基于照护者的老年患者综合评估的衰弱指数问卷汉化及初步应用研究

发布时间：2018-06-18 11:41

本文选题：CP-FI-CGA问卷 + 汉化　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:对CP-FI-CGA(Care partner-frailty index-comprehensive geriatric assessment)[1]问卷进行汉化及初步应用研究:首先通过对老年病科患者衰弱及其等级的筛查,评价其信度和效度;然后对问卷进行初步应用,分析患者衰弱程度以及衰弱的影响因素等,为临床上分级护理提供参考。方法:1.通过查找外文文献,选取较符合中国文化背景的由加拿大教授Goldstein Judah编制的问卷:CP-FI-CGA,通过E-mail与作者取得联系,并得到作者的授权。2.采用改良版的Brislin翻译模式对问卷进行翻译回译,采用专家咨询评价其内容效度,在选定的四所医院对该问卷进行条目区分度、重测信度、内部一致性信度、评定者间信度、折半信度、校标关联效度、结构效度等的检验。3.选取太原市设立老年病科的四所三级甲等综合医院,抽取2016年6月到2016年8月的300名老年患者,对其进行CP-FI-CGA问卷的信度和效度检验;抽取2016年9月到2016年12月的385名患者对其进行一般资料、CP-FI-CGA问卷、加拿大研发的临床衰弱等级量表(CFS)的资料收集,对数据进行统计分析。结果:1.通过德尔菲专家咨询该问卷的平均内容效度S-CVI/Ave=0.986。2.信度检测:重测信度r=0.970,评定者间信度r=0.995,折半信度r=0.851。3.效度检测:校标关联效度:FI与CFS的简单相关系数r=0.796,与年龄的相关系数r=0.486;结构效度:各条目得分与衰弱指数得分的相关系数r在0.019-0.636之间波动(P0.05);内部一致性效度:内部一致性Cronbach's系数a=0.843。4.接受性评价:条目的长度、条目的内容清晰度以及问卷内容范围的接受性为100%,问卷的长度接受性为98.67%,完成时间为(5.45±0.650)min。5.385名患者衰弱指数计算结果为(0.32±0.165)分,CFS等级为(5.04±1.483)级,两者相关系数r=0.819(P0.05),呈正相关。6.单因素分析结果:年龄、婚姻状况、用药种类、需要帮助的多少、社会支持情况、睡眠情况这6个因素衰弱指数得分差异有统计学意义;随着年龄的增加、跌倒史和5种以上用药所占比例的增加,患者的衰弱等级加重;不同性别的衰弱程度比较以及不同性别衰弱等级分层比较,均有P0.05,差异不具有统计学意义。7.多重线性回归分析结果:年龄、用药种类、需要帮助的多少、睡眠情况是影响衰弱指数得分的独立因素。结论:1.CP-FI-CGA问卷综合评估患者身体各个系统的健康状况,综合分析患者的衰弱程度,能够较全面反应患者的身心状况,可以将之推广应用。2.该问卷包括43个条目,具有良好的信效度,可以用于老年病科患者衰弱及其等级的筛查,可为临床上分级护理提供参考。3.年龄、用药种类、需要帮助的多少、睡眠情况是影响衰弱指数得分的独立危险因素,所以家属和医务人员可针对性的采取措施来减缓衰弱的进展。
[Abstract]:Objective: to evaluate the reliability and validity of CP-FI-CGAA Care partner-frailty index-comprehensive geriatric assessment [1] questionnaire by screening the debilitating and grade of geriatric patients, and then to apply the questionnaire. To analyze the degree of debilitating and the influencing factors of debilitating patients, to provide reference for clinical graded nursing. Method 1: 1. By looking up foreign literature, we selected the questionnaire: CP-FI-CGA compiled by Goldstein Judah, a Canadian professor, which fits the Chinese cultural background, and contacted the author by E-mail, and obtained the authorisation of the author. An improved version of Brislin translation model was used to translate back the questionnaire. The validity of the questionnaire was evaluated by expert consultation. The questionnaire was divided into items, retest reliability, internal consistency reliability, and reliability between the four selected hospitals. Half-fold reliability, calibration correlation validity, structural validity, etc. Four Grade 3A hospitals with geriatrics were selected from Taiyuan, and 300 elderly patients were selected from June 2016 to August 2016. The reliability and validity of CP-FI-CGA questionnaire were tested. General data were collected from 385 patients from September 2016 to December 2016. The CP-FI-CGA questionnaire and the clinical debilitating rating scale (CFS) developed by Canada were collected and analyzed statistically. The result is 1: 1. The average content validity of the questionnaire was 0.986.2. Reliability test: retest reliability r = 0.970, r = 0.995, r = 0.851.3. Validity test: the simple correlation coefficient (r = 0.796) and the correlation coefficient (r = 0.486) between the correlate validity of: 1% fi and CFS; the structural validity: the correlation coefficient between item score and debilitating index score (r) fluctuated between 0.019-0.636 (P 0.05); the internal consistency validity: The coefficient of Cronbachs is 0.843.4. Acceptance evaluation: the length of items, the clarity of items and the acceptance of the scope of the questionnaire were 100, 98.67, and the time of completion was 5.45 卤0.165 and 5.04 卤1.483, respectively. The correlation coefficient between them was 0.819, P 0.05, with a positive correlation of. 6. 6. Univariate analysis results: age, marital status, drug types, the number of needed help, social support, sleep, these six factors of debilitating index scores were statistically significant; with the increase of age, With the increase of fall history and the proportion of more than 5 kinds of drugs, the debilitating grade of the patients was aggravated, and the comparison of the debilitating degree of different genders and the stratified comparison of different gender grades were all P0.05, the difference was not statistically significant. 7. Multiple linear regression analysis: age, type of medication, need of help, sleep condition is an independent factor affecting the score of debilitating index. Conclusion: 1. The CP-FI-CGA questionnaire can comprehensively assess the health status of the patients and analyze the degree of weakness of the patients. It can reflect the physical and mental status of the patients comprehensively and can be popularized and applied. The questionnaire includes 43 items and has good reliability and validity. It can be used for the screening of debilitating and grade of geriatric patients and can provide reference for clinical graded nursing. Age, type of medication, how much help is needed, sleep is an independent risk factor for debilitating index scores, so family members and medical staff can take targeted measures to slow the decline.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473

【参考文献】