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护理学报 ›› 2021, Vol. 28 ›› Issue (4): 67-72.doi: 10.16460/j.issn1008-9969.2021.04.067

• 妇产科护理 • 上一篇    下一篇

高危孕产妇病情预警评估表的构建及信效度检验

夏杰1,2, 段霞3, 张佳男4, 于婵5, 王可可4   

  1. 1.同济大学医学院,上海 200092;
    2.上海建桥学院,上海 201306;
    3.同济大学附属第一妇婴保健院,上海 201204;
    4.同济大学附属第十人民医院,上海 200072;
    5.上海市第一人民医院,上海 200080
  • 收稿日期:2020-07-15 出版日期:2021-02-25 发布日期:2021-03-12
  • 通讯作者: 段霞（1983-）,女,湖南常德人,博士,副主任护师,硕士研究生导师。E-mail:bamboo-714@163.com
  • 作者简介:夏杰（1979-）,女,河北承德人,硕士,副主任护师。
  • 基金资助:
    国家自然科学基金（71603183）

Construction of Early Warning Assessment Scale for High-risk Pregnant Women and Its Reliability and Validity

XIA Jie1,2, DUAN Xia3, ZHANG Jia-nan4, YU Chan5, WANG Ke-ke4   

  1. 1. School College of Medicine, TongjiUniversity, Shanghai 200092, China;
    2. Shanghai Jian QiaoUniversity, Shanghai 201306,China;
    3. Maternal and Infant Health Care Hospital Affiliated to TongjiUniversity, Shanghai 201204, China;
    4. the 10th People's Hospital Affiliated to TongjiUniversity, Shanghai 200072, China;
    5. Shanghai General Hospital, Shanghai 200080, China
  • Received:2020-07-15 Online:2021-02-25 Published:2021-03-12

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摘要： 目的 研制适合我国临床使用的高危孕产妇病情预警评估表,检验评估表的信效度和对病情的预测效能。方法 通过文献研究、德尔菲专家咨询法,形成高危孕产妇病情预警评估表初稿;应用评估表对150例入院高危孕产妇进行评估,检验评估表的信度和效度,并分析其对高危孕产妇发生病危/病重的预测效能。结果 高危孕产妇病情预警评估表包括4个维度,23个条目;评定者间信度（intra-class correlation coefficient,ICC）为0.905,95%可信区间（confidence interval,CI）为0.855~0.945;内容效度比（content validity ratio,CVR）平均值为0.96,评估表灵敏性为92.5%,特异度为68.2%,阳性预测值为51.4%,阴性预测值为97.4%,阳性似然比为18.00,阴性似然比为0.53,约登指数为0.61,受试者工作特征曲线下面积（area under the receiver operating characteristic curve,AUROC）为0.803;预测病危/病重的AUROC为0.719,灵敏性85.7%,特异度为58.1%,阳性似然比为10.23,阴性似然比为0.64,预测效果较好。结论 本研究构建的高危孕产妇病情预警评估表具有较好的信度和效度,对发生产科急性事件和产科危重症的预测效果好,可作为临床高危孕产妇病情评估的工具,为高危孕产妇病情的早期预警评估提供依据。

关键词: 高危孕产妇, 早期预警, 评估, 信度, 效度

Abstract: Objective To develop an early warning assessment scale for high-risk pregnant women, and to test the reliability and validity and explore its predictive value. Methods With literature review and Delphi expert consultation method, the draft of early warning assessment scale for high-risk pregnant women was formed. The reliability and validity of the scale were tested in 150 high-risk hospitalized pregnant women, and the predictive efficacy of the scale for the occurrence of serious/critical disease in high-risk pregnant women was analyzed. Results The early warning assessment scale for high-risk pregnant women consisted of 4 dimensions and 23 items. The intra-class correlation coefficient (ICC) was 0.905, and the 95% confidence interval (CI) ranged from 0.855 to 0.945. The average content validity ratio (CVR) was 0.96 and the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and Jordan index were 92.5%, 68.2%, 51.4%, 97.4%, 18.00, 0.53 and 0.61 respectively, and AUROC of the assessment scale was 0.803. AUROC of predicting severe/critical disease was 0.719 and the sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were 85.7%, 58.1%, 10.23, and 0.64 respectively. Conclusion The early warning assessment scale for high-risk pregnant women constructed in this study has good reliability and validity. It can predict the occurrence of acute obstetric events and critical obstetric diseases. The scale can be used as a tool to evaluate the condition of high-risk pregnant women and provide basis for early warning and evaluation of high-risk pregnant women.

Key words: high-risk pregnant women, early warning, assessment, reliability, validity

中图分类号: 

  • R473.71
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