循证护理实践准备度评估量表的研制及信效度评价

目的：研制适合我国国情的循证护理实践准备度评估量表,并检验其信度和效度。方法：对PARIHS模式核心元素的衍变进行文献范畴分析,结合质性访谈结果构建循证实践准备度评估量表项目池,经两轮德尔菲专家函询确定量表测试稿,并请专家对形成条目相关性进行评估,测试内容效度。选取2016年12月-2017年1月参与复旦大学护理学院“第一期证据应用培训项目”的三级医院中所有参与实践项目的临床护士为调查对象,通过项目分析对测试量表进行条目筛选、探索性因素分析进行量表维度划分,并进行信度分析,形成正式量表。结果：共纳入300名调查对象,剔除44份无效问卷,最终256份（85.33%）问卷纳入正式分析。各条目与对应维度总分的相关系数为0.569~0.829（P<0.01）,各条目与量表总分的相关系数为0.482~0.781（P<0.01）,量表内容效度为0.976,探索性因素分析共提取出3个因子,各条目的因子负荷量为0.455~0.853,累积解释总方差为62.524%,3个因子分别命名为证据、组织环境、促进因素,正式量表包括31个条目。总的Cronbach′sα系数为0.959,3个维度的Cronbach′sα系数分别为0.940、0.933、0.915,拆半信度为0.978,重测信度为0.917。结论：研制的循证护理实践准备度评估量表具有良好的信度和效度,能够指导我国循证护理实践的开展。     

中文版《新生儿疼痛和不适量表》在0至5岁儿童急性发热舒适度的信度和效度研究

目的 评估中文版《新生儿疼痛与不适量表》（EDIN）在0～5岁儿童急性发热时舒适度研究中的信度、效度和反应度。方法 对英文版EDIN量表行翻译、回译,语言学、儿科学和量表学专家对EDIN翻译版本进行讨论、修改,形成中文EDIN预试验版。邀约5名儿科临床专家和30名急性发热儿童的监护人,在不对量表条目进行解释情况下,当场填写中文EDIN预试验版,分别行表面效度检验,形成中文版EDIN。纳入四川大学华西第二医院收治的100例0～5岁急性发热患儿作为中文版EDIN评价人群,行信度、效度和反应度评价,并以Wong-Baker量表为标准,检验中文版EDIN与Wong-Bakerl表测定结果的相关性。结果 ①5名儿科临床专家和30名急性发热患儿的监护人对中文EDIN预试验版填写完整,完成时间均＜5 min,反映中文版EDIN条目表达清楚,易于理解。② 97例急性发热患儿家长完成了对中文版EDIN填写,其数据用于信效度分析。分半信度为0.887,重测信度为0.734,总克朗巴赫系数为0.892。③中文版EDIN各条目的相关系数（r）在0.513~0.782,各条目与量表总分间的r在0.788~0.896。④对5个条目进行主成分分析,显示面部活动对总体方差贡献率为78.4%。⑤中文版EDIN与Wong-Baker量表得分的r为0.885,标准关联效度非常好。⑥分别在入院2 h后和首次填写72 h后行中文版EDIN评价,量表得分分别为7.56和2.82,效应尺度为-1.45,差异有统计学意义（P均为0.000）。结论 中文版EDIN信度、标准关联效度和反应度均良好,结构效度有待进一步验证,基本可以用于中国0～5岁儿童急性发热舒适度评价。     

