儿童疼痛行为量表在唇腭裂患儿术后疼痛评估中的应用及其信效度

目的对中文版儿童疼痛行为量表(The face,legs,activity,cry,consolability behavioral tool,FLACC)进行信度和效度评价,探讨该量表对我国唇腭裂患儿术后疼痛评估的应用价值。方法将FLACC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。采用方便抽样法选择2012年1-3月在上海交通大学医学院附属第九人民医院施行手术的100例年龄为6～33个月的唇腭裂患儿为研究对象,在手术清醒后6、10h采用FLACC量表对其进行疼痛评估,并分析其信度和效度。结果 FLACC量表的评定者间信度较好(t=1.439,P>0.05);内在一致性好,Cronbachα系数为0.745;总体重测相关系数为0.946,各条目重测相关系数为0.868～0.955;总体内容效度为1.000,量表各条目的内容效度指数均为1.000。该量表共提取1个公因子,累计贡献率为50.723%。术后10h对于量表评估分数≥4分的88例患儿进行疼痛干预,并在干预后30min再次进行评估,患儿疼痛分值明显降低,差异有统计学意义(t=37.122,P<0.001)。结论 FLACC量表(中文版)具有较好的信度和效度,可用于我国唇腭裂患儿手术疼痛的评估。

The Appraisal of Reliability and Validity of the FLACC Observation Tool for Scoring Painfulness of Children with Cleft Lip and Palate

Objective To appraise the reliability and validity of the Chinese version of FLACC（the face, legs, activity, cry, consolability behavioral tool）so as to explore the applicability of this asessment tool onto the children with cleft lip and palate of China. Methods The basic procedures of FLACC Assessment Tool were translated into Chinese. Five experts of the relevant medical fields evaluated the content validity index of the scale. From January to March 2012,100 children （ranged from 6 to 33 months old ） with cleft lip and palate were sampled to measure the painfulness of these children with the Assessment Tool by six hours and ten hours respectively after the surgery （under conscious status）,so as to appraise the reliahility and validity of the Assessment Tool. Results the FLACC Assessment Tool（Chinese version） had sound reliability and showed a good consistency among different raters （t= 1. 439,P〉0.05）; Cronbach a index was 0. 745; the overall re-test relevant index was 0. 946 while the re-test relevant index individual items ranged from 0. 868 to 0. 955 ; the overall content validity index was 1. 000 while the average of content validity indices for individual items was 1. 000; 1 common factor were derived by the factor analysis and the cumulative contributing rate for factor analysis was 50. 723%. For those 88 children tested 10 hours after the surgery with the Assessment Tool scale point ≥4（on average 5.92±1.46） ,interferences were applied against their painfulness; and re-assessments were made 30 minutes thereafter which show a prominent drop in scale point （t=37. 122,P〈0. 001）. Conclusion The FLACC Assessment Tool （Chinese version） has good reliability and validity,which is suitable for the post surgical operation painfulness assessment for children with cleft lip and palate.