脑卒中照顾者照护结局量表中文版的信效度研究

[目的]检验脑卒中照顾者照护结局量表(BCOS)中文版的信度和效度.[方法]引进并翻译BCOS英文版,使用BCOS中文版对147位脑卒中主要照护者进行评估.[结果] BCOS总的Cronbach's α系数为0.857,重测信度总的相关系数为0.878(P＜0.001).内容效度指数为0.968.经分析得到4个公因子,累积方差贡献率为64.180%.BCOS与脑卒中照顾者压力量表中文版呈负相关(r=-0.319,P＜0.01),证实了其效标关联效度.[结论] BCOS中文版具有良好的信度和效度,可行性高,可用于脑卒中主要照顾者照顾负担的测评.     

脑卒中主要居家照顾者照顾负荷与照顾者需求研究

[目的]了解脑卒中主要居家照顾者的照顾负荷与照顾者需求现状,分析照顾者照顾负荷与照顾者需求之间的关系.[方法]对180例社区脑卒中病人及其主要照顾者进行问卷调查.[结果]脑卒中主要居家照顾者照顾负荷总分为48.83分±8.05分,其中生理负荷最重.脑卒中主要居家照顾者需求总分为34.62分±9.93分,家庭访诊、康复锻炼方法、预防常见并发症、疾病基础知识、饮食指导和电话咨询服务排在需求列表的前5位.照顾者照顾负荷与照顾者需求总分及各维度得分呈负相关(P＜0.01或P＜0.05).[结论]脑卒中主要居家照顾者承受着较重的负荷,了解照顾者需求,制订和实施针对性的干预措施将有助于减轻照顾者的照顾负荷.     

脑卒中病人居家主要照顾者负荷水平与社会支持度的相关性研究

目的　寻求脑卒中病人居家主要照顾者负荷水平与社会支持度之间的关系。方法　选取 79例脑卒中病人居家主要照顾者 ,用自编脑卒中病人居家主要照顾者负荷量表和自编脑卒中病人居家主要照顾者社会支持量表评定。结果　脑卒中病人居家主要照顾者负荷水平和社会支持度之间存在着负性相关 (r =- 0 .5 1,P <0 .0 1)。结论　提高脑卒中病人居家主要照顾者的社会支持度可以有效地降低其负荷水平 ,促进主要照顾者的身心健康 ,并最终提高照顾脑卒中病人的质量。     

以增强应对资源为重点的护理干预对减轻脑卒中居家照顾者负荷的影响

目的 检测以增强照顾者应对资源为重点的综合性护理干预对减轻脑卒中患者主要居家照顾者负荷的效果.方法 从上海市某5社区中选择脑卒中患者主要居家照顾者60例,随机分为干预组（30例）和对照组（30例）.对照组接受常规社区护理,干预组在接受常规社区护理的同时,给予增强照顾者应对资源为重点的综合性护理干预,为期3个月.以BCOS量表、照顾知识问卷、一般自我效能量表、社会支持量表作为主要评价工具,于干预后、干预后3个月分别进行干预效果的评价.结果 干预后干预组照顾者总体负荷明显降低,尤以身体负荷和社会负荷的降低明显.重复测量方差分析,干预组BCOS总分及身体负荷和社会负荷2个维度的得分均高于对照组（P＜0.01;＜0.05,P＜0.01）.多元方差分析,干预后、干预后3个月2个时间点,干预组照顾者负荷总分,身体负荷得分、社会负荷得分均高于对照组（P＜0.05）;干预组心理负荷得分于干预后3个月高于对照组（P＜0.01）.照顾者应对资源增强.重复测量方差分析和多元方差分析结果显示,干预组照顾知识总分以及疾病知识、护理知识和康复知识3个维度的得分均高于对照组（P＜0.01;P＜0.01;P＜0.05;P＜0.01）;干预组社会支持水平高于对照组（P＜0.01）.结论 以增强照顾者应对资源为重点的综合性护理干预方案,明显地减轻了脑卒中患者主要居家照顾者的负荷,适用于在减轻脑卒中患者主要居家照顾者负荷的干预中推行.     

