社区老年人跌倒危险评估工具的信效度检验

目的:通过测试内部一致性、条目分析、重测信度,评价自制跌倒危险量表的可靠性,分析其在社区老年人跌倒预防中应用的可行性。方法:使用老年人跌倒评估量表对100名社区老年人进行跌倒危险评估,根据评估结果检验该工具的信度和效度。结果:老年人跌倒评估量表Cronbach’sα系数为0.706,具有较好的内部一致性,护理实习生和社区医生应用老年人跌倒评估量表测评结果比较,差异无统计学意义(P0.05)。有跌倒与无跌倒的老年人评分比较,差异有统计学意义(P0.01)。结论:老年人跌倒评估量表是一种简单、方便、安全的评估工具,其信度和效度较好,适合社区卫生服务人员评估老年人的跌倒危险性。     

中文版骨质疏松症自我效能量表应用于社区中老年人的信效度分析

目的：评价中文版21条目骨质疏松症自我效能（ OSE）量表的效度及信度。方法由专业英语教师及社区医护专家共同对量表条目进行翻译形成中文版OSE量表（21条）,对297名社区中老年人进行调查,评价其效度及信度。结果中文版OSE总量表及分量表的Cronbach ’ s α系数分别为0．885,0．927及0．929,均大于0．7;折半信度（ Split-half reliability ）系数分别为0．812,0．875及0．719。结论中文版OSE量表具有较高的效度及信度,可应用于中国社区中老年人预防骨质疏松症的方法研究。     

中文版活动步态指数在老年入跌倒风险评估中应用的信效度分析

目的探讨中文版活动步态指数（DGI）在老年人跌倒风险评估中应用的信效度。方法采用便利抽样,对成都市两所老年院中的200名老年人采用DGI进行评估,对其信故度进行检验。结果总量表的Combaehd为0．959,分半信度系数为0．951,重测信度为0．758。各条目得分与量表总分的相关系数为0．729-0．919;因子分析共提取了1个公因子,方差贡献率为71．899％,项目因子负荷值为0．710-0．922;跌倒组得分低于无跌倒组,差异具有统计学意义;效标关联效度为0．937。结论中文版活动步态指数具有良好的信度及效度,可在我国老年人跌倒风险评估中推广应用。     

中文版社会融合度量表在社区75岁及以上老年人中的信效度检验

目的引进社会融合度量表(Social cohesion scale,SCS),并在我国社区老年人中检测其信度和效度。方法采用经Brislin法翻译和文化调适的中文版SCS及领悟社会支持量表对上海市312名社区老年人进行测试,评价中文版SCS的信度和效度。结果 SCS的内部一致性信度为0.765,折半系数为0.774;重测信度为0.824(P0.01);量表的内容效度指数为0.975;与领悟支持量表总分的相关性为0.458(P0.01),并具有良好的区分度(P0.01),探索性因子分析提取出2个公因子,累积方差贡献率为58.419%。结论中文版社会融合度量表具有良好的信效度,可用于社区老年人社会融合度的测评。     

养老机构跌倒自我效能量表的汉化及信效度研究

[目的]汉化养老机构跌倒自我效能量表(NHFSS)并检验其在养老机构老年人中的信效度。[方法]采用Brislin翻译模式翻译量表,形成中文版NHFSS。于2017年8月—9月采用便利抽样法抽取成都市3家养老机构中的300名老年人进行问卷调查,通过内容效度指数(CVI)、探索性因子分析、验证性因子分析、聚合效度和效标关联效度评价量表效度;采用内部一致性信度和重测信度检验量表信度。[结果]条目水平的内容效度指数(I-CVI)为0. 83～1. 00;探索性因子分析提取了2个公因子,累计方差贡献率为83. 775%;验证性因子分析显示:卡方自由度比为0. 199,拟合优度指数为0. 997,残差均方根为0. 012,近似误差均方根为0. 000,规范拟合指数为0. 997,Tucker-Lewis指数为1. 027,比较拟合指数为1. 000;害怕跌倒组和不害怕跌倒组中文版NHFSS自我效能维度、结果期望维度得分及总分比较差异有统计学意义(P0. 001);中文版NHFSS跌倒效能总分与中文版MFES总分呈正相关(r=0. 613,P0. 001);量表Cronbach′sα系数为0. 761,两个维度Cronbach′sα系数分别为0. 914和0. 710,量表的重测信度为0. 945。[结论]中文版NHFSS在养老机构老年人中具有较好的信效度,可作为养老机构老年人害怕跌倒心理的测评工具。     