中文版《婴幼儿社会认知发展筛查量表》的信度和效度评价

目的对中文版《婴幼儿社会认知发展筛查量表》进行信度和效度评价。 方法在广州市和佛山市选取无精神发育疾病、无重大生理疾病的正常婴幼儿843名,选取中山大学附属第三医院儿童发育行为中心确诊为孤独症的幼儿170例,对中文版《婴幼儿社会认知发展筛查量表》进行修订,并且评价量表的信度和效度。结果①信度分析：全量表及4个子量表的Cronbach′s α系数均>0.7;全量表及4个子量表的分半信度系数为0.69～0.94;全量表及4个子量表的重测信度系数为0.79～0.95。②效度分析：各条目与全量表的相关系数为0.31～0.86;除认人子量表与所属条目n10的相关系数为0.40,各子量表与其他所属条目相关系数均＞0.5,但与其他子量表所属条目相关性不强;各子量表间、子量表与全量表间的相关系数均>0.5。因子分析共提取6个公因子,解释总变异的60.63％,因子分析结果与原量表结构基本一致。2～3.5岁正常幼儿全量表和4个子量表得分都显著高于同年龄段孤独症幼儿。结论中文版《婴幼儿社会认知发展筛查量表》具有较好的信度和效度,且操作简便,可用于临床上评价0.5～3.5岁婴幼儿社会认知能力的发展情况。     

《加拿大急性呼吸道疾病和流感量表》中文版本的修订与信度效度检验

目的对《加拿大急性呼吸道疾病和流感量表》(CARIFS)行跨文化调适,检验其中文版本的信度、效度和反应度。方法①对CARIFS进行翻译、回译,语言、儿科临床和量表专家组成的专家委员会对CARIFS翻译版本进行讨论、修改后,形成中文CARIFS预试验版。②约请20名儿科临床专家和40名急性上呼吸道感染患儿监护人分别填写中文CARIFS预试验版,行初步内容效度和表面效度检验,形成中文版CARIFS。③依据纳入和排除标准对有发热的急性上呼吸道感染患儿家长采用相关系数法、克朗巴赫系数法等检验中文版CARIFS的信度,并行正式内容效度和反应度检验。结果中文CARIFS预试验版将"不爱玩耍"和"对任何事情都提不起兴趣"2个条目删除形成中文版CARIFS;中文版CARIFS初步内容效度指数为0.890 6,内容效度良好;40名急性上呼吸道感染患儿监护人均认为中文版CARIFS条目清楚易懂,完成时间均在15 min以内,表面效度良好。纳入193例急性上呼吸道感染患儿行中文版CARIFS信度和正式内容效度检验,①分半信度为0.851,总克朗巴赫系数为0.812,信度较好;②正式内容效度:功能维度、影响父母维度和症状维度,与中文版CARIFS总分的相关系数分别为0.848、0.700和0.632;对每个维度拟合所建立的不同维度模型(模型1:功能维度,模型2:功能+症状维度,模型3:功能+症状+影响父母维度)与中文版CARIFS总分行逐步回归分析并行拟合优度检验,上述模型均有统计学意义,其中模型3高度显著,3个维度得分对总分均有贡献;③间隔3 d来院复诊142例、电话随访51例,功能、症状、影响父母3个维度评分及总分经配对t检验第1次和3 d后差异均有统计学意义(P均为0.000),反应度很好。结论中文版CARIFS信度、效度和反应度均良好,适用于中国有发热的儿童急性上呼吸道感染病情严重程度评估。     

家属版复苏陪伴利弊评估量表的汉化及信效度研究

目的：对家属版复苏陪伴利弊评估量表(FPDR-BRS)进行汉化,并检测其信效度。方法：翻译并修订FPDR-BRS,采用中文版FPDR-BRS对2016年5月24日至2016年11月2日253名儿童急诊Ⅰ、Ⅱ级及急诊重症留观病危患儿的家属进行调查,分析评价其信度和效度。结果：对中文版FPDR-BRS在临界组比较、条目与总分相关、同质性检验3个方面进行量表的项目分析,结果显示量表条目具有良好的适切及可靠程度。量表的内容效度指数为1.0。分别对利益和风险子量表进行探索性因子分析,利益项量表因子分析结果显示,Bartlett球形检验KMO值为0.876（P＜0.01）,主成分分析提取2个主因子,可解释总体方差的53.0%,各条目的因子载荷为0.588~0.795,可很好地解释原量表的13个条目,分别命名为充分理解与积极应对,Cronbach's α系数为0.873;风险项量表因子分析结果显示,Bartlett球形检验KMO值为0.883（P＜0.01）,主成分分析提取2个主因子,可解释总体方差的64.5%,各条目的因子载荷为0.726~0.892,可很好地解释原量表的10个条目,分别命名为个人风险与人员风险,Cronbach's α系数为0.890。结论：中文版FPDR-BRS具有良好的信度和效度,可以应用于评估家属对复苏陪伴的态度及意向。     