脑卒中照顾者照护结局量表中文版的信效度研究

[目的]检验脑卒中照顾者照护结局量表（BCOS）中文版的信度和效度。[方法]引进并翻译13（20S英文版,使用BCOS中文版对147位脑卒中主要照护者进行评估。[结果]BCOS总的Cronbaeh’s a系数为0．857,重测信度总的相关系数为0．878（P〈0．00]）。内容效度指数为0．968。经分析得到4个公因子,累积方差贡献率为64．180％。BCOS与脑卒中照顾者压力量表中文版呈负相关（r=-0．319,P〈0．01）,证实了其效标关联效度。[结论]BCOS中文版具有良好的信度和效度,可行性高,可用于脑卒中主要照顾者照顾负担的测评。     

脑卒中主要居家照顾者照顾负荷与照顾者需求研究

[目的]了解脑卒中主要居家照顾者的照顾负荷与照顾者需求现状,分析照顾者照顾负荷与照顾者需求之间的关系。[方法]对180例社区脑卒中病人及其主要照顾者进行问卷调查。[结果]脑卒中主要居家照顾者照顾负荷总分为48.83分±8.05分,其中生理负荷最重。脑卒中主要居家照顾者需求总分为34.62分±9.93分,家庭访诊、康复锻炼方法、预防常见并发症、疾病基础知识、饮食指导和电话咨询服务排在需求列表的前5位。照顾者照顾负荷与照顾者需求总分及各维度得分呈负相关（P〈0.01或P〈0.05）。[结论]脑卒中主要居家照顾者承受着较重的负荷,了解照顾者需求,制订和实施针对性的干预措施将有助于减轻照顾者的照顾负荷。     

脑卒中患者居家主要照顾者负荷水平与影响因素的调查

目的　探讨脑卒中患者居家主要照顾者的负荷水平及其影响因素。方法　选取脑卒中患者居家主要照顾者79例,用自编脑卒中患者居家主要照顾者负荷量表和社会支持量表进行评定。结果　脑卒中患者居家主要照顾者负荷的得分指标为5 7.88%,处于中等水平,身体负荷最重,其次为经济负荷。对负荷影响最大的因素为照顾对象需人照顾项目总分为(β=为0 .4 5 5 ) ,其次为社会支持度(β=为0 .4 0 5 ) ,均有显著性意义(P<0 .0 0 1 )。共它影响因素包括照顾对象是否有慢性疾病(P<0 .0 5 )、照顾对象医疗费用支付形式(P<0 .0 1 )、照顾对象家中常见症状(P<0 .0 0 1 )、照顾者每天用于照顾患者时间(P<0 .0 0 1 )和照顾者是否有宗教信仰(P<0 .0 5 )。结论　脑卒中患者居家主要照顾者承受着较重的身体负荷和经济负荷。在社会支持方面信息性支持是最为不足的。因此,要为照顾者提供可及、可承受的社区服务,建立多种渠道加强信息性支持,以提高社会支持度,同时给予主要照顾者更多的情感和精神支持,这样才能全面降低脑卒中患者居家主要照顾者的负荷水平,促进其身心两方面的健康,以提高脑卒中患者的照顾质量。     

照顾技能培训对脑卒中患者照顾者照顾压力及生活质量的影响

目的:探讨照顾技能培训对脑卒中患者照顾者照顾压力及生活质量的影响。方法:将150例脑卒中患者照顾者按入院时间先后次序随机分为实验组和对照组各75例,实验组对照顾者实施个体化、系统性照顾技能培训,对照组按常规护理方法进行干预。采用脑卒中照顾者综合照顾能力评估问卷评价照顾者脑卒中相关知识认知,以照顾者压力量表和SF-36量表评价两组干预3个月后照顾压力与生活质量。结果:实验组脑卒中相关知识平均得分高于对照组(P0.01),实验组总压力平均得分低于对照组(P0.01),实验组PF、RP、MH、VT、GH得分均高于对照组(P0.05,P0.01)。结论:住院期实施个体化、系统性照顾技能培训,能有效地提高照顾者脑卒中相关知识和照顾技能,缓解居家照顾压力和提高生活质量。     

中文版照顾者反应评估量表信效度研究

目的 引进照顾者反应评估量表(Caregiver Reaction Assessment,CRA),测定其中文版信效度.方法 使用CRA量表对79例骨肉瘤患者照顾者进行压力评定,对测定结果 进行信效度分析.结果 CRA量表Cronbach's α系数为0.612-0.732,折半信度为0.736,具有良好的内部一致性;CVI平均值为0.9.因子分析产生的7个因子共能解释总变异的65.15%,且基本上各个条目在相应维度上有较高的因子负荷.结论 CRA中文版具有较好的信效度,其维度设置适用于骨肉瘤患者照顾者压力测定.     

