精神障碍患者营养筛查工具的汉化与信度、效度研究

doi:10.3969/j.issn.1674-8115.2023.09.014

上海交通大学学报（医学版） ›› 2023, Vol. 43 ›› Issue (9): 1194-1200.doi: 10.3969/j.issn.1674-8115.2023.09.014

• 临床护理专题 • 上一篇

精神障碍患者营养筛查工具的汉化与信度、效度研究

周爽¹(), 陆惠洁¹, 杜哲一¹, 胡诗敏¹, 董萍¹(), 蒋颖²()

^1.上海交通大学医学院附属精神卫生中心护理二科，上海 200030
^2.上海健康医学院护理与健康管理学院，上海 201318

收稿日期:2023-02-03 接受日期:2023-06-12 出版日期:2023-09-28 发布日期:2023-09-28
通讯作者: 董萍,蒋颖 E-mail:1358482911@qq.com;shdp_730@126.com;jiangying401@163.com
作者简介:周爽（1993—），女，护师，硕士；电子信箱：1358482911@qq.com。
基金资助:
上海交通大学医学院护理基金项目(Jyhz2121);上海高校教师产学研践习计划(A1-2602-21-311006-5)

Reliability and validity of the Chinese version of St Andrew′s Nutrition Screening Instrument

ZHOU Shuang¹(), LU Huijie¹, DU Zheyi¹, HU Shimin¹, DONG Ping¹(), JIANG Ying²()

^1.Second Nursing Department, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
^2.Shanghai University of Medicine & Health Sciences School of Nursing and Health Management, Shanghai 201318, China

Received:2023-02-03 Accepted:2023-06-12 Online:2023-09-28 Published:2023-09-28
Contact: DONG Ping,JIANG Ying E-mail:1358482911@qq.com;shdp_730@126.com;jiangying401@163.com
Supported by:
Nursing Fund Project of Shanghai Jiao Tong University School of Medicine(Jyhz2121);Shanghai Higher Education Institution Teacher′ Industry- Academia-Research Practice Project(A1-2602-21-311006-5)

摘要/Abstract

摘要：

目的·翻译圣安德鲁营养筛查工具（St Andrew′s Nutrition Screening Instrument，SANSI），并对其进行信度和效度检验。方法·征得原作者同意后按照Brislin翻译模型对SANSI进行汉化，并行跨文化调试。从上海交通大学医学院附属精神卫生中心选取5名临床医护人员对10名患者进行预调查，并根据反馈对量表条目的表达、结构进行微调。于2022年1月—2月采用方便抽样法在上海交通大学医学院附属精神卫生中心选取221名住院精神障碍患者作为研究对象，收集这些患者的一般临床资料。采用Spearman相关性分析评价第3部分条目与该部分判定风险的相关性，并根据结果进行条目删减。遴选8名精神障碍或营养方面的专家评价中文版SANSI的各条目，计算内容效度指数（content validity index，CVI）。以营养筛查通用工具（Nutritional Risk Screening 2002，NRS2002）作为标准，采用Spearman相关性分析评价中文版SANSI的校标效度。采用内部一致性Cronbach′s α系数、折半信度、评定者间信度（一致性κ系数）来评价该量表第3部分的信度。结果·通过直译、回译、跨文化调试、预调查，形成中文版SANSI。纳入的221名精神障碍患者中男性174例（78.73%），平均年龄（64.12±13.87）岁，病程（26.06±17.65）年，包括精神分裂症128例（57.92%）、器质性精神障碍75例（33.94%）、心境障碍10例（4.52%）、其他精神障碍8例（3.62%）。根据第3部分条目相关性分析结果删除原条目1、3、10后，剩余7个条目与该部分判定风险的相关系数为0.391~0.734（均P<0.01），予以保留。中文版SANSI的条目水平CVI介于0.88~1.00，量表水平CVI为0.95。该量表与NRS2002的校标效度为0.400（P<0.01）。第3部分的Cronbach′s α系数为0.759，折半信度为0.747。2名护士使用中文版SANSI检测同一批50名患者结果的一致性κ系数为0.886（P>0.05）。结论·中文版SANSI对于精神障碍住院患者具有较好的信度和效度。

关键词: 圣安德鲁营养筛查工具, 精神障碍, 营养不良, 营养风险, 信度, 效度

Abstract:

