的总体内部一致性信度为0．927,各维度的内部一致性信度为0．702—0．877;各维度与总体的相关系数为0．785—0．919,各维度之间的相关系数为0．564～0．711。结论护理组织氛围量表具有较好的信度和效度,可作为衡量护理组织氛围的有效工具。     

精神科保护性约束评估量表的编制及信效度检验

目的：编制精神科保护性约束评估量表,并评估其信度与效度,为精神科病房保护性约束的使用提供参考依据。方法：通过访谈法,结合文献资料建立保护性约束评估量表的基本框架及发展条目池;经专家咨询及预试验,形成量表。对234名精神疾病患者进行样本测试,评价量表的信度、效度。结果：最终形成了“攻击、自杀、自残、外走、跌倒、坠床”等9个评估指标和27个评估条目。量表总Cronbach’α系数为0.856,各维度的Cronbach’α系数为0.726～0.938;问卷各条目I-CVI的范围为0.80～1.00,S-CVI 为0.98;评定者间信度为0.987。结论：精神科保护性约束评估量表具有较好的信度与效度,作为精神科护士实施保护性约束的测评工具,具有重要的临床应用价值。     

癌因性疲乏自评量表的编制及信效度检验

目的研制一种经过标准化、简便可行的符合我国文化背景和我国肿瘤患者疲乏特征的疲乏测评工具,并进行信效度检验。方法采用深度访谈、文献回顾和德尔菲法形成初期量表,经过预测试、大样本测试形成正式量表。采用项目分析、探索性因子分析、验证性因子分析、相关性分析、内部一致性检验、折半信度分析、内容效度等对量表进行评价。结果形成的癌因性疲乏自评量表包括4个维度,15个条目,累积方差贡献率为71.304%;验证性因子分析结果为χ2/df=1.956,RMSEA=0.064,CFI=0.961,GFI=0.912,AGFI=0.874,IFI=0.962;Cronbach'α为0.92,折半系数为0.850;内容效度为0.903;较标效度为0.717。结论量表具有良好的信度和效度,可以作为肿瘤患者疲乏状况的测量工具。     

中文版护士工作满意度量表的信、效度研究

目的 评定中文版护士工作满意度量表的信效度,为护士工作满意度的测定提供量化工具.方法 利用中文版护士工作满意度量表对14所综合性医院中的336名护士进行测试,根据测试结果对量表的信、效度进行分析.结果 中文版护士工作满意度量表总体的克伦巴赫α系数为0.901,各维度的克伦巴赫α系数为0.732-0.921;量表的重测信度为0.832;主成分分析共提取9个公因子,累积贡献率为59.57%.结论 中文版护士工作满意度量表具有较好的信效度,可初步应用于护士满意度的评价.     

Reliability and validity of pressure ulcer diagnosis and grading: an image-based survey

BACKGROUND: The reliability and validity of pressure ulcer diagnosis and grading are major methodological issues in studies and reports on pressure ulcer frequency. OBJECTIVES: The aim of the study was to estimate the reliability and validity of pressure ulcer diagnosis and grading within the interdisciplinary pressure ulcer project of the University Clinics of Essen, Germany. DESIGN: Fifty images of wounds from the foot/heel region and 50 images of wounds from the buttock/hip region were classified using a 4-grade scale. A gold standard was established by consensus of two senior physicians. SETTINGS: The images were assessed PC-based, independently by each rater. PARTICIPANTS: Five nursing experts and two physicians participated. METHODS: Mean simple Kappa and per cent agreement were calculated to assess reliability and validity. RESULTS: Mean simple Kappa values showed a moderate interrater agreement for grading and a fair interrater agreement for diagnosis. The percentage of agreements was highest for pressure ulcer diagnosis in the buttock/hip region with 90.5% and lowest for pressure ulcer grading in the buttock/hip region with 63.5%. No differences could be found between nurses and physicians. CONCLUSIONS: The differentiation between pressure ulcers and other skin lesions is rather difficult. It is important to assign the lower grade when the available information does not definitely support the higher grade. The level of agreement found was intermediate in the range of published results. A substantial level of agreement should be obtainable through further standardisation and training. Future studies should control for dependency in the assessment situation and dispense with the category "uncertain".     

成年人健康自我管理能力测评量表的编制及信度和效度检验

目的编制成年人健康自我管理能力测评量表,检验其信度和效度,为评估成年人健康自我管理能力提供一个有效的测评工具。方法本研究是在前期研究的基础上,选取哈尔滨和福州1205名成年人为研究对象,应用暂定版量表进行施测,并对量表的信效度进行检验。结果形成的成年人健康自我管理能力测评量表由3个分量表,7个维度和38个条目组成;其累积解释总方差的59．039％,量表具有良好的信、效度。结论本量表具有较好的信度和效度,既可作为测评成年人健康自我管理能力的工具之一,也可为以后有针对性地进行健康教育干预提供依据。     

门诊优质护理服务质量评价量表的编制及信效度的检验

目的 探讨编制适合我国现阶段门诊优质护理服务质量评价量表,评价其信度和效度。 方法 在参考国内外文献研究和护理专家审核的基础上,拟定门诊优质护理服务质量评价指标,形成门诊优质护理质量量表,对某两所三级甲等医院就诊的236例门诊患者进行调查。 结果量表中的 5个维度(医院环境、科室环境、护士言行、工作制度、护理技能)和22个条目均具有较好的内部一致性信度(总量表的Cronbach's α为0.862,分半信度为0.786),内容效度(I-CVI为0.87,S-CVI为0.96),探索性因子分析KMO值为0.921;验证性因子分析 χ²/v<3,拟合优度指数(GFI)、比较拟合指数(CFI)、非规范拟合指数(NNFI)均大于0.90,近似误差平方根(RMSEA)及标准差均方根(RMR)小于0.08。 结论 此量表不但可以作为门诊优质护理服务质量的测评工具,而且为进一步深入研究提供了理论依据。