中文版《青少女性自我保护意识量表》构建及其信度和效度评价

目的 构建适用于中国文化框架下青少女性自我保护意识量表(SSPAS),并检验其信度与效度。 方法 翻译并主要参考英文版SSPAS量表等文献,确定中国16～18岁青少女为调查人群,结合对中国青少女半结构访谈结果和专家咨询意见,形成中文版SSPAS预实验量表,在中国16～18岁青少女中调查修订为中文版SSPAS验证量表,再在另一中国16～18岁青少女人群中行信度和效度评价。中文版SSPAS预实验和验证量表集中于学校匿名填写,填写问卷时间约10 min。对施测量表条目采用等距5级评分,即从不如此、很少如此、偶尔如此、经常如此和总是如此,分别赋予1、2、3、4和5分,得分越高表示性自我保护意识越好。 结果 中文版SSPAS预实验量表基于321名中国16～18岁青少女学生,有效问卷88.2%;中文版SSPAS验证量表基于560名中国16～18岁青少女学生,有效问卷91.2%。经探索性因子分析,中文版SSPAS量表由22个条目组成,包括性健康态度、性自我概念和性危险行为3个公因子,累计贡献率为72.5%;各条目内容效度指数为0.902～0.922,量表总体内容效度指数为0.918;总量表的Cronbach's α系数为0.842,重测信度为0.886;验证性因子分析,卡方值/自由度为2.218（P<0.001）、拟合优度指数为0.958,近似误差均方根性为0.052,调和拟合优度指数为0.962,正规拟合指数为0.924,比较拟合优度指数为0.936,以上指标均＞0.90,具有较好的适配。 结论 中文版SSPAS量表在中国16～18岁青少女中具有很好的信度与效度,可作为评价中国青少女性自我保护意识情况的量化工具。     

中文版儿童生命质量哮喘特异性量表的信度和效度评价

目的：评价简体中文版儿童生命质量（PedsQLTM）哮喘特异性量表家长报告的信度和效度。方法：采用 PedsQLTM 哮喘特异性量表家长报告量表及自设一般情况问卷,对重庆医科大学附属儿童医院哮喘中心就诊的 233 例哮喘患儿及其家长进行问卷调查。用克朗巴赫α系数考核其信度,分别用探索性因子分析、相关分析考核其效度。结果：中文版 PedsQLTM 哮喘特异性量表家长报告全量表、症状相关问题、治疗相关问题、担心相关问题、沟通相关问题的α系数分别为0.86、0.80、0.78、0.89和0.93,表明量表有较好的内部一致性。通过因子分析共提取7个公因子,与量表基本结构一致,主成分累积贡献率接近 66%。4个维度得分与所含条目得分间均有较强的相关关系(r=0.41~0.92, P＜0.01)。结论：中文版PedsQLTM 哮喘特异性量表家长报告有良好的信度和效度,与原语言版本一致,可适用于中国哮喘患儿健康相关生命质量评价。［中国当代儿科杂志,2010,12(12)：943-946］     