约翰霍普金斯跌倒风险评估量表应用于住院患者的信效度分析

目的对约翰霍普金斯跌倒风险评估量表汉化并进行信效度分析,确定其应用价值,为我国住院患者提供有效的跌倒评估工具。方法采用分层随机抽样方法抽取浙江省1所三级甲等综合医院成年住院患者400例,由2名研究者运用中文版约翰霍普金斯跌倒风险量表独立对同一例患者进行测定并进行信效度分析。结果中文版约翰霍普金斯跌倒风险评估量表总的Cronbach’sα系数为0.791,剔除当前条目后量表Cronbach’sα系数在0.649~0.703,评定者间信度r=0.949,探索性因素分析提取的4个公因子累积方差贡献率为62.437%。结论中文版约翰霍普金斯跌倒风险评估量表具有较好的信度和效度,可用于我国住院患者的跌倒风险评估。     

中文版跌倒危险评定量表在住院老年患者中应用的信度和效度评价

目的对美国约翰霍普金斯医院跌倒危险评定量表（中文版）的信度和效度进行测评,探讨该量表在我国住院老年患者中的应用价值。方法 将美国约翰霍普金斯医院跌倒危险评定量表按照外文量表翻译的基本程序译成中文。由5名相关领域的医疗护理专家对该量表进行内容效度的评定;对201例60岁以上的住院老年患者进行量表的测试,用于评价量表的信度和效度。结果跌倒危险评定量表（中文版）的评定者间信度较好;量表第2部分的Cronbach’sα系数为0.703。量表各条目的内容效度指数为0.8-1.0,量表总体内容效度为0.833;该量表共提取2个公因子,累计贡献率为58.83%。以是否有跌倒史为分组变量,提示该量表的区分度成立（t=2.81,P〈0.01）。结论跌倒危险评定量表（中文版）具有较好的信度、效度和区分度,适合在我国住院老年患者中使用。     

中文版国际跌倒效能量表在孕妇中应用的信效度检验

目的:检验中文版国际跌倒效能量表在孕妇中应用的信度和效度。方法:采用一般资料调查表、中文版国际跌倒效能量表对浙江省某三级甲等妇产科医院产科门诊常规产前检查的1 118名孕妇进行面对面调查,以检验量表的信度和效度。结果:中文版国际跌倒效能量表条目水平内容效度指数(I-CVI)为0.857～1.000,量表水平内容效度指数(S-CVI/UA)为0.813,平均水平内容效度指数(S-CVI/Ave)为0.969。临界比值法结果显示,各条目在高分组和低分组的得分比较差异均有统计学意义(P<0.05)。Pearson相关分析显示,量表各条目与总分的相关系数为0.479～0.843(P<0.01)。探索性因子分析提取室内活动、室外活动2个因子,共解释变异量的60%。验证性因子分析结果,2因子模型拟合良好;总量表的Cronbach′s α系数为0.929,折半系数为0.806,2个因子Cronbach′s ɑ系数分别为0.928和0.806,折半系数分别为0.904和0.735。结论:中文版国际跌倒效能量表在孕妇人群中具有较好的信效度,可以很好地评价孕妇跌倒恐惧水平,为减少孕妇跌倒及跌倒...     

血液透析跌倒风险指数量表的汉化及信效度检验

目的 汉化血液透析跌倒风险指数(dialysis falls risk index, DFRI)量表并检验其信效度。方法 遵循Brislin翻译模型对DFRI进行翻译、文化调试和预调查，形成中文版DFRI。使用该量表对衡阳市两所医院141例血液透析(hemodialysis, HD)患者进行评估，以检验其信效度。结果 中文版DFRI共7个条目，提取3个公因子，累计方差贡献率61.729%,内容效度指数为0.80～1.00,量表平均内容效度指数为0.967,Cronbach’s α系数为0.507,重测信度为0.948,评定者信度为0.926。该量表ROC曲线下面积为0.719,最佳截点值为≥5.25分，敏感度为0.773,特异度为0.580。结论 中文版DFRI量表具有较好的信效度及诊断效能，简捷有效，可用于我国HD患者跌倒风险评估。     

