改良耶魯術前焦慮量表的漢化及信效度評價(碩士)

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•中文摘要•
改良耶魯術前焦慮量表的漢化及信效度評價(碩士)(論文25000字)
摘 要
研究目的:
1.采用科學的方法引進國外改良耶魯術前焦慮量表(the Modified Yale Preoperative Anxiety Scale, m-YPAS),經過翻譯、回譯及文化調試的漢化程序,形成中文版改良耶魯術前焦慮量表,為建立適用于我國兒童術前焦慮的測評工具提供研究基礎。
2.評價中文版改良耶魯術前焦慮量表的信度和效度,探索量表在評估中國兒童術前焦慮程度的適用性。
研究方法:
1.在獲得量表原作者Zeev N. Kain同意的前提下,按照科學的Brislin雙人雙譯法對英文版的m-YPAS量表進行翻譯、回譯及文化調適,形成中文版改良耶魯術前焦慮量表(the Chinese Version of the Modified Yale Preoperative Anxiety Scale, Cm-YPAS)。
2.于2017年7月至2017年10月采用方便抽樣法在XX市XXXXXXXXXX醫院耳鼻喉科、眼科選取2~12歲接受擇期手術的患兒31名。在術前一日進行患兒基本信息資料收集,研究者當場檢查調查表,確保項目無缺失。手術當日,在患兒進入術前等待區直至麻醉誘導期進行全程視頻錄像。
3.請9位不同資質和專業的專家觀看視頻,使用中文版Cm-YPAS量表對患兒在術前等待區、走向手術室、進入手術室、麻醉誘導期4個時間點的焦慮程度進行評分;2周后請9位專家再次觀看視頻對患兒焦慮程度進行重新評分。
4.所得資料運用SPSS23.0進行統計分析,用內部一致性信度、評定者間信度、重測信度、內容效度及結構效度等對中文版Cm-YPAS量表測試結果進行評價,檢驗量表的信度和效度。
研究結果:
1.經過對英文版m-YPAS量表的翻譯、回譯及文化調試,形成中文版Cm-YPAS量表;
2.量表信度:中文版Cm-YPAS量表內部一致性Cronbach’s α系數為0.936~0.943,不同評定者間相關系數為 ?(P<0.05),折半信度的Spearman 相關系數rxx 為0.935~0.951(P<0.01),重測信度中各時間點兩次測量值的Pearson相關系數為0.9~0.947(P<0.05);綜合評價中文版Cm-YPAS量表的信度較好。
3.量表效度:采用專家法評價量表的內容效度,得出內容效度指數(Content Validity Index,CVI)為 0.67~1.00,平均值為0.91;量表的結構效度采用因子分析的方法進行考察,用探索性因素分析在各個時間點均提取了特征值大于 1 的公因子1個,其累積方差貢獻率均大于82 %,表明該量表只有一個維度是單量表,結構穩定;綜合評價中文版Cm-YPAS量表的效度較好。
研究結論:
1.中文版Cm-YPAS量表簡潔易懂、使用方便,能夠較好地評估兒童手術前各個時間點的焦慮程度,可以作為臨床用于兒童術前焦慮的篩查工具。
2.中文版Cm-YPAS量表具有較好的信度及效度,穩定性好、可靠性高,符合計量學標準,可以應用于我國兒童術前焦慮評估。
關鍵詞:兒童 術前焦慮 量表 漢化 評價

•英文摘要•
The Reliability and Validity of the Chinese Version of the Modified
Abstract
Purposes:
1.Using the scientific method to introduce foreign modified Yale preoperative anxiety scale (m-YPAS), through the translation, back translation, cultural adaptation finished the program, forming the Chinese version modified Yale preoperative anxiety scale.To provide a basis for the establishment of anxiety assessment tools for children before operation in China.
2. To evaluate the reliability and validity of the Chinese version of the modified Yale preoperative anxiety scale, and to explore the applicability of the scale in assessing the anxiety level of Chinese children before operation.                  
Methods:
With the permission from the author of m-YPAS, Kain ZN, according to the scientific Brislin translation method, the English version of the m-YPAS scale is translated, to form the Chinese version of modified Yale preoperative anxiety scale (Cm-YPAS).From July 2017 to October 2017, 31 children who were 2~12 years old who received selective operation were obtained from Department of ENT and ophthalmology in a three grade hospital in Dalian by convenience sampling. The basic information of the children was collected on the day before the operation, and the investigators examined the questionnaire to ensure that the items were not missing. On the day of the operation, the child entered the waiting area of the operation until  the induction period of the anesthesia was videotaped. 9 experts with different qualifications and professional qualifications were asked to score the anxiety degree of children in 4 time points by watching videos, and then 9 experts were asked to reassess videos after 2 weeks. Cm-YPAS was used to score the anxiety level of children at different time points. Data were statistically analyzed by SPSS23.0 and Cm-YPAS was evaluated by content validity, construct validity and internal consistency reliability, so as to verify its validity and reliability.          
Results:
1.After the translation, back translation and evaluation of the content validity of the English version of the scale, the Chinese version of the scale is formed. The CVI value of the scale is 0.67 to 1, the average value is 0.91 ;           
2. reliability:          
3.content validity:           
4. structure validity:
Conclusions:
1. Cm-YPAS is simple, easy to understand, easy to use, and easy to be accepted by Chinese medical staff. At the same time, it also provides a more convenient assessment tool for preoperative anxiety in children, so as to provide a theoretical basis for effective interventions for children's preoperative anxiety.           
2. Cm-YPAS has good content validity and construct validity, and has good internal consistency reliability. The scale has good stability: high reliability and compliance with the metrology standard, which can be applied to the preoperative anxiety assessment of children in China.           
3. Cm-YPAS can be used to assess the anxiety degree of children before surgery at different time points.In order to evaluate the effectiveness of children to reduce negative experience and improve the quality of nursing interventions, that scale can be used as a clinical screening tool for children with anxiety before surgery, through reliable assessment of children's anxiety, can timely and accurately take targeted interventions. By using the same measuring tools, interventions in different locations and cultures can be compared.                 
Key Words: Preoperative Anxiety  Children  Scale  Reliability  Validity

目    錄
一、摘 要    1
(一)中文摘要    1
(二)英文摘要    4
二、正 文    8
(一)前  言    8
1.研究背景............................................... 8
2.相關概念................................................9
3.國內外研究現狀..........................................9
4.研究目的.............................................. 11
5.研究意義.............................................. 11
(二)研究對象和方法    12
1.研究對象    12
 2.研究方法    12
 3.質量控制    14
 4.統計學分析方法    15
 5.倫理學原則    15
(三)結 果    17
(四)討 論    26
(五)結 論    35
(六)研究的局限性和改進措施    36
(七)參考文獻    37
三、綜 述    43
(一)綜述    43
(二)參考文獻    48
四、附 錄    52
五、攻讀學位期間發表文章情況    58
六、致 謝................................................. 59

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