复旦中文版神经肌肉疾病运动功能评估量表在儿童和青少年中的信度和效度研究

目的：验证复旦中文版神经肌肉疾病（NMD）运动功能评估量表（MFM）在中国儿童和青少年NMD中的信度和效度。 方法：2013年6月至2017年7月在复旦大学附属儿科医院（我院）神经科经基因检测或肌肉活检明确诊断为各类NMD、＞2岁且在我院康复科接受过复旦中文版MFM 20和MFM 32评估的患儿,排除1年内接受过手术、具有严重认知障碍和测试前3 d内从事过严重影响体力的活动患儿。2名物理治疗师同时进行MFM 20和MFM 32测试,检验不同测试者间的信度;同一评价者在第1次评价后间隔3~7d进行第2次评价,检测重测信度;以6 min步行距离（6MWT）和4项功能性计时测试为效度指标;通过分析MFM分值与之的相关性确定关联效度。通过分析纳入对象中杜氏进行性肌营养不良（DMD）患儿的MFM分值与北极星移动量表（NSAA）分值之间的相关性确定关联效度。 结果：372例患儿符合本文纳入排除标准,平均（6.5±2.7）岁,<7岁222例,男性338例,其中DMD 263例,重测信度（2~7岁16例,>7岁38例）和测试者间信度（2~7岁16例,＞7岁29例）检测结果显示,MFM 32和MFM 20的总分和各分区分值ICC=0.89~0.97。基于372例患儿,MFM 32和MFM 20的总分和D1区分值与6MWT和功能性计时测试结果具有中等和较强的相关性（r=0.48~0.73）,与D2和D3分区的分值相关性为中等和较弱。在263例DMD患儿中,MFM 32和MFM 20的总分和D1区分值与NSAA分值的相关性为强和极强相关性。 结论：复旦中文版MFM量表在儿童和青少年NMD患儿中具有很好的信度和效度,可以有效地测定NMD患儿的运动功能状态。     

鼾症儿童睡眠障碍量表研制及评价

目的研究制订适合鼾症儿童睡眠障碍状况调查的量表,应用于临床。方法选择2015年1月至12月就诊于首都医科大学附属北京儿童医院睡眠中心的存在夜间打鼾或张口呼吸症状持续2个月及以上的3~14岁儿童1017例,根据量表制订规范,结合儿童常见睡眠障碍理论知识,查阅文献后形成条目池,再由专家组对条目池进行修正及删除,形成初量表。采用因子分析法筛选出40个条目作为最终量表,再进行信度、效度考核。结果鼾症儿童睡眠呼吸障碍量表由5个维度、40个条目组成。信度方面,本量表总克朗巴赫系数(Cronbach’αcoefficient)为0.7373,其余各维度的克朗巴赫系数分别为夜间打鼾相关症状0.5789、睡眠伴随症状及相关疾病情况0.6769、日间嗜睡相关症状0.6038、行为相关症状0.7983、他人对儿童嗜睡的评价0.8354。结构效度方面,验证性因子分析显示60%的条目其标准化系数载荷0.4,可接受。结论鼾症儿童睡眠障碍量表信度较好,效度可接受。     

