中文版防肺炎吞咽功能评估量表在老年中枢神经系统疾病病人中应用的信效度研究

doi:10.3969/j.issn.1003-9198.2024.06.016

摘要/Abstract

摘要： 目的将防肺炎吞咽功能评估量表(Assessment of Swallowing Ability for Pneumonia,ASAP)翻译成中文版,并评价其在我国老年中枢神经系统疾病病人中应用的信度和效度。方法翻译ASAP,并邀请8名相关领域专家对ASAP中文版进行内容效度评价。由1名护士和1名康复医生分别对50例老年中枢神经系统疾病住院病人进行ASAP中文版和标准吞咽功能评估量表(SSA)评估,比较2个量表的评估用时,并分析两个量表得分的相关性。随机选取其中20例病人,由康复医生于当天再次进行ASAP中文版评估,护士于第2天再次进行ASAP中文版评估,计算内部、外部的组内相关系数(ICC)。根据ASAP分级标准指导所有病人调整进食方式,并观察吸入性肺炎(aspirationg pneumonia,AP)的发生情况。结果 ASAP中文版具有很好的评定者内部一致性(ICC=0.93,P<0.001)和评定者间一致性(ICC=0.91,P<0.001)。ASAP中文版各项目的Cronbach’s α系数为0.913～0.945,量表的Cronbach’s α系数为0.938;ASAP中文版各项目内容效度指数(I-CVI)为0.875~1.000,量表内容效度指数(S-CVI)为1,平均S-CVI为0.984。ASAP中文版与SSA评分呈显著负相关(r=-0.93,P<0.001),且ASAP中文版用时显著短于SSA[(7.1±1.8)min比(19.3±3.0)min,P=0.02]。ASAP中度异常者的AP发生率明显高于正常者和轻度异常者(P<0.001)。结论 ASAP中文版在我国老年中枢神经系统疾病病人中具有很好的信度和效度,其操作简便、安全可靠、评估用时少,便于临床推广应用;此外,该量表还可以指导病人调整进食方式,减少AP的发生。

关键词: 老年人, 吞咽障碍, 吸入性肺炎, 信度, 效度

Abstract: Objective To translate Assessment of Swallowing Ability for Pneumonia (ASAP) from English into Chinese and to evaluate the reliability and validity of Chinese version in Chinese elderly patients with central nervous system diseases. Methods Eight experts were invited to evaluate the content validity of the Chineses version of ASAP. Fifty elderly inpatients with central nervous system diseases were evaluated using the Chinese version of ASAP and Standard Swallowing Assessment (SSA) by one nurse and one rehabilitation doctor, respectively. The evaluation time was compared and the relationship between the two scales was analyzed. Twenty patients were randomly selected, and they were evaluated using the Chinese version of ASAP by the rehabilitation doctor on the same day, and were evaluated again by the nurse on the second day. The internal and external intraclass correlation coefficients (ICC) were calculated. All patients were guided to adjust the eating patterns according to their ASAP grades, and the incidence of aspiration pneumonia (AP) was observed. Results ASAP Chinese version showed good internal consistency among intra-evaluators consistency (ICC=0.93, P<0.001) and inter-evaluator consistency (ICC=0.91, P<0.001); The Cronbach’s α coefficient of each item was 0.913-0.945, while the Cronbach’s α coefficient of the scale was 0.938; Each item content validity index (I-CVI) was 0.875-1.000, and the scale content validity index (S-CVI) was 1, and the average S-CVI was 0.984. ASAP Chinese version was negatively correlated with SSA (r=-0.93, P<0.001), and the evaluation time of ASAP Chinese version was less than that of SSA (7.1±1.8 min vs 19.3±3.0 min, P=0.02). The incidence rate of AP among the patients with moderate abnormal ASAP was significantly higher than that among the patients with normal ASAP or mildly abnormal ASAP (P<0.01). Conclusions ASAP Chinese version shows good reliability and validity in Chinese elderly patients with central nervous system diseases. It is easy, safe and reliable to operate, and needs less evaluation time. Furthermore, the scale can also guide the patients to adjust their eating patterns and reduce the incidence of AP.

Key words: aged, dysphagia, aspiration pneumonia, reliability, validity

中图分类号:

R741

常欣欣, 潘蓓, 匡雯, 杜文津, 刘玮, 李雨梦, 郭秀敏, 陈大伟. 中文版防肺炎吞咽功能评估量表在老年中枢神经系统疾病病人中应用的信效度研究[J]. 实用老年医学, 2024, 38(6): 612-616.

CHANG Xinxin, PAN Bei, KUANG Wen, DU Wenjin, LIU Wei, LI Yumeng, GUO Xiumin, CHEN Dawei. Reliability and validity of the Chinese version of Assessment of Swallowing Ability for Pneumonia in Chinese elderly patients with central nervous system diseases[J]. Practical Geriatrics, 2024, 38(6): 612-616.

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