2型糖尿病患者饮食行为依从性测评量表的开发及信效度检验

目的开发适用于2型糖尿病患者饮食行为依从性的评估量表,为临床护理干预提供科学、有效的测评工具。方法采用文献回顾法、访谈法并结合《中国居民膳食指南》等建立量表条目池,以专家评议及调查336例2型糖尿病患者方式检验量表的信效度。结果最终形成5个维度,包括23个条目的量表。量表总体Cronbacn′sα系数为0.886,各维度Cronbacn′sα系数为0.740~0.882;重测信度为0.932;探索性因子分析提取5个公因子,量表总体累积方差贡献率为60.712%;验证性因子分析结果显示RMSEA为0.067,CFI为0.878,提示模型的拟合较好。结论开发的2型糖尿病患者饮食行为依从性测评量表具有良好的信效度,可作为测评工具应用于临床实践。     

OMAS-37药物依从性量表的汉化及信效度检验

目的 对OMAS-37药物依从性量表进行汉化,并检验其信度和效度。方法 通过翻译、回译、跨文化调试及预调查,形成中文版OMAS药物依从性量表,并对442例非特异性疾病服药患者进行问卷调查,检验量表的信度和效度。结果 中文版OMAS药物依从性量表探索性因子分析提取出10个公因子,累积方差贡献率为69.327%。总量表的Cronbach′s α系数为0.849,各维度Cronbach′s α系数为0.824～0.934。Spearman-Brown折半信度系数为0.835。量表33个条目的条目水平内容效度指数(I-CVI)为0.850～1.000,总量表S-CVI/UA为0.818,S-CVI/Ave为0.970。验证性因子分析显示,χ²/df为1.506,TLI为0.958,CFI为0.918,IFI为0.966,RMSEA为0.037。结论 中文版OMAS具有良好的信效度,适用于对非特异性疾病患者服药依从性的评价和测量。     

护士伦理行为量表的汉化及信效度检验

目的 汉化护士伦理行为量表修订版(the Ethical Behavior Scale for Nurses-Revise),并检验其信效度。方法 获取原量表作者授权后,通过正译、回译、文化调适、认知性访谈和预调查对原量表进行汉化,形成中文版护士伦理行为量表。选取535名临床护士进行调查,以评价量表信效度。结果 中文版护士伦理行为量表包括3个维度、15个条目。条目水平的内容效度指数为0.890～1.000,量表水平的内容效度指数为0.985;探索性因子分析提取3个公因子,累计方差贡献率为60.952%。量表总的Cronbach′s α系数为0.892,3个维度的Cronbach′s α系数分别为0.897、0.870、0.838;Guttman分半信度为0.918。结论 中文版护士伦理行为量表具有良好的信效度,适合作为中国文化背景下护士伦理行为的评估工具。     

痛风患者治疗依从性量表的编制及信效度检验

目的 研制痛风患者治疗依从性量表并检验其信效度,为痛风患者治疗依从性评估提供可靠工具.方法 采用文献回顾和专家咨询法形成痛风患者治疗依从性初量表,选取三甲医院门诊就诊的痛风患者193例进行问卷调查,运用项目分析、探索性因子分析等方法检验初量表的信效度并形成终量表.结果 形成的量表包括服药依从性、饮食依从性、运动保暖依从...     

脑卒中患者健康行为量表的编制及信效度检验

目的编制脑卒中患者健康行为量表并检验其信度效度,为脑卒中患者提供简易的专用健康行为评估工具。方法在中文版健康促进生活方式量表基础上,结合相关指南及文献编制脑卒中患者健康行为量表。对235例脑卒中患者进行问卷调查,采用SPSS17.0及Mplus7.0软件进行分析。结果量表的内容效度为0.850;总量表的同质性信度、分半信度、重测信度系数分别为0.878、0.801、0.845;探索性因子分析提取出6个公因子,共解释总变异量的69.073%。验证性因子分析模型的χ~2/df为1.355,比较拟合指数(CFI)为0.916,Tucker-Lewis指数(TLI)为0.903,标准化残差均方根(SRMR)为0.075,平均平方误差平方根(RMSEA)为0.054,P=0.303,模型精确拟合数据。结论编制的脑卒中患者健康行为量表具有较好的信度和效度,可作为脑卒中患者健康行为的测评工具。     

痴呆恐惧量表的汉化及信效度检验

目的 汉化痴呆恐惧量表,并在社区老年人中检验其信效度.方法 根据Brislin翻译原则翻译痴呆恐惧量表,通过专家咨询和预试验进行文化调适,采用便利抽样法选取230名社区老年人进行问卷调查,检验中文版量表的信度和效度.结果 中文版痴呆恐惧量表包含认知、社会和躯体3个维度,涉及痴呆症的体验与认识(7个条目)、担心家庭负担(...     

