摘要
目的:研究脑卒中后9个吞咽困难量表在国内使用的信度和效度。方法:56例连续住院的神经内科住院患者进行量表的评定及电视透视检查。量表的信度用kappa相关,校标效度用Spearman相关分析,预测效度用分组方差分析、Logistic回归分析及Spearman相关。敏感度采用效应尺度分析,量表间的相关性用Spearman相关分析。结果:所有量表均具有统计学意义的重测信度及评定者间信度。量表2的信度最好(重测信度Kappa值=0.87,P<0.01;评定者间信度Kappa值=0.665,P<0.01),但量表2,5,6,7,9的效度指标(与VF下分级的相关性、误吸预测准确率、与住院期间肺炎和出院时皮脂厚度的相关性)总体来讲不满意,量表1和4的结构及侧重点相似,相关性较好(r=0.728,P<0.01),但前者效度优于后者。量表3是9个量表中信度效度均佳的量表。结论:今后的临床使用或科研中推荐使用量表3评定脑卒中后吞咽功能。
AIM:To study the reliability and validity of the nine rating scales for dysphagia in stroke patients in China.METHODS:Totally 56 consecutive inpatients with dysphagia of stroke at the Department of Neurology were assessed with the nine scales and received video-fluoroscopy test.Reliability was analyzed by using Kappa correlation. Criteria validity was determined by Spearman rank correlation coefficients.Predictive validity was completed by analysis of variance,logistic regression analysis and spearman correlation analysis.Sensitivity was analyzed by effective scale.The correlation among the 9 scales was evaluated by Spearman correlation analysis.RESULTS:All the scales had significant test-retest reliability and inter-rater reliability.Scale 2 had the best reliability(Test-retest reliability,Kappa=0.87,P< 0.01;Inter-rater reliability,Kappa=0.665,P< 0.01). However,in the mass,there were not satisfied validity markers(the correlation with the grade under video-fluoroscopy,the predictive accuracy of aspiration,correlation with pneumonia in hospital and skin-fold thickness discharged from hosptial) in the scales 2,5,6,7 and 9.Scales 1 and 4 had the similar construction and emphasis,but scale 1 had better validity than scale 4(r=0.728,P< 0.01).Scale 3 had the better reliability and validity of the 9 scales.CONCLUSION:Scale 3 is recommended in evaluation of dysphagia in patients with stroke for the future clinical work or study.
出处
《中国临床康复》
CSCD
2004年第7期1201-1203,共3页
Chinese Journal of Clinical Rehabilitation