健康老龄化量表的汉化及信效度评价

[目的]引进健康老龄化量表(HAI),并进行信度、效度检验。[方法]依据量表翻译及文化调适指南,对量表进行正向翻译、回译、预试验。选取5名专家对中文版量表的内容效度进行评价。纳入254名60岁及以上的社区居民对量表信度和效度进行检验。[结果]中文版健康老龄化量表Cronbach′sα系数为0.93,Spearman-Brown系数为0.78。全体一致量表水平的内容效度指数(S-CVI/UA)为0.80,平均S-CVI为0.95。[结论]翻译后的中文版健康老龄化量表在我国城市社区老年人群的应用中具有较好的信度、效度,可为健康老龄化的测量提供参考。     

以护士为主导的多学科团队干预对预防老年患者跌倒的效果研究

目的探讨以护士为主导的多学科团队干预模式对预防老年患者跌倒的效果。方法根据SPSS 19.0软件生成的随机化编码,将370例老年患者分为对照组和观察组各185例,对照组采用挂警示标识、健康教育等预防跌倒的常规护理方法,观察组采用护士为主导的多学科团队综合干预模式。干预6个月后比较两组患者跌倒发生率、跌倒可以预防知晓率、Tinetti平衡和步态量表评分、Morse跌倒评估量表评分、中文版跌倒效能量表评分。结果观察组患者跌倒发生率低于对照组,跌倒可以预防知晓率高于对照组,Tinetti平衡和步态量表及中文版跌倒效能量表评分均高于对照组,Morse跌倒评估量表评分低于对照组,比较差异均有统计学意义(P0.05)。结论以护士为主导的多学科团队综合干预模式可改善老年患者对跌倒的认知,改善老年患者躯体功能状态,从而降低跌倒发生率。     

住院老年患者害怕跌倒心理状况的调查

目的探讨住院老年患者害怕跌倒心理的现状。方法使用跌倒效能量表对190例住院老年患者进行问卷调查,比较不同分组的评分差异。结果回收有效问卷185份。住院老年患者跌倒效能量表的平均分为（6.47±2.69）。随着年龄增加,跌倒效能量表评分明显下降,差异有统计学意义（P〈0.05）;有跌倒史患者评分显著低于无跌倒史患者（P〈0.05）;不同性别患者评分无差异（P〉0.05）;有抑郁史患者评分高于无抑郁史患者（P〈0.05）。结论害怕跌倒是住院老年患者的一种较为普遍的心理现象,在高龄、有跌倒史和有抑郁史的患者中更为明显。针对这些患者实施个性化的心理疏导和防范跌倒的指导,可减轻患者对跌倒的害怕,并有效预防跌倒的发生,提高生活质量。     

基于现实环境的功能性步态训练对社区卒中后康复期老人步态特征及害怕跌倒的影响

目的 探讨在现实环境下运用功能性步态训练来分析社区卒中后康复期老人步态特征的改变,以及对其害怕跌倒的影响。方法 选取在南京市某三级甲等医院康复出院的卒中患者进行追踪,采用随机数字表法分为干预组30例和对照组29例,对照组给予常规出院康复训练,而干预组在此基础上增加现实环境中的步态训练,分别在出院前,出院后8周采用便携式步态分析仪采集患者常速行走10 m的步态参数,同时采用单条目问题法和修订版跌倒效能量表分析老人跌倒恐惧的状况。结果 干预前,2组老人各项步态参数、跌倒效能得分比较无统计学意义（P>0.05）,经过干预8周后2组患者在患侧站立相、患侧摆动相、摆动强度、落脚强度、落脚时脚角度、步频、跨步时间变异性差异有统计学意义（P<0.05）,跌倒效能干预组差异有统计学意义（P<0.05）。干预前对照组害怕跌倒的老人为14例（48.28%）,干预组为13例（43.33%）;8周后对照组害怕跌倒老人为11例（37.93%）,干预组为5例（16.67%）,差异有统计学意义（P<0.05）。结论 基于现实环境的功能性步态训练对社区卒中后康复期老人步态特征及害怕跌倒有积极的改善效果。     

Validating the Falls Behavioural (FaB) scale for older people: a Rasch analysis

Purpose. Rasch modelling was used to establish the validity and robustness of the Falls Behavioural (FaB) Scale for Older people.

