糖尿病中医阴虚热盛证护理评估量表的编制

发布时间：2018-05-24 11:23

本文选题：糖尿病 + 阴虚热盛　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:编制符合中医护理评估方法的糖尿病中医阴虚热盛证护理评估量表,确立其阈值并验证其信效度,为临床护理人员辨识此证型提供简便易行的评估工具。方法:(1)本研究采用文献调研联合两轮德尔菲专家函询法,初步拟定了糖尿病中医阴虚热盛证护理评估量表的条目池,通过临床调研的方式收集了 210位糖尿病患者的中医四诊信息,阴虚热盛证主证应用离散趋势法、区分度分析法、相关系数法、克朗巴赫系数法以及因子分析法对条目进行筛选,兼证条目筛选则灵活选取了频数分析法、区分度分析法、相关系数分析法和克朗巴赫系数法。(2)运用主观专家评定法和客观因子分析法进行条目赋权,建立评估模型,进而采用ROC分析方法进行诊断阈值的确立。(3)通过临床调研对量表的信度和效度对量表进行测评。结果:(1)通过主客观的方法,最终确立糖尿病阴虚热盛证量表,阴虚热盛证包括18个条目,兼证湿热证包括7个条目,兼证血瘀证包括3个条目。(2)建立量表评估模型Y=舌红*3+苔黄*11+语音高亢*2+语速快*2+口渴*3+口燥*3+咽干*5+口干*8+易饥*5+多饮*5+心烦*4+烦躁易怒*5+怕热*3+手足心热*7+小便频数*11+大便秘结*9+体重减轻*10+脉数*2(Y代表量表积分,数字代表对权重,"*"代表乘),量表的阈值为241分。(3)量表具有较好的信效度,体现在各测评指标均符合量表编制的要求。糖尿病阴虚热盛证主证重测信度为0.784,兼证湿热证重测信度0.898,兼证血瘀证重测信度为0.826。糖尿病阴虚热盛证主证分半信度为0.832,兼证湿热证分半信度为0.712,兼证血瘀证分半信度为0.705。糖尿病阴虚热盛证主证Cronbach' α系数为0.835,兼证湿热证的Cronbach' α系数为0.708,兼证血瘀证Cronbach' α系数为0.712。阴虚热盛证主证各条目水平内容效度指数在0.889～1之间,兼证湿热证各条目水平内容效度指数在0.83～1之间,血瘀证各条目水平内容效度指数在0.83～1之间,阴虚热盛证主证量表水平内容效度指数为0.944,兼证湿热证量表水平内容效度指数为0.865,兼证血瘀证量表水平内容效度指数为0.852。量表和亚量表结构效度解释方差变异率60%,说明具有较好的结构效度。结论:本研究建立的糖尿病阴虚热盛证量表,包括两个兼证量表,具有较好的信度和效度,适合作为糖尿病阴虚热盛证的中医护理评估工具。
[Abstract]:Objective: to develop a nursing evaluation scale for diabetes mellitus in accordance with TCM nursing evaluation method, establish its threshold value and verify its reliability and validity, and provide a simple and convenient evaluation tool for clinical nurses to identify this syndrome type. Methods in this study, by using literature investigation and two rounds of Delphi's expert letter, we have preliminarily drawn up the item pool of the scale of nursing evaluation of TCM Yin deficiency and Heat Sheng Syndrome in diabetes mellitus. The information of four diagnoses of 210 patients with diabetes mellitus was collected by clinical investigation. The main syndromes of Yin deficiency and heat flourishing syndrome were divided into four methods: discrete trend method, differentiation analysis method, correlation coefficient method, and so on. The Cronbach coefficient method and the factor analysis method are used to screen the items, and the frequency analysis method and the discriminant analysis method are chosen flexibly. Correlation coefficient analysis method and Cronbach coefficient method. Then the diagnostic threshold was established by ROC analysis. The reliability and validity of the scale were evaluated by clinical investigation. Results (1) through subjective and objective methods, the scale of deficiency of yin and heat of diabetes mellitus was finally established. The syndrome of deficiency of yin and heat of deficiency included 18 items, and the syndrome of dampness and heat of diabetes included 7 items. Establishment of a scale of evaluation model Y1 = tongue red 3 moss 3 moss 11 high speech hyperactivity 2 fast speech speed 2 thirst 3 mouth dryness 3 pharynx dryness 5 dry stomachs 8 easy hunger 5 drink 5 upset 5 irritable 4 irritable 5 fear of heat 3 palms heat 7 fen Urination frequency, 11 constipation problems, 9 weight loss, 10 pulse count and 2y represent scale integral, The number represents the weight, "*" means multiplies, and the threshold value of the scale is 241. 3) the scale has good reliability and validity, which is reflected in the fact that all the evaluation indexes are in line with the requirements of the development of the scale. The reliability of the main syndrome of diabetes mellitus was 0.784, that of dampness and heat was 0.898, and that of the syndrome of blood stasis was 0.826. The semi-reliability of the main syndrome of diabetes mellitus is 0.832, that of the damp-heat syndrome is 0.712, and that of the syndrome of blood stasis is 0.705. The coefficient of Cronbach'伪 in diabetes mellitus was 0.835, that of damp-heat syndrome was 0.708, and that of blood stasis syndrome was 0.7122.The coefficient of Cronbach'伪 was 0.835 in the syndrome of yin deficiency and heat, 0.708 in the syndrome of dampness and heat, and 0.712in the syndrome of blood stasis. The content validity index of each item was between 0.889 and 1, that of dampness and heat syndrome was between 0.83N-1, and that of blood stasis syndrome was between 0.831 and 0.831, respectively. The content validity index of the main syndrome scale was 0.944, the content validity index of the dampness and heat syndrome scale was 0.865, and the content validity index of the blood stasis scale was 0.852. The structural validity of the scale and subscale explained the variance variation rate of 60%, which indicated that it had better structural validity. Conclusion: the diabetes yin deficiency and heat syndrome scale, including two syndromes scale, has good reliability and validity, and is suitable for TCM nursing evaluation tool.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R248.1

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