中文简明儿童阻塞性睡眠呼吸暂停综合征筛查量表信效度和筛查效能

目的：评价中文版简明儿童阻塞性睡眠呼吸暂停综合征（OSAS）筛查量表（简称量表）在打鼾儿童中的信效度和筛查OSAS的能力。方法：汉化量表,包括问题Q1~Q6。前瞻性收集2015年1月至2015年12月在上海交通大学医学院附属上海儿童医学中心（我院）睡眠门诊和耳鼻咽喉科门诊就诊的、以夜间睡眠打鼾为主诉的、年龄≥3岁的连续病例,在行PSG前由患儿家长回顾孩子近6个月的睡眠情况自行填写量表,以多导睡眠监测（PSG）作为诊断OSAS的金标准（阻塞性呼吸暂停低通气指数（OAHI）每小时≥5次）。考察量表的信度和效度,以OAHI每小时 1次、3次和5次界值分组考察量表筛查儿童OSAS的效能。结果符合本文纳入、排除和剔除标准的425例夜间睡眠打鼾儿童进入本文分析,以OAHI≥每小时5次为诊断标准,82例（19%）被诊断为OSAS（OSAS组）,余为非OSAS组。两组性别、最低血氧饱和度和阻塞性呼吸暂停低通气指数（AHI）差异有统计学意义。量表筛查OSAS的整体内在信度克朗巴赫α系数0.785。对量表行探索性因子分析,抽样适度度量为0.783,Bartlett's球形检验P＜0.001,适合进行因子分析,共提取2个因子（对各问题）,载荷系数均＞0.5。以OAHI每小时≥5次、3次和1次作为OSAS组和非OSAS组的分组标准时,最佳临界值分别为2.32、2.32和1.99,敏感度均＞65%,特异度50%~60%。结论：量表具有较好的信度和效度,可以快速有效地用于在夜间打鼾儿童中筛查中重度OSAS。     

Development of an instrument to measure parents' preferences and goals for the treatment of attention deficit-hyperactivity disorder

ObjectivesTo describe the development and validation of an instrument to measure parents’ attention deficit–hyperactivity disorder (ADHD) treatment preferences and goals.MethodsParents of children 6 to 12 years of age diagnosed with ADHD in the past 18 months were recruited from 8 primary care sites and an ADHD treatment center (autism excluded). A 16-item medication, 15-item behavior therapy preference scale and a 23-item goal scale, were developed after a review of the literature, 90 parent and clinician semistructured interviews, and input from parent advocates and professional experts were administered to parents. Parent cognitive interviews confirmed item readability, clarity, content, and response range. We conducted an exploratory factor analysis and assessed internal consistency and test-retest reliability and construct and concurrent validity.ResultsWe recruited 237 parents (mean child age 8.1 years, 51% black, 59% from primary care, 61% of children medication naive). Factor analyses identified 4 medication preference subscales (treatment acceptability, feasibility, stigma, and adverse effects, Cronbach’s α 0.74–0.87); 3 behavior therapy subscales (treatment acceptability, feasibility, and adverse effects, α 0.76–0.83); and 3 goal subscales (academic achievement, behavioral compliance, and interpersonal relationships, α 0.83–0.86). The most strongly endorsed goal was academic achievement. The scales demonstrated construct validity, concurrent validity (r = 0.3–0.6) compared with the Treatment Acceptability Questionnaire and Impairment Rating Scale and moderate to excellent test–retest reliability (intraclass coefficient = 0.7–0.9).ConclusionsWe developed a valid and reliable instrument for measuring preferences and goals for ADHD treatment, which may help clinicians more easily comply with new national treatment guidelines for ADHD that emphasize shared decision making.     

The Transition Readiness Assessment Questionnaire (TRAQ): Its Factor Structure,Reliability, and Validity

ObjectiveNational consensus statements recommend that providers regularly assess the transition readiness skills of adolescent and young adults (AYA). In 2010 we developed a 29-item version of Transition Readiness Assessment Questionnaire (TRAQ). We reevaluated item performance and factor structure, and reassessed the TRAQ's reliability and validity.MethodsWe surveyed youth from 3 academic clinics in Jacksonville, Florida; Chapel Hill, North Carolina; and Boston, Massachusetts. Participants were AYA with special health care needs aged 14 to 21 years. From a convenience sample of 306 patients, we conducted item reduction strategies and exploratory factor analysis (EFA). On a second convenience sample of 221 patients, we conducted confirmatory factor analysis (CFA). Internal reliability was assessed by Cronbach's alpha and criterion validity. Analyses were conducted by the Wilcoxon rank sum test and mixed linear models.ResultsThe item reduction and EFA resulted in a 20-item scale with 5 identified subscales. The CFA conducted on a second sample provided a good fit to the data. The overall scale has high reliability overall (Cronbach's alpha = .94) and good reliability for 4 of the 5 subscales (Cronbach's alpha ranging from .90 to .77 in the pooled sample). Each of the 5 subscale scores were significantly higher for adolescents aged 18 years and older versus those younger than 18 (P < .0001) in both univariate and multivariate analyses.ConclusionsThe 20-item, 5-factor structure for the TRAQ is supported by EFA and CFA on independent samples and has good internal reliability and criterion validity. Additional work is needed to expand or revise the TRAQ subscales and test their predictive validity.     

