护士直觉评估患者病情恶化量表汉化及在急诊患者中的信效度检验

doi:10.3761/j.issn.2096-7446.2025.02.011

摘要/Abstract

摘要：

目的汉化护士直觉评估患者病情恶化量表（Nurse Intuition Patient Deterioration Scale，NIPDS）并检验其信效度，验证该量表在急诊患者病情恶化中的预测作用。方法采用Brislin翻译模型对NIPDS进行翻译、回译和跨文化调试。2023年12月2日—2024年1月31日便利选取232例急诊科入院患者，值班护士直觉评估患者病情恶化时进行NIPDS登记，评价量表信效度。结果中文版NIPDS为单维度量表，共9个条目。量表总的Cronbach’s α系数为0.891，折半信度为0.848；量表内容效度为0.920，条目内容效度为0.840~1.000，累计方差贡献率为54.305%，标准化因子载荷系数为0.544~0.790，受试者操作特征曲线下面积为0.753（95%CI=0.656~0.850，P<0.001），截断值为6分，约登指数为0.483，敏感度为0.622，特异度为0.861，量表效度良好。Rasch模型分析显示，条目信度和样本信度分别为0.98和0.77，条目难度载荷范围为-2.534~1.439，条目难度适宜。结论中文版NIPDS具有良好的信效度，是有效且准确的工具，可以作为现有预警系统的辅助补充，帮助护士对急诊患者病情恶化做出早期判断。

关键词: 护理, 直觉, 恶化, 量表, 信度, 效度

Abstract:

Objective To translate and test the reliability and validity of Nurse Intuition Patient Deterioration Scale（NIPDS），and to verify the predictive role of the scale in emergency patients’ deterioration. Methods The Brislin translation method was used to translate the NIPDS literally，back-translate and cross-culturally adjust to the Chinese version of the NIPDS. A total of 232 patients admitted to the emergency department were conveniently selected，and NIPDS registration was performed when the on-duty nurse intuited the deterioration of the patient’s condition，so as to evaluate the reliability and validity of the scale. Results The Chinese version of Nurse Intuition Patient Deterioration Scale was a single dimension scale with 9 items in total. The total Cronbach’s α coefficient was 0.891，and the broken half reliability was 0.848. The content validity of the scale was 0.920，the item content validity was 0.840~1.000，and the cumulative variance contribution rate was 54.305%. Standardized factor load coefficient was 0.544~0.790. When area under the receiver operating characteristic（ROC） curve was 0.753（95%CI =0.656~0.850，P<0.001），truncation value was 6 points，Youden index was 0.483，sensitivity was 0.622，specificity was 0.861，and scale validity was good. Rasch model analysis showed that the item reliability and sample reliability are 0.980 and 0.770 respectively，the item difficulty load ranges from -2.534 to 1.439，and the item difficulty was suitable. Conclusion The Chinese version of NIPDS has good reliability and validity，and is an effective and accurate tool，which can be used as an auxiliary supplement to the existing early warning system to help nurses make early judgment on the deterioration of emergency patients.

Key words: Nursing Care, Intuition, Deterioration, Scale, Reliability, Validity

马世林, 郑栋莲, 保金涛, 吉双对, 黄豆豆, 米光丽. 护士直觉评估患者病情恶化量表汉化及在急诊患者中的信效度检验[J]. 中华急危重症护理杂志, 2025, 6(2): 194-200.

MA Shilin, ZHENG Donglian, BAO Jintao, JI Shuangdui, HUANG Doudou, MI Guangli. The translation of Nurses’ Intuition Patient Deterioration Scale and its application in emergency patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(2): 194-200.

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