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基于照護(hù)者的老年患者綜合評(píng)估的衰弱指數(shù)問(wèn)卷漢化及初步應(yīng)用研究

發(fā)布時(shí)間:2018-06-18 11:41

  本文選題:CP-FI-CGA問(wèn)卷 + 漢化 ; 參考:《山西醫(yī)科大學(xué)》2017年碩士論文


【摘要】:目的:對(duì)CP-FI-CGA(Care partner-frailty index-comprehensive geriatric assessment)[1]問(wèn)卷進(jìn)行漢化及初步應(yīng)用研究:首先通過(guò)對(duì)老年病科患者衰弱及其等級(jí)的篩查,評(píng)價(jià)其信度和效度;然后對(duì)問(wèn)卷進(jìn)行初步應(yīng)用,分析患者衰弱程度以及衰弱的影響因素等,為臨床上分級(jí)護(hù)理提供參考。方法:1.通過(guò)查找外文文獻(xiàn),選取較符合中國(guó)文化背景的由加拿大教授Goldstein Judah編制的問(wèn)卷:CP-FI-CGA,通過(guò)E-mail與作者取得聯(lián)系,并得到作者的授權(quán)。2.采用改良版的Brislin翻譯模式對(duì)問(wèn)卷進(jìn)行翻譯回譯,采用專(zhuān)家咨詢?cè)u(píng)價(jià)其內(nèi)容效度,在選定的四所醫(yī)院對(duì)該問(wèn)卷進(jìn)行條目區(qū)分度、重測(cè)信度、內(nèi)部一致性信度、評(píng)定者間信度、折半信度、校標(biāo)關(guān)聯(lián)效度、結(jié)構(gòu)效度等的檢驗(yàn)。3.選取太原市設(shè)立老年病科的四所三級(jí)甲等綜合醫(yī)院,抽取2016年6月到2016年8月的300名老年患者,對(duì)其進(jìn)行CP-FI-CGA問(wèn)卷的信度和效度檢驗(yàn);抽取2016年9月到2016年12月的385名患者對(duì)其進(jìn)行一般資料、CP-FI-CGA問(wèn)卷、加拿大研發(fā)的臨床衰弱等級(jí)量表(CFS)的資料收集,對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果:1.通過(guò)德?tīng)柗茖?zhuān)家咨詢?cè)搯?wèn)卷的平均內(nèi)容效度S-CVI/Ave=0.986。2.信度檢測(cè):重測(cè)信度r=0.970,評(píng)定者間信度r=0.995,折半信度r=0.851。3.效度檢測(cè):校標(biāo)關(guān)聯(lián)效度:FI與CFS的簡(jiǎn)單相關(guān)系數(shù)r=0.796,與年齡的相關(guān)系數(shù)r=0.486;結(jié)構(gòu)效度:各條目得分與衰弱指數(shù)得分的相關(guān)系數(shù)r在0.019-0.636之間波動(dòng)(P0.05);內(nèi)部一致性效度:內(nèi)部一致性Cronbach's系數(shù)a=0.843。4.接受性評(píng)價(jià):條目的長(zhǎng)度、條目的內(nèi)容清晰度以及問(wèn)卷內(nèi)容范圍的接受性為100%,問(wèn)卷的長(zhǎng)度接受性為98.67%,完成時(shí)間為(5.45±0.650)min。5.385名患者衰弱指數(shù)計(jì)算結(jié)果為(0.32±0.165)分,CFS等級(jí)為(5.04±1.483)級(jí),兩者相關(guān)系數(shù)r=0.819(P0.05),呈正相關(guān)。6.單因素分析結(jié)果:年齡、婚姻狀況、用藥種類(lèi)、需要幫助的多少、社會(huì)支持情況、睡眠情況這6個(gè)因素衰弱指數(shù)得分差異有統(tǒng)計(jì)學(xué)意義;隨著年齡的增加、跌倒史和5種以上用藥所占比例的增加,患者的衰弱等級(jí)加重;不同性別的衰弱程度比較以及不同性別衰弱等級(jí)分層比較,均有P0.05,差異不具有統(tǒng)計(jì)學(xué)意義。7.多重線性回歸分析結(jié)果:年齡、用藥種類(lèi)、需要幫助的多少、睡眠情況是影響衰弱指數(shù)得分的獨(dú)立因素。結(jié)論:1.CP-FI-CGA問(wèn)卷綜合評(píng)估患者身體各個(gè)系統(tǒng)的健康狀況,綜合分析患者的衰弱程度,能夠較全面反應(yīng)患者的身心狀況,可以將之推廣應(yīng)用。2.該問(wèn)卷包括43個(gè)條目,具有良好的信效度,可以用于老年病科患者衰弱及其等級(jí)的篩查,可為臨床上分級(jí)護(hù)理提供參考。3.年齡、用藥種類(lèi)、需要幫助的多少、睡眠情況是影響衰弱指數(shù)得分的獨(dú)立危險(xiǎn)因素,所以家屬和醫(yī)務(wù)人員可針對(duì)性的采取措施來(lái)減緩衰弱的進(jìn)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 鹵0.165 and 5.04 鹵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.
【學(xué)位授予單位】:山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2017
【分類(lèi)號(hào)】:R473

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