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。

Study on reliability and validity of Chinese version of EDIN scale in 0 to 5 year-old children with acute fever about comfort

Objective To assess reliability, validity and responsiveness of evaluation to comfort by using Echelle DouleurInconfort Nouveau-Ne, neonatal pain and discomfort scale (EDIN) in 0 to 5 year-old children with acute fever. Methods Pretesting-version of EDIN was introduced into China through translating and back translating, then each version was discussed and modified, and developed by the experts. Five pediatric clinical experts and guardians of 30 children with acute fever were recruited to administer the EDIN scale Chinese pre-testing version to form Chinese version of EDIN by surface validity test. One hundred guardians of children with acute fever completed Chinese version of EDIN to evaluate the validity, reliability and responsiveness with correlation coefficient and Cronbach coefficient. Results ①Five experts and 30 children guardians considered that the scale items were clear and understandable, completed filling in the scale within 5 minutes. ②97 cases filled in Chinese version EDIN to analyze reliability and validity. The split-half reliability was 0.887, the test-retest reliability was 0.734, the Cronbach coefficient scale factor was 0.892. ③The consistency rate of the Wong-Baker scale and EDIN scale was 0.885, the criterion-related validity was good. Component analysis showed facial activity defined the 78.4% of the full variant. ④There were significant differences in 5 dimensions and the total scores in reactivity of the first visit and the third visit after 72 hours, which indicated the reactivity was very good (P<0.001). Conclusion Evaluation of the Chinese version of EDIN shows that the criterion-related validity, reliability and reactivity are relatively good, the construct validity is subject to increase. It can be applied to evaluate the comfort in 0 to 5 year-old children with acute fever.