Development and psychometric assessment of the collaborative care for attention-deficit disorders scale.

OBJECTIVE: To describe the development and assess the validity and reliability of the Collaborative Care for Attention-Deficit Disorders Scale (CCADDS), a measure of collaborative care processes for children with attention-deficit/hyperactivity disorder who attend primary care practices. METHODS: Collaborative care was conceptualized as a multidimensional construct. The 41-item CCADDS was developed from an existing instrument, review of the literature, focus groups, and an expert panel. The CCADDS was field tested in a national mail survey of 600 stratified and randomly selected practicing general pediatricians. Psychometric analysis included assessments of factor structure, construct validity, and internal consistency. RESULTS: The overall response rate was 51%. Most respondents were male (56%), 46 years old or older (59%), and white (69%). Common factor analysis identified 3 subscales: beliefs, collaborative activities, and connectedness. Internal consistency reliability (coefficient alpha) for the overall scale was .91, and subscale scores ranged from .80 to .89. The CCADDS correlated with a validated measure of provider psychosocial orientation (r = -.36, P < .001) and with self-reported frequency of mental health referrals or consultations (r = -.24 to -.42, P < .001). CCADDS scores were similar among physicians by race/ethnicity, gender, age group, and practice location. CONCLUSIONS: Scores on the CCADDS were reliable for measuring collaborative care processes in this sample of primary care clinicians who provide treatment for children with attention-deficit/hyperactivity disorder. Evidence for validity of scores was limited. Future research is needed to confirm its psychometric properties and factor structure and provide guidance on score interpretation.     

Development of Preschool Children Sibling Rivalry Scale (PSRS)

The purpose of the current study was to develop a valid and reliable scale to assess the sibling rivalry behavior of 3–6-year-old preschool children with one or more younger siblings, based on their parents’ reports. The pilot study was conducted with 544 parents. Through exploratory factor analysis, six factors were obtained: warmth/closeness, parental partiality, competition, regression and restlessness, antagonism, and negative behavioral changes. The validation study was conducted with 203 parents, using the final version of the scale consisting of 39 items. Confirmatory factor analysis results verified the six-factor solution. The Cronbach’s alpha values for the six factors ranged from .63 to .82. The findings showed the reliability and validity of the Preschool Children Sibling Rivalry Scale.     

Portuguese Children's Sleep Habits Questionnaire - validation and cross-cultural comparison

Objectiveto validate the Portuguese version of the Children's Sleep Habits Questionnaire (CSHQ-PT) and compare it to the versions from other countries.Methodsthe questionnaire was previously adapted to the Portuguese language according to international guidelines. 500 questionnaires were delivered to the parents of a Portuguese community sample of children aged 2 to 10 years old. 370 (74%) valid questionnaires were obtained, 55 children met exclusion criteria and 315 entered in the validation study.Resultsthe CSHQ-PT internal consistency (Cronbach's α) was 0.78 for the total scale and ranged from 0.44 to 0.74 for subscales. The test-retest reliability for subscales (Pearson's correlations, n=58) ranged from 0.59 to 0.85. Our data did not adjust to the original 8 domains structure in Confirmatory Factor Analysis but the Exploratory Factor Analysis extracted 5 factors that have correspondence to CSHQ subscales.Conclusionthe CSHQ-PT evidenced psychometric properties that are comparable to the versions from other countries and adequate for the screening of sleep disturbances in children from 2 to 10 years old.