Methods. The sample comprised 678 community-residing elderly people aged 65 - 98 years. Data were analysed by calculating goodness of fit statistics, principal components analysis of residuals and by exploring the effectiveness of the category rating response-scale.

Results. A partial-credit rating scale was the best fitting solution and the major change to the original version of the FaB. Analysis supported a 29-item intervention version and a briefer 24-item outcome evaluation (research) version. The latter produced item mean infit statistics of 1.00 (Z = 0.0, SD = 0.33) and mean outfit statistics of 1.03 (Z = 0.0, SD = 0.53), a person separation of 2.36 and internal reliability of 0.85.

Conclusion. The 29 item partial rating scale is valid, reliable and would be useful in clinical situations when used as a prompt for discussion and in raising clients' awareness of potential hazards; it also can be used as an outcome measure. The short form is a useful alternate for evaluating the effectiveness of fall reduction interventions that aim to encourage protective strategies when negotiating the environment, mobilizing and doing activities of daily living. Both scales would be improved by adding very difficult and very easy items to increase the range of ability levels of the people to whom it can be applied with precision.     

Validation of the short form of the chinese childbirth self‐efficacy inventory in Mainland China

Self‐efficacy increasingly has been reported as an important outcome measure in childbirth care. The purpose of this study was to evaluate the psychometrics of the short form of the Chinese Childbirth Self‐Efficacy Inventory (CBSEI‐C32) in mainland China. A convenience sample of 297 pregnant Chinese women who were attending the out‐patient clinic of the study hospital in Guangzhou participated in the study. The participants were asked to complete the CBSEI‐C32, the Chinese Self‐Rating Anxiety Scale (CSAS), the Chinese Self‐Efficacy Scale (CSE) and the socio‐demographic questionnaire. A subgroup of 75 pregnant women was selected randomly from the total sample using a table of random numbers for test–retest reliability assessment. The findings demonstrate high internal consistency (Cronbach's α = .96) and test–retest reliability (intraclass correlation coefficient = .88) for the CBSEI‐C32. Confirmatory factor analysis showed some support for a two‐factor structure of the CBSEI‐C32, and construct validity was further supported by a significant relationship with CSAS. The CBSEI‐C32 has the potential to be used as a clinical and research instrument for measuring childbirth self‐efficacy in women in mainland China. © 2010 Wiley Periodicals, Inc. Res Nurs Health 34:49–59, 2011     

The Effects of Obesity on Fall Efficacy in Elderly People

[Purpose] The aim of this study was to identify the effects of obesity on falls as a practical verification of the importance of obesity-targeting interventions as part of future fall prevention programs. [Subjects and Methods] The study involved 351 elderly people (172 men, 179 women) living in rural areas. The dependent variable, fall efficacy, was measured using the Falls Efficacy Scale, while the independent variables, body mass index (BMI) and visceral fat, were measured using the InBody 720. The Faces Pain Scale was used to measure pain. Mobility was measured using the Timed Up and Go Test, and balance ability was measured according to the duration subjects could stand on one foot with their eyes closed. Hierarchical multiple regression analysis was performed for the final data analysis. [Results] Investigation of the correlations between the variables revealed a negative correlation between fall efficacy and the other variables. Ultimatley, investigation of the causality of fall efficacy revealed that the BMI, pain, and mobility were influential factors. In other words, fall efficacy tends to be lower when there are higher degrees of obesity, increased pain, and decreased mobility. [Conclusion] To improve the fall efficacy of elderly people living in rural areas, pain management and the maintenance of physical functionality are required. The present study confirms that the elderly need continuous obesity management to lead healthy lives.Key words: Fall efficacy, Obesity, Elderly     

Validating the Falls Behavioural (FaB) scale for older people: A Rasch analysis

Purpose. Rasch modelling was used to establish the validity and robustness of the Falls Behavioural (FaB) Scale for Older people.

Methods. The sample comprised 678 community-residing elderly people aged 65 – 98 years. Data were analysed by calculating goodness of fit statistics, principal components analysis of residuals and by exploring the effectiveness of the category rating response-scale.