痴呆患者居家老年照顾者生活质量评估量表的汉化和信效度检验

目的 汉化痴呆患者居家老年照顾者生活质量评估量表并进行信效度检验。 方法 按照改良版的Brislin回译模型将痴呆患者居家老年照顾者生活质量评估量表翻译成中文,并对其进行文化调适,采用便利抽样法对242例痴呆患者的居家老年照顾者进行问卷调查,30 d后从中随机抽取50名照顾者重测,检验量表的信效度。 结果 中文版痴呆患者居家老年照顾者生活质量评估量表包括1个维度,共22个条目。量表的条目内容效度指数为0.83~1.00,全体一致内容效度指数为0.82,平均内容效度指数为0.91。量表结构模型适配指标的卡方/自由度为2.33,近似误差均方根为0.07,拟合优度指数为0.92,非规准适配指数为0.92。量表的Cronbach’s α系数为0.92,重测信度为0.81。 结论 中文版痴呆患者居家老年照顾者生活质量评估量表具有良好的信度和效度,可用于评估痴呆患者居家老年照顾者的生活质量,为研究者下一步减轻其负担、制订针对性的干预策略提供依据。     

Psychometric testing of the revised 15-item Bakas Caregiving Outcomes Scale

BACKGROUND: Family caregivers of stroke survivors experience a variety of negative social, emotional, and health-related outcomes as a result of providing care. OBJECTIVES:: To psychometrically test the revised 15-item Bakas Caregiving Outcomes Scale (BCOS) measuring life changes specifically resulting from providing care. The original 10-item BCOS was improved by adding five items addressing financial well-being, level of energy, role functioning, physical functioning, and general health. METHODS: Psychometric testing of the revised 15-item BCOS using a sample of 147 family caregivers of stroke survivors approximately 4 months after stroke was conducted to determine the quality of the items, internal consistency reliability, test-retest reliability, construct validity, and criterion-related validity. Most caregivers were women (78.9%), White (68.0%) or African American (29.9%), and either spouses (60.1%) or adult children (31.3%). RESULTS: Satisfactory evidence of internal consistency (alpha = .90) and 2-week test-retest reliability (intraclass coefficient [ICC] = .66; 95% confidence interval [CI] = 0.42-0.81) was provided, with item-to-total correlations ranging from .41 to .74. Unidimensionality was supported by confirmatory factor analysis with indices, indicating a good fit. Using hierarchical multiple regression, 36% of the BCOS variance was explained by constructs in the conceptual model [F(11,132) = 6.72, p < .001]. Criterion-related validity was supported by correlations with the 36-item Short Form (SF-36) General Health Subscale (r = .32, p < .001) and a criterion variable measuring how caregivers' lives had changed overall (r = .67, p < .001). DISCUSSION: The revised 15-item BCOS has evidence of satisfactory reliability and validity in family caregivers of stroke survivors. The BCOS is a valuable measure in research and can be used to identify priority areas for nursing interventions designed to improve caregivers' outcomes.     

Development and psychometric testing of the Bakas Caregiving Outcomes Scale.

BACKGROUND: Family caregivers of stroke survivors experience more depression, emotional problems, social inactivity, and general ill-health than noncaregiving individuals. While a number of instruments measure these variables in family caregivers, they are often too global, indicating the need for a situation-specific instrument measuring life changes resulting from providing care. OBJECTIVES: To develop and psychometrically test the Bakas Caregiving Outcomes Scale (BCOS) measuring changes in family caregiving outcomes in the stroke population. METHOD: 48 items were developed, with 27 being judged as content valid by a panel of five experts. Psychometric testing with two convenience samples of family caregivers of stroke survivors (ns = 92, 104) was conducted using item analysis, Cronbach's alpha, factor analysis, and hierarchical multiple regression. RESULTS: Item analysis in sample no. 1 resulted in a 12-item scale with alpha = .90. The scale was further shortened to a 10-item scale in sample no. 2 with alpha = .77. Unidimensionality was supported by factor analysis in both samples. Using hierarchical multiple regression, 63% of the variance of the 12-item BCOS in sample no. 1, and 45% of the variance of the 10-item BCOS in sample no. 2 was accounted for by the constructs in the conceptual model. Criterion-related validity was supported in both samples by significant correlations with the LIFE-3 and a criterion variable with the same response format as the BCOS. Significant BCOS correlations with the SF-36 Health Survey subscales in sample no. 2 provided further evidence of criterion-related validity. CONCLUSION: The 10-item BCOS is a brief, easy to administer instrument that has evidence of reliability and validity in family caregivers of stroke survivors. The 10-item BCOS could serve as a valuable measure in research, as well as an assessment tool to identify family caregivers in need of intervention.     

