WOWI量表的汉化及其在慢性伤口患者中的应用研究

发布时间：2018-04-30 04:38

本文选题：慢性伤口 + 积极心理　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的随着伤口专科的不断发展,慢性伤口越来越多,大家更多的关注伤口局部的治疗方法,而对全身因素、特别是心理对伤口愈合的影响关注不足。本研究通过引进英文版WOWI量表(Well-being in wounds inventory,WOWI),并对其进行汉化及信效度检验,探索其在国内慢性伤口患者临床治疗中的适用性,为评估慢性伤口患者心理状况提供量化工具。然后将修订完善的中文版WOWI量表在国内慢性伤口患者中应用,了解该类人群心理状态,特别是正面的、积极的心理状况,通过分析其影响因素,为从事慢性伤口的护理工作者提供理论依据,从而对慢性伤口患者治疗过程中能全面进行评估,不单评估伤口局部,也要关注心理、情绪等全身因素对伤口愈合的影响,加快伤口的愈合。方法1、引进WOWI量表,首先通过邮件与量表原作者进行沟通,获得使用授权。遵照Brislin原则对WOWI量表进行翻译、回译以及跨文化调试和预调查,最终得出汉化后的中文版WOWI量表。其次,采取便利取样的方法,选取2016年4月~2016年9月期间,在天津市某三家三级甲等医院的伤口治疗门诊或病房接受治疗的181例慢性伤口患者为研究对象,应用中文版WOWI量表及TIME-H伤口评估量表进行现况调查,采用项目分析、内容效度、结构效度、辨别效度、内部一致性信度以及重测信度对中文版WOWI量表进行信效度检验。2、应用第一部分修订完善的中文版WOWI量表,对2016年10月~2017年1月共计168例慢性伤口患者进行调查,同时收集患者的一般资料及社会支持情况,对一般资料、社会支持情况进行描述性分析、采用单因素方差分析及多元线性回归分析对慢性伤口患者的积极心理状况及其影响因素进行探索、分析。结果1、量表的汉化结果:聘请6名专家根据文化及背景差异对中文版WOWI量表进行跨文化调试,未对量表条目进行删减,但对个别条目的表达进行了修改。在预调查过程中,有93.3%的患者认为问卷的条目内容容易理解,说明该量表条目简单并且使用方便,适合在临床中应用。整个问卷的完成时间为5~15min。2、量表的信效度检验:(1)项目分析:各条目得分与WOWI量表总分之间的相关系数为0.390~0.720,各维度得分与量表总分之间的相关系数为0.812~0.873,均具有统计学意义(P0.01),表明条目与量表的同质性较好;极端组法显示所有条目的决断值为5.595~10.504,均大于3.0,均具有统计学意义(P0.01),表明可保留所有条目。(2)内容效度:该量表通过德尔菲法专家咨询得出水平内容效度为0.83~1,平均内容效度为0.96;结构效度:中文版WOWI量表共19个条目,经探索性因子分析,KMO值为0.790,提取2个公因子,累计因子贡献率为51.549%,各条目因子负荷的取值范围为0.426~0.825,均0.4;辨别效度:根据TIME-H评分量表得分分级作为外在校标,结果显示三组的WOWI总分及各分量表得分均有统计学意义,能辨别三者之间的差别,提示中文版WOWI量表辨别效度较好。(3)信度:中文版WOWI量表的Cronbach’sα系数为0.890,两个维度的Cronbach’sα系数分别为0.868和0.886,量表的重测信度为0.983,两个维度的重测信度分别为0.973和0.977,中文版WOWI量表的信度良好。3、慢性伤口患者的积极心理状况结果及其影响因素:本研究中慢性伤口患者的WOWI量表总分为(58.21±11.41)分,处于中度水平,其中伤口消极影响得分为(35.61±16.69)分,个人主观情绪及应对得分为(71.39±11.52)分。不同文化程度、居住地、职业、家庭人均月收入、家庭关系、伤口类型、伤口持续时间和社会支持得分的患者,其WOWI量表得分差异具有统计学意义(P0.05);多元线性回归分析结果显示,影响慢性伤口患者积极心理状况的变量为社会支持、伤口持续时间、家庭关系、糖尿病性溃疡,这四个变量共解释总变异的63.7%。结论1、经过汉化后形成的中文版WOWI量表表达通俗易懂且具有良好的信度和效度,可作为临床慢性伤口患者积极心理状况评价的工具。2、研究中慢性伤口患者的WOWI得分处于中度水平,其中影响慢性伤口患者积极心理状况的主要因素包括社会支持、伤口持续时间、家庭关系、糖尿病性溃疡。
[Abstract]:Objective with the continuous development of the specialty of the wound, more and more chronic wounds, more attention is paid to the local treatment of the wound, and the influence of the whole body factors, especially the psychological effect on the wound healing, is not enough. The study was carried out by introducing the English version of the WOWI scale (Well-being in wounds inventory, WOWI) and carrying out the sinicization and reliability test. To explore its applicability in the clinical treatment of chronic wound patients in China and to provide a quantitative tool for assessing the psychological status of patients with chronic wounds. Then the revised and improved Chinese version of the WOWI scale is used in the domestic chronic wound patients to understand the psychological state of the population, especially the positive and positive psychological conditions, by analyzing its influence. Factors, provide a theoretical basis for the nursing workers engaged in chronic wounds, so as to evaluate the chronic wound patients in the course of treatment, not only to evaluate the part of the wound, but also to pay attention to the effect of psychological, emotional and other systemic factors on the healing of the wound and accelerate the healing of the wound. Method 1, the introduction of the WOWI scale, first of all by mail and scale original work In accordance with the Brislin principle, the WOWI scale is translated, translated, and cross cultural debugging and pre investigation, and then the Chinese version of the Chinese version of the WOWI scale is finally obtained. Secondly, the method of convenient sampling is adopted to select the wound treatment outpatient of three class three grade A hospitals in Tianjin in April 2016 or September. 