Results. A partial-credit rating scale was the best fitting solution and the major change to the original version of the FaB. Analysis supported a 29-item intervention version and a briefer 24-item outcome evaluation (research) version. The latter produced item mean infit statistics of 1.00 (Z = 0.0, SD = 0.33) and mean outfit statistics of 1.03 (Z = 0.0, SD = 0.53), a person separation of 2.36 and internal reliability of 0.85.

Conclusion. The 29 item partial rating scale is valid, reliable and would be useful in clinical situations when used as a prompt for discussion and in raising clients' awareness of potential hazards; it also can be used as an outcome measure. The short form is a useful alternate for evaluating the effectiveness of fall reduction interventions that aim to encourage protective strategies when negotiating the environment, mobilizing and doing activities of daily living. Both scales would be improved by adding very difficult and very easy items to increase the range of ability levels of the people to whom it can be applied with precision.     

Promoting Fall Self-Efficacy and Fall Risk Awareness in Older Adults

ABSTRACT

Introduction: This study examined whether participation in a modified version of the “Stepping On” program was effective in increasing fall self-efficacy, static and dynamic balance, and awareness of fall risks in older adults. Design: A mixed methods, one-group, nonexperimental, pretest-posttest design. Participants: Nineteen women aged 65 and older residing in a senior living facility. Intervention: Participants attended a 7-week fall prevention education program focused on group exercises, home hazards, community safety and footwear, and vision and medication management. The program met for 2 h weekly for 7 weeks. Participants were assessed pre- and postintervention using the Modified Falls-Efficacy Scale, Get Up and Go Test, and Romberg Balance Test. In addition, a focus group was facilitated postintervention to determine participants’ awareness of fall risks. Results: While the Modified Falls-Efficacy Scale (MFES) postintervention results were not statistically significant, they did indicate a decreased level of confidence in participants’ ability to avoid a fall postintervention. “Get Up and Go” completion time also increased postintervention, but was not statistically significant. No change in static balance was noted in Romberg Balance Test results. Participants did report an overall increase in awareness of fall risks postintervention. Conclusion: Although results did not support the hypotheses regarding increased fall self-efficacy and static and dynamic balance, participation in the modified “Stepping On” program did lead to an overall increase in awareness of fall risks. Modifying the evidence-based program made it feasible to test in a new community and may have empowered older adults with the knowledge to prevent future falls.     

中文版决策自我效能量表在原发性肝癌患者治疗决策中的信效度检验

目的对决策自我效能量表汉化,并通过在原发性肝癌患者决策中的应用进行信效度检验,以评价该量表在我国癌症患者治疗决策领域应用的可行性。方法按照Brislin量表汉化原则,对量表进行翻译、回译和跨文化调适。采用便利抽样法选取150名原发性肝癌住院患者为研究对象,检验中文版决策自我效能量表的信效度。结果中文版决策自我效能量表共11个条目,因子分析提取1个公因子,累计贡献率55.073%;量表内容效度指数为0.966;Cronbach’sα系数为0.918,Guttman折半系数为0.876,各条目得分与总分的相关系数为0.627~0.796(均P<0.01),验证性因子分析显示量表的模型拟合较好。结论中文版决策自我效能量表具有良好的信效度,可作为我国评价目标人群参与治疗决策时自我效能水平的有效工具。     

汉化版关节炎患者自我效能量表信度效度的测试研究

目的探讨分析汉化版关节炎患者自我效能量表的信度与效度。方法专家小组翻译关节炎自我效能量表,并对其进行文化调适和对量表的内容效度进行评价,然后进行预试验并修订;回收有效问卷90份,并随机抽取其中40例研究对象于2周后进行重测。采用相关分析法、因子分析法等对结果进行统计学分析。结果关节炎患者自我效能量表的内部一致性信度Cronbaeh’s仅系数为0．920,各维度的Cronbach’sα系数为0．807～0．831,重测信度系数为0．800～0．921;各维度之间以及各维度与总分之间的相关系数r值分别为0．705～0．799、0．875～0．921;3个维度整体解释的累积变异量是56．47％。结论汉化版关节炎患者自我效能量表具有良好的信度和效度,适合关节炎患者自我效能的评价。