Objective ·To translate St Andrew′s Nutrition Screening Instrument (SANSI), and test its reliability and validity. Methods ·With the consent of the authors, the SANSI was translated into Chinese in accordance with the "Brislin translation-back translation method" and the Chinese version underwent cross-cultural debugging. Five clinical medical staff were selected to a pre-survey on 10 patients, and the expression and structure of the scale items were fine-tuned according to the feedback. A total of 221 inpatients with mental disorders were selected by convenient sampling method in Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine as research objects from January to February 2022, and the general clinical data of these patients were collected. The correlation between the items in Part Ⅲ and the identified risks in that part was evaluated by Spearman correlation analysis, and some items were deleted according to the results. Eight experts in mental disorders or nutrition were selected to evaluate the items of Chinese version of SANSI, and then the content validation indexes (CVIs) were calculated. With the standard of Nutritional Risk Screening 2002 (NRS2002), Spearman correlation analysis was used to evaluate the calibration validity of Chinese version of SANSI. Cronbach′s α coefficient, split half reliability and inter-rater reliability (κ consistency coefficient) were used to evaluate the reliability of the Part Ⅲ of the scale. Results ·Through literal translation, back translation, cross-cultural debugging and pre-investigation, Chinese version of SANSI was formed. Among the 221 patients with mental disorders, 174 (78.73%) were males, the mean age was (64.12±13.87) years, and the duration of diseases was (26.06±17.65) years. There were 128 cases of schizophrenia (57.92%), 75 cases of organic mental disorders (33.94%), 10 cases of mood disorders (4.52%) and 8 cases of other mental disorders (3.62%). According to the results of correlation analysis in Part Ⅲ, the original items 1, 3, and 10 were deleted. The correlation coefficients between the remaining 7 items and the risk degree in this part were 0.391－0.734 (all P<0.01), which were retained. The item-level CVIs of Chinese version of SANSI ranged from 0.88 to 1.00, and the scale-level CVI was 0.95. The calibration validity of the scale with NRS2002 was 0.400 (P<0.01). The Cronbach′s α coefficient for Part Ⅲ was 0.759 and the split half reliability was 0.747. The κ consistency coefficient of 2 nurses using Chinese version of SANSI in the same group of 50 patients was 0.886 (P>0.05). Conclusion ·Chinese version of SANSI has good reliability and validity for hospitalized patients with mental disorders.

Key words: St Andrew′s Nutrition Screening Instrument (SANSI), mental disorders, malnutrition, nutritional risk, reliability, validity

中图分类号:

R749

周爽, 陆惠洁, 杜哲一, 胡诗敏, 董萍, 蒋颖. 精神障碍患者营养筛查工具的汉化与信度、效度研究[J]. 上海交通大学学报（医学版）, 2023, 43(9): 1194-1200.

ZHOU Shuang, LU Huijie, DU Zheyi, HU Shimin, DONG Ping, JIANG Ying. Reliability and validity of the Chinese version of St Andrew′s Nutrition Screening Instrument[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(9): 1194-1200.

图/表 1

参考文献 30

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Item	Correlation coefficient	P value
患者有特定的进食要求(如糖尿病饮食、过敏性饮食)吗? [Does the patient have specific dietary requirements (e.g. diabetes, allergy)?]	0.210	0.002
患者有鼻胃管或胃造口术喂养管吗? (Is there a nasogastric or gastrostomy feeding tube?)	0.391	0.000
患者有营养补充剂医嘱吗? (Is the patient prescribed for nutritional supplements?)	0.136	0.043
有观察到患者有进食障碍或患者有进食障碍史吗? (Does the patient have been observed to have eating disorder or have a history of eating disorder?)	0.626	0.000
患者经常拒绝吃饭或者一天内只吃一顿主餐吗? (Does the patient often refuse to eat or eat only one main meal a day?)	0.486	0.000
患者经常都没有吃完一半的食物吗? (Does the patient often fail to eat at least half of their serving at most mealtimes?)	0.607	0.000
患者经常拒绝喝水或无法把水喝完吗? (Does the patient often refuse to drink water or fail to finish it?)	0.734	0.000
患者有咀嚼或吞咽困难吗? (Does the patient have any chewing or swallowing difficulties?)	0.545	0.000
患者有恶心、不自主呕吐或腹泻吗? (Does the patient suffer from nausea, involuntary vomiting or diarrhea?)	0.490	0.000
患者不愿吃某类食物(例如乳制品、水果和蔬菜)吗? [Does the patient not want to eat certain foods (e.g. dairy products, fruit & vegetables)?]	0.111	0.100

Item	Correlation coefficient	P value
患者有特定的进食要求(如糖尿病饮食、过敏性饮食)吗? [Does the patient have specific dietary requirements (e.g. diabetes, allergy)?]	0.210	0.002
患者有鼻胃管或胃造口术喂养管吗? (Is there a nasogastric or gastrostomy feeding tube?)	0.391	0.000
患者有营养补充剂医嘱吗? (Is the patient prescribed for nutritional supplements?)	0.136	0.043
有观察到患者有进食障碍或患者有进食障碍史吗? (Does the patient have been observed to have eating disorder or have a history of eating disorder?)	0.626	0.000
患者经常拒绝吃饭或者一天内只吃一顿主餐吗? (Does the patient often refuse to eat or eat only one main meal a day?)	0.486	0.000
患者经常都没有吃完一半的食物吗? (Does the patient often fail to eat at least half of their serving at most mealtimes?)	0.607	0.000
患者经常拒绝喝水或无法把水喝完吗? (Does the patient often refuse to drink water or fail to finish it?)	0.734	0.000
患者有咀嚼或吞咽困难吗? (Does the patient have any chewing or swallowing difficulties?)	0.545	0.000
患者有恶心、不自主呕吐或腹泻吗? (Does the patient suffer from nausea, involuntary vomiting or diarrhea?)	0.490	0.000
患者不愿吃某类食物(例如乳制品、水果和蔬菜)吗? [Does the patient not want to eat certain foods (e.g. dairy products, fruit & vegetables)?]	0.111	0.100

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精神障碍患者营养筛查工具的汉化与信度、效度研究

Reliability and validity of the Chinese version of St Andrew′s Nutrition Screening Instrument

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