脑卒中患者主要照顾者的负担和应对方式及其相关性分析

目的探讨脑卒中患者的主要照顾者的负担水平与应对方式以及二者的相关性。方法采用Zarit照顾者负担量表和简易应对方式问卷调查120位脑卒中患者的主要照顾者。结果脑卒中患者的主要照顾者的负担总分（39．54±13．88）分,86．7％的照顾者负担处于轻、中度水平;照顾者多采取积极应对方式应对负担,偶尔也采取消极应对方式;负担与积极应对方式呈负相关,与消极应对方式呈正相关,差异均有统计学意义（P〈0．01）。结论脑卒中患者的主要照顾者普遍存在不同程度的照顾负担,脑卒中患者主要照顾者的负担与其应对方式密切相关,护理工作者应正确引导照顾者采取适当的应对方式,减轻照顾负担。     

脑卒中患者疾病不确定感及自我感受负担的相关性研究

目的探讨脑卒中患者疾病不确定感与自我感受负担的关系,为制订护理干预措施提供依据。方法选取住院治疗的脑卒中患者414例,采用一般资料调查表、中文版Mishel疾病不确定感问卷及自我感受负担问卷对其进行问卷调查。结果脑卒中患者疾病不确定感总分为(70.68±14.34)分,处于中等程度;自我感受负担得分为(29.17±7.64)分,88.16%患者存在不同程度的自我感受负担;疾病不确定感各维度得分及总分与自我感受负担呈正相关(P0.01或P0.05)。结论医护人员应正确评估脑卒中患者的疾病不确定感和自我感受负担,给予相应的干预措施,通过减轻患者的自我感受负担水平降低其疾病不确定感程度,促进脑卒中患者的身心健康。     

抑郁症患者家庭功能和家庭成员生活质量的调查

目的了解抑郁症患者的家庭功能和家庭成员的生活质量。方法采用家庭关怀度指数问卷（APGAR）和健康状况问卷（SF-36）,对96例符合DSM-Ⅳ标准的抑郁症患者的家庭功能和家庭成员的生活质量进行评定,并与一般家庭作对照,从家庭的角度评价抑郁症的疾病负担。结果抑郁症患者患病后家庭功能存在障碍的家庭均显著多于对照组,差异具有统计学意义（62．5％比17．3％;χ^2=68．125,P〈Q05）,患病后比患病前家庭功能出现障碍的比例显著升高,差异具有统计学意义（62．5％比24．0％;χ^2=118．387,P〈0.01）。经配对检验,患病后APGAR总分及各因子分均比患病前显著降低（t分别为10．874,7．330,11．649,8．240,11．797,10．162;P〈0.01）。家庭成员生活质量评定,在SF-36的8个因子中,生理职能（t=6.024,P〈0.01）、一般健康（t=12．254,P〈0．01）、社会功能（t=11．225,P〈0．01）、情感职能（t=10．328,P〈0．01）和精神健康（t=14．625,P〈0．01）因子评分显著低于对照组,生理机能（t=1．856,P〉0.05）、躯体疼痛（t=1．114,P〉0.05）、精力（t=0．032,P〉0.05）三个因子评分差异无统计学意义。结论抑郁症对家庭功能和家庭成员生活质量的影响是严重和多层次的,需进行相应干预。     

A reliable and valid instrument to assess competency in basic surgical skills in second-year medical students

BACKGROUND: Despite calls for competency based education, a dearth of validated instruments for measuring basic skills currently exists. We developed an instrument to assess competency in basic surgical skills in second-year medical students and tested it for psychometric reliability and validity. METHODS: From a review of the literature, an instrument comprised of numerically scaled items was constructed. After initial tests, several items were divided to produce a final instrument more specific and more appropriate for providing feedback to students. The final instrument was empirically tested for reliability and validity. RESULTS: The final 10-item instrument is presented here along with all of the empirical evidence including internal consistency reliability and interrater reliability, and content, criterion-related, and construct validity. Overall alpha reliability was 0.84 and interrater reliability was r = 0.83, P < 0.01 for the total scores. Factor analysis provided evidence of construct validity. CONCLUSIONS: The instrument has psychometric properties adequate for use as one criterion for summative evaluation and is educationally practical enough to provide focused and detailed feedback for student improvement.     