181 patients with chronic wounds treated in the ward were studied. The Chinese version of the WOWI scale and the TIME-H wound assessment scale were used to investigate the current situation. The validity and validity of the Chinese version WOWI scale was tested by the project analysis, content validity, structural validity, discrimination validity, internal consistency reliability and retest reliability. The first part was revised. A complete Chinese version of the WOWI scale was used to investigate 168 patients with chronic wounds in January October 2016. The general data and social support were collected and the general data and social support were described. The positive heart of the patients with chronic wounds was analyzed by single factor analysis of variance and multiple linear regression analysis. The reason and its influencing factors were explored and analyzed. Results 1, the results of the scale were sinicated: 6 experts were hired to carry out cross-cultural debugging on the Chinese version of the WOWI scale according to the cultural and background differences, and the list items were not deleted, but the expression of individual items was modified. In the process of pre investigation, 93.3% of the patients considered the items of the questionnaire. The content is easy to understand and is easy to use. It is suitable for clinical application. The completion time of the whole questionnaire is 5~15min.2, and the reliability and validity of the scale is tested: (1) project analysis: the correlation coefficient between the scores of each item and the total score of the WOWI scale is 0.390~0.720, and the correlation coefficient between the scores of each dimension and the total score of the scale is 0.81. 2~0.873, which had statistical significance (P0.01), showed that the homogeneity of the entries and the scale was better. The extreme group method showed that the decision value of all the items was 5.595~10.504, both were more than 3, and all had statistical significance (P0.01), indicating that all entries could be retained. (2) the content validity of the scale: the content validity of the scale was 0.83~1 by Delphy Fa expert consultation, and the content validity was 0.83~1 The average content validity was 0.96; the structure validity: the Chinese version of the WOWI scale was 19 items. After the exploratory factor analysis, the KMO value was 0.790, and 2 public factors were extracted. The cumulative factor contribution rate was 51.549%. The range of each item factor load was 0.426~0.825 and 0.4; the discrimination efficiency was based on the TIME-H score scale as the external standard, the result was the result. The scores of the total scores and the subscales of the three groups were statistically significant, and the differences between the three groups were statistically significant, suggesting that the discriminating validity of the Chinese version of the WOWI scale was better. (3) reliability: the Cronbach 's alpha coefficient of the Chinese version WOWI scale was 0.890, the Cronbach' s alpha coefficient of the two dimensions was 0.868 and 0.886, and the retest reliability of the scale was 0.983 and two. The retest reliability of the dimension was 0.973 and 0.977 respectively, the reliability of the Chinese version WOWI scale was good.3, the positive psychological status of the chronic wound patients and its influencing factors: the WOWI scale of the chronic wound patients in this study was (58.21 + 11.41) and was in the moderate level, and the score of the negative effect of the wound was (35.61 + 16.69) points, and the individual subjective was subjective. The scores of emotion and coping were (71.39 + 11.52). The scores of WOWI scales were statistically significant (P0.05) in the patients with different educational level, residence, occupation, family per capita income, family relationship, wound type, wound duration and social support (P0.05); multiple linear regression analysis showed that the patients with chronic wound were positive. The four variables, such as social support, wound duration, family relationship and diabetic ulcers, explained the 63.7%. conclusion 1 of the total variation. The Chinese version of the WOWI scale, formed after the Sinicization, was easy to understand and had good reliability and validity, which could be used as a tool for evaluating the positive psychological status of patients with chronic wounds,.2, The WOWI score of chronic wound patients was moderate in the study, and the main factors affecting the positive psychological status of chronic wound patients were social support, duration of wound, family relationship, and diabetic ulcers.

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.6

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