护理教育欺凌行为量表的汉化及信效度检验

目的汉化护理教育欺凌行为量表并评价其在中国护生中的信效度.方法经Brislin模式翻译和文化调适形成中文版,对552名护生进行调查检验量表的信效度.结果中文版共18个条目,探索性因子分析提取4个公因子,累积方差贡献率为73.244％;验证性因子分析拟合较好(CFI=0.916,IFI = 0.918,RMSEA=0.0...     

中文版女性排尿行为量表的信效度检验

目的 检测中文版女性排尿行为量表在中国社区女性尿失禁患者中应用的信度和效度.方法 方便选取某社区254名女性尿失禁患者进行施测,采用t检验、Cronbach's α系数、因素分析进行条目筛选,评定其修订后的信度和效度.结果 最终保留14个条目、共4个因子,解释变异量的79.3％,分别为排尿用力、无尿意排尿、憋尿和排尿地点选择倾向,其Cronbach' sα系数分别为0.950,0.924,0.801,0.750.结论 经过调整后的中文版女性排尿行为量表具有较为理想的信度和结构效度,符合心理测量的要求,可以用于排尿行为的评估.     

全膝关节置换术患者居家康复训练依从性量表的编制及信效度检验

目的构建全膝关节置换术患者居家康复训练依从性评估工具。方法参考相关文献联合讨论法形成初始全膝关节置换术患者居家康复训练依从性量表(依从性量表),进行2轮专家咨询,发放给176例全膝关节置换术患者检验其信效度。结果专家积极性为84.62%、81.82%,专家协调系数为0.332,专家权威系数为0.839;依从性量表含3个维度11个条目,累积方差贡献率为69.855%;I-CVI为0.889～1.000,S-CVI为0.978,3个维度及量表总的Cronbach′sα系数为0.747～0.885及0.850,各维度与总分的相关系数r为0.622～0.865。结论全膝关节置换术患者居家康复训练依从性量表编制合理,信度效度较好,可作为全膝关节置换术患者居家康复训练依从性评估工具。     

护理管理者毒性领导行为量表的汉化及信效度检验

目的 对护理管理者毒性领导行为(Toxic Leadership Behaviors of Nurse Managers, ToxBH-NM)量表进行汉化并检验信效度。方法 遵循Brislin模型对原量表进行翻译、回译、跨文化调适和预调查后,形成中文版ToxBH-NM量表。采用便利抽样法,对贵州省501名护士进行问卷调查,评价量表的信效度。结果 中文版ToxBH-NM量表共30个条目,探索性因子分析提取4个公因子,累计方差贡献率为65.200%;验证性因子分析显示模型适配指标：χ²/df=1.639、RMSEA=0.036、CFI=0.974、TLI=0.972、IFI=0.974。量表水平的平均内容效度指数为0.946,与辱虐管理问卷得分的相关系数为0.669。Cronbach′s α系数为0.951,折半信度为0.831,重测信度为0.959。结论 中文版ToxBH-NM量表具有良好的信效度,适用于我国文化背景下的护理管理者毒性领导行为测量。     

Emotional Eating and Emotional Eating Alternatives in Subjects Undergoing Bariatric Surgery

Background The purpose of this study was to characterize emotional eating and its alternatives in obese patients undergoing bariatric surgery. Methods The medical charts of 178 consecutive patients who had laparoscopic Roux-en-Y gastric bypass provided by a multidisciplinary bariatric program were reviewed. Data from patients who had emotional eating, reported strategies to overcome their urges to emotionally eat, and had their 6 months follow-up after surgery (N = 50) were further analyzed in terms of weight history, medical co-morbidity prior to surgery, weight loss after surgery, and lifetime psychiatric status. Results 38.7% of the 178 bariatric surgery patients reported emotional eating. Patients reported using three main types of behaviors (oral, sedentary and physical activity) to overcome urges to eat emotionally. Most patients (42%) experiencing emotional eating chose sedentary behaviors to overcome urges to eat in response to emotion. The three groups did not differ in any of the examined variables. Conclusions While patients using different coping mechanisms to overcome urges to eat emotionally did not differ before and 6 months after surgery, further research is needed to examine the frequency and long-term effects of emotional eating in bariatric surgery patients. This research project was performed as part of Dr. Guerdjikova’s MSW internship with Tristate Surgical Weight Loss Center.     

