本文選題：慢性傷口 + 積極心理�。� 參考：《天津醫(yī)科大學》2017年碩士論文

【摘要】：目的隨著傷口�？频牟粩喟l(fā)展,慢性傷口越來越多,大家更多的關注傷口局部的治療方法,而對全身因素、特別是心理對傷口愈合的影響關注不足。本研究通過引進英文版WOWI量表(Well-being in wounds inventory,WOWI),并對其進行漢化及信效度檢驗,探索其在國內慢性傷口患者臨床治療中的適用性,為評估慢性傷口患者心理狀況提供量化工具。然后將修訂完善的中文版WOWI量表在國內慢性傷口患者中應用,了解該類人群心理狀態(tài),特別是正面的、積極的心理狀況,通過分析其影響因素,為從事慢性傷口的護理工作者提供理論依據(jù),從而對慢性傷口患者治療過程中能全面進行評估,不單評估傷口局部,也要關注心理、情緒等全身因素對傷口愈合的影響,加快傷口的愈合。方法1、引進WOWI量表,首先通過郵件與量表原作者進行溝通,獲得使用授權。遵照Brislin原則對WOWI量表進行翻譯、回譯以及跨文化調試和預調查,最終得出漢化后的中文版WOWI量表。其次,采取便利取樣的方法,選取2016年4月~2016年9月期間,在天津市某三家三級甲等醫(yī)院的傷口治療門診或病房接受治療的181例慢性傷口患者為研究對象,應用中文版WOWI量表及TIME-H傷口評估量表進行現(xiàn)況調查,采用項目分析、內容效度、結構效度、辨別效度、內部一致性信度以及重測信度對中文版WOWI量表進行信效度檢驗。2、應用第一部分修訂完善的中文版WOWI量表,對2016年10月~2017年1月共計168例慢性傷口患者進行調查,同時收集患者的一般資料及社會支持情況,對一般資料、社會支持情況進行描述性分析、采用單因素方差分析及多元線性回歸分析對慢性傷口患者的積極心理狀況及其影響因素進行探索、分析。結果1、量表的漢化結果:聘請6名專家根據(jù)文化及背景差異對中文版WOWI量表進行跨文化調試,未對量表條目進行刪減,但對個別條目的表達進行了修改。在預調查過程中,有93.3%的患者認為問卷的條目內容容易理解,說明該量表條目簡單并且使用方便,適合在臨床中應用。整個問卷的完成時間為5~15min。2、量表的信效度檢驗:(1)項目分析:各條目得分與WOWI量表總分之間的相關系數(shù)為0.390~0.720,各維度得分與量表總分之間的相關系數(shù)為0.812~0.873,均具有統(tǒng)計學意義(P0.01),表明條目與量表的同質性較好;極端組法顯示所有條目的決斷值為5.595~10.504,均大于3.0,均具有統(tǒng)計學意義(P0.01),表明可保留所有條目。(2)內容效度:該量表通過德爾菲法專家咨詢得出水平內容效度為0.83~1,平均內容效度為0.96;結構效度:中文版WOWI量表共19個條目,經(jīng)探索性因子分析,KMO值為0.790,提取2個公因子,累計因子貢獻率為51.549%,各條目因子負荷的取值范圍為0.426~0.825,均0.4;辨別效度:根據(jù)TIME-H評分量表得分分級作為外在校標,結果顯示三組的WOWI總分及各分量表得分均有統(tǒng)計學意義,能辨別三者之間的差別,提示中文版WOWI量表辨別效度較好。(3)信度:中文版WOWI量表的Cronbach’sα系數(shù)為0.890,兩個維度的Cronbach’sα系數(shù)分別為0.868和0.886,量表的重測信度為0.983,兩個維度的重測信度分別為0.973和0.977,中文版WOWI量表的信度良好。3、慢性傷口患者的積極心理狀況結果及其影響因素:本研究中慢性傷口患者的WOWI量表總分為(58.21±11.41)分,處于中度水平,其中傷口消極影響得分為(35.61±16.69)分,個人主觀情緒及應對得分為(71.39±11.52)分。不同文化程度、居住地、職業(yè)、家庭人均月收入、家庭關系、傷口類型、傷口持續(xù)時間和社會支持得分的患者,其WOWI量表得分差異具有統(tǒng)計學意義(P0.05);多元線性回歸分析結果顯示,影響慢性傷口患者積極心理狀況的變量為社會支持、傷口持續(xù)時間、家庭關系、糖尿病性潰瘍,這四個變量共解釋總變異的63.7%。結論1、經(jīng)過漢化后形成的中文版WOWI量表表達通俗易懂且具有良好的信度和效度,可作為臨床慢性傷口患者積極心理狀況評價的工具。2、研究中慢性傷口患者的WOWI得分處于中度水平,其中影響慢性傷口患者積極心理狀況的主要因素包括社會支持、傷口持續(xù)時間、家庭關系、糖尿病性潰瘍。
[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.

【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.6

【參考文獻】

相關期刊論文 前10條

1 石娟;宋瑰琦;宋永霞;齊永扎;王維利;;護-護合作量表在我國護士中的普適性研究[J];中華疾病控制雜志;2016年05期

2 張欣;岳容兆;陸凱宇;張Y，

本文編號：1823141