Testing daily functions post-stroke with standardized practical equipment

Two hundred and seven stroke patients were tested with Standardized Practical Equipment (SPE) three months after a stroke. One year after the stroke 183 survivors from this stroke population were tested with the equipment. The SPE test consists of 12 common daily activities, which the patient was asked to perform. The construct validity of SPE was estimated by factor analysis from the results of one-year follow-up. Three factors explained 82% of the variance of the 12 variables of SPE. Factor 1 mainly concerned cognitive factors and co-ordination, Factor 2 construction and hand function and Factor 3 variables that were dependent on mobility and balance. No significant difference was noted between the performance with SPE three months and one year after the stroke among the one-year survivors. There were some differences between men and women; for example the men were more successful in tasks with technical components. The women had more difficulty with some of the tasks involving mobility, such as climbing stairs without support. The Standardized Practical Equipment gave good additive information about the ability of a stroke patient to manage at home and could be used in any set-up.     

原发性青光眼患者自我感受负担、自我管理行为与其应对方式的相关性研究

目的：探讨原发性青光眼患者自我感受负担、自我管理行为及应对方式的相关性,为制定改善患者自我感受负担的护理措施提供依据。方法：采用一般资料调查表、自我感受负担量表、医学应对方式问卷和自我管理行为问卷,对236例原发性青光眼患者进行调查。结果：原发性青光眼患者自我感受负担得分（31.10±9.34）分,为中等水平;自我管理行为总分为（48.27±6.271）分。自我感受负担总分与回避及屈服维度呈正相关（r=0.239,P＜0.001;r=0.294,P＜0.001）,与面对维度呈负相关（r=-0.133,P＜0.05）;自我管理行为总分和面对维度呈正相关（r=0.534,P＜0.001）,与回避和屈服维度呈负相关（r=-0.308,P＜0.001;r=-0.178,P＜0.01;r=-0.446,P＜0.001）。结论：原发性青光眼患者自我感受负担、自我管理行为与其应对方式相关,医护人员应鼓励患者建立良好的自我管理行为,积极面对疾病,降低患者的自我感受负担。     

Validity and reliability of Turkish Caregiver Burden Scale among family caregivers of haemodialysis patients

Aims and objectives. To investigate the validity and reliability of the Caregiver Burden Scale in family members who provide primary care for haemodialysis patients. Background. In Turkey, there is a need for a multi‐dimensional instrument to evaluate the caregiver burden in people who provide care for patients with chronic diseases. Design. A methodological study. Methods. The study sample consisted of 161 family members who provide primary care for haemodialysis patients. The forward‐backward translation method was used to develop the Turkish Caregiver Burden Scale. The reliability was based on internal consistency investigated by Cronbach’s alpha and item–total correlation. The factorial construct validity of the scale was tested with confirmatory factor analysis. By means of convergent and divergent validity, correlation between Caregiver Burden Scale and 36‐Item Short Form Health Survey (SF‐36) and correlation between Caregiver Burden Scale and the Maslach Burnout Scale were investigated. Results. Cronbach’s alpha and item–total correlations results suggested that there was good internal reliability. We found five underlying factors similar to original Scale’s five‐factor solution. The confirmatory factor analysis five‐factor model represented an acceptable fit. Factor loadings were significant, with standardised loadings ranging from 0·43–0·81. By means of divergent validity, all sub‐dimension scores and the total score of the Caregiver Burden Scale were negatively correlated with the SF‐36, whereas there was a positive correlation with the emotional exhaustion and depersonalisation subscales of the Maslach Burnout Scale as expected. Conclusion. These results suggest that the Caregiver Burden Scale is a reliable and valid instrument which can be used with confidence in Turkish caregivers for haemodialysis patients to screen caregiver burden. Relevance to clinical practice. The burden experienced by people who provide care for patients with chronic diseases can be evaluated with the Caregiver Burden Scale. Additionally, the Caregiver Burden Scale can be used in the evaluation of the effectiveness of attempts to decrease caregiver burden.