A New Questionnaire for Quick Assessment of Food Tolerance after Bariatric Surgery

Background Bariatric surgery is often associated with reduced food tolerance and sometimes frequent vomiting, which influence quality of life, but are not included in the overall evaluation of these procedures, notably the BAROS. Our aim was to develop a simple questionnaire to evaluate food tolerance during follow-up visits. Methods A one-page questionnaire including questions about overall satisfaction regarding quality of alimentation, timing of eating over the day, tolerance to several types of food, and frequency of vomiting/ regurgitation was developed. A composite score was derived from this questionnaire, giving a score of 1 to 27.Validation was performed with a group of nonobese adults and a group of morbidly obese nonoperated patients. Patients were administered the questionnaire at follow-up visits since January 1999. Data were collected prospectively. Results It takes 1–2 minutes to fill out the questionnaire. Food tolerance is worse in the morbidly obese population compared with non-obese adults (24.2 vs 25.2, P = 0.004). Following Roux-en-Y gastric bypass, food tolerance is reduced after 3 months (21.2), but becomes comparable to that of the normal population and remains so at 1 year postoperatively. Following gastric banding, food tolerance is already significantly reduced after 3 months (22.3), and worsens continuously over time (19.03 after 7 years). In the gastric banding population, the decision to adjust the band is based at least partially on food tolerance, and the questionnaire proved helpful in that respect. Conclusion Our new questionnaire proved very easy to use, and helpful in day-to-day practice, especially after gastric banding. It was also helpful in comparing food tolerance over time after surgery, and in comparing food tolerance between procedures. Evaluation of food tolerance should be part of the overall evaluation of the results after bariatric surgery.     

Problematic Eating Behaviors Predict Outcomes After Bariatric Surgery

Background

There are no clear psychosocial predictors of weight loss following bariatric surgery. The purpose of this study was to investigate whether preoperative problematic eating behaviors predict weight loss outcomes following bariatric surgery.

Methods

Clinical records were utilized to examine outcomes of 101 patients who completed a pre-surgical psychosocial evaluation and underwent gastric bypass or sleeve gastrectomy. Information analyzed included binge eating history and scores from the Hospital Anxiety and Depression Scale, Yale Food Addiction Scale, and Emotional Eating Scale. Measures of weight loss 1 year post-surgery were compared to pre-surgical assessments.

Results

One-year follow-up data were available for 60 patients. Patients with higher levels of eating in response to anger/frustration (p?=?.02), anxiety (p?=?.01), or depression (p?=?.05) were more likely to miss the 1-year follow-up appointment. Eating in response to anger/frustration and depression were related to poorer weight loss outcomes. There was a trend for binge eating to predict greater %EWL (p?=?.06). A higher number of food addiction symptoms increased the likelihood that patients would experience less weight loss (p?=?.01). Psychiatric symptoms were not related to weight loss outcomes.

Conclusions

Patients who endorsed higher levels of pre-surgical emotional eating and food addiction symptoms had poorer weight loss 1 year post-surgery. Providers should consider screening patients for these behaviors during the pre-surgical psychosocial evaluation which would allow opportunities for psychotherapy and potential improvement in weight loss outcomes. Future research should examine which interventions are successful at improving problematic eating behaviors.

     

Night Eating Syndrome: Impact on Bariatric Surgery

Individuals with night eating syndrome (NES) display a time-delayed pattern of food intake, outside the natural circadian rhythm. High prevalence estimates have been reported among bariatric surgery candidates, and some evidence suggests that NES is positively associated with obesity, negatively associated with weight loss efficacy, and follows a chronic course. In order to evaluate current NES theory, and the association between NES and bariatric surgery, literature searches were conducted to identify relevant literature published in English up to 2005. Because of inconsistencies in NES characterization, and significant heterogeneity in study design and methods, a qualitative assessment of NES and its relation to bariatric surgery was then undertaken. Within the literature, variable NES definitions highlight the distinct lack of clarity as to which behavioral features constitute a clinically meaningful entity. Prevalence estimates appear high among persons seeking bariatric surgery; however, no consistent pre- or postoperative demographic, clinical, or psychological factors reliably differentiate NES from non-NES. Further examination of the clinical significance, correlates, and course of NES in general and surgical samples is important, given the link with obesity. The ways in which NES departs from "normal" eating behavior must be clarified. Behavioral and psychological traits of NES need elucidation, and the establishment of agreed diagnostic criteria is essential for research to move forward. Therapy options should focus on aspects of the syndrome that cause greatest impairment, distress, or health risk.     

ICU护士静脉用药错误知信行问卷的汉化及信效度检验

目的 汉化ICU护士静脉用药错误知信行问卷（Knowledge, Attitude, and Behavior in Medication Errors Questionnaire,KAB-MEQ）并检验信效度。方法 获取原作者授权,根据Brislin经典翻译模型对原问卷进行顺译、回译、原作者审查、跨文化调适和预调查,形成中文版KAB-MEQ,采用便利抽样法对328名ICU护士进行问卷调查,评价问卷的信效度。结果 中文版KAB-MEQ包含3个维度共20个条目,累计方差贡献率为73.689%。修正后验证性因子分析结果显示：χ2/df=1.702、RMSEA=0.057、IFI=0.972、TLI=0.966、CFI=0.972,模型拟合良好。问卷条目水平的内容效度为0.889～1.000,问卷水平的内容效度为0.978。问卷的Cronbach′s α系数为0.925,折半信度为0.818,重测信度为0.862。结论 中文版KAB-MEQ具有良好的信度和效度,可作为ICU护士静脉用药错误知信行评估工具。     

Rhabdomyolysis after Bariatric Surgery

Background: Rhabdomyolysis is a potential threat after bariatric surgey. The severity ranges from asymptomatic elevations of serum muscle enzyme levels to life-threatening cases associated with muscle necrosis, compartment syndrome, acute renal failure and cardiac arrest. Methods: We studied 98 consecutive obese patients who underwent primary uncomplicated bariatric surgery during a 1-year period. A database was created for all patients (sex, age, BMI, duration of the operation); serum creatinine phosphokinase (CPK) was systematically measured before surgery and on the first and second postoperative day. Results: The study sample consisted of 35 males (35.7%) and 63 females (64.3%) with preoperative CPK level 156.6 ± 41.1 U/L (40 to 220), 24 hours postoperatively 1,075.2 ± 596.5 U/L, (85 to 2,790 U/L) and 48 hours postoperatively 967.3 ± 545.3 U/L (79 to 2,630). There was no difference in mean BMI (P=0.1) and mean duration of operation (P=0.5) between males and females. However, a statistically significant difference in mean elevation of CPK between males and females (P=0.003) was found. The variables sex, age, weight and duration of surgery were analyzed by multivariate logistic regression, but did not show a statistically significant difference. Conclusion: Rhabdomyolysis is a potentially fatal complication of surgical procedures in obese patients, and can be minimized with simple measures such as additional padding, aggressive hydration and urine alkalinization. Diagnosis requires a high level of physician awareness.     

Response of Recurrent Binge Eating and Weight Gain to Topiramate in Patients with Binge Eating Disorder after Bariatric Surgery

Background: The effectiveness of topiramate was evaluated in the treatment of recurrent binge eating and weight gain in patients with binge eating disorder (BED) and obesity who had undergone initially successful bariatric surgery. Methods: The records of 3 consecutive patients with BED and obesity who presented to our clinic with recurrent binge eating and weight gain after undergoing initially successful bariatric surgery were reviewed. They were treated with topiramate for an average of 10 months. Results: All three patients reported complete amelioration of their binge eating symptoms and displayed weight loss (31.7 kg in 17 months, 14.5 kg in 9 months, 2 kg in 4 months, respectively) in response to topiramate (mean dose 541 mg). Conclusion: Although anecdotal, these observations suggest that topiramate may be an effective treatment for patients with BED and obesity who experience recurrent binge eating and weight gain after initially successful bariatric surgery.     

绝经期配偶支持问卷的汉化及信效度检验

目的 汉化绝经期配偶支持问卷,并检验其信效度,为评估我国绝经期女性感知配偶支持提供测量工具。方法 应用Brislin翻译模型对英文版绝经期配偶支持问卷进行翻译、回译、文化调适及预试验,形成中文版问卷。采用便利抽样法选择锦州市600名社区绝经期女性进行调查,评价问卷的信效度。结果 中文版问卷包括情感支持、工具性支持、评价性支持、性亲密支持4个维度共17个条目。问卷各条目的内容效度指数为0.714～1.000,问卷的平均内容效度指数为0.966。探索性因子分析提取4个公因子,累积方差贡献率为75.834%;验证性因子分析显示,χ²/df为2.095,RMSEA为0.061,CFI为0.958,IFI为0.958,TLI为0.949。问卷的Cronbach′s α系数为0.876,重测信度为0.911,折半信度为0.945。结论 中文版绝经期配偶支持问卷具有较好的信效度,可用于测评绝经期女性感知配偶的支持程度。     

Dialectical Behavior Therapy for Emotional and Mindless Eating After Bariatric Surgery: a Prospective Exploratory Cohort Study

Obesity Surgery - To assess the effect of dialectical behavior therapy (DBT) on emotional and mindless eating and, consequently, body mass index (BMI) loss, in patients who have undergone bariatric...