一种用于早期发现和风险评估幼儿养育和发育问题的结构化访谈的有效性和可靠性：一项横断面研究。
Validity and reliability of a structured interview for early detection and risk assessment of parenting and developmental problems in young children: a cross-sectional study.
机构信息
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
出版信息
BMC Pediatr. 2012 Jun 14;12:71. doi: 10.1186/1471-2431-12-71.
BACKGROUND
Preventive child health care is well suited for the early detection of parenting and developmental problems. However, as far as the younger age group is concerned, there are no validated early detection instruments which cover both the child and its environment. Therefore, we have developed a broad-scope structured interview which assesses parents' concerns and their need for support, using both the parental perspective and the experience of the child health care nurse: the Structured Problem Analysis of Raising Kids (SPARK). This study reports the psychometric characteristics of the SPARK.
METHOD
A cross-sectional study of 2012 18-month-old children, living in Zeeland, a province of the Netherlands. Inter-rater reliability was assessed in 67 children. Convergent validity was assessed by comparing SPARK-domains with domains in self-report questionnaires on child development and parenting stress. Discriminative validity was assessed by comparing different outcomes of the SPARK between groups with different levels of socio-economic status and by performing an extreme-groups comparison. The user experience of both parents and nurses was assessed with the aid of an online survey.
RESULTS
The response rate was 92.1% for the SPARK. Self-report questionnaires were returned in the case of 66.9% of the remaining 1721 children. There was selective non-reporting: 33.1% of the questionnaires were not returned, covering 65.2% of the children with a high-risk label according to the SPARK (p < 0.001). Inter-rater reliability was good to excellent with intraclass correlations between 0.85 and 1.0 for physical topics; between 0.61 and 0.8 for social-emotional topics and 0.92 for the overall risk assessment. Convergent validity was unexpectedly low (all correlations ≤0.3) although the pattern was as expected. Discriminative validity was good. Users were satisfied with the SPARK and identified some topics for improvement.
CONCLUSION
The SPARK discriminates between children with a high, increased and low risk of parenting and developmental problems. It does so in a reliable way, but more research is needed on aspects of validity and in other populations.
背景
预防儿童保健非常适合早期发现育儿和发育问题。然而，就年龄较小的儿童而言，目前还没有经过验证的早期检测工具可以同时涵盖儿童及其环境。因此，我们开发了一种广泛的结构化访谈，该访谈使用父母的观点和儿童保健护士的经验评估父母的关注和他们对支持的需求：结构化育儿问题分析（SPARK）。本研究报告了 SPARK 的心理测量特征。
方法
对居住在荷兰泽兰省的 2012 名 18 个月大的儿童进行了横断面研究。在 67 名儿童中评估了评分者间信度。通过比较 SPARK 域与儿童发展和育儿压力自我报告问卷的域，评估了聚合效度。通过比较 SPARK 之间具有不同社会经济地位水平的组之间的不同结果，以及进行极端组比较，评估了区分效度。使用在线调查评估了父母和护士的用户体验。
结果
SPARK 的回复率为 92.1％。在其余 1721 名儿童中，有 66.9％的儿童返回了自我报告问卷。存在选择性未报告：有 33.1％的问卷未返回，涵盖了根据 SPARK 具有高风险标签的 65.2％的儿童（p <0.001）。评分者间信度良好到优秀，身体主题的组内相关系数为 0.85 至 1.0；社会情感主题为 0.61 至 0.8；整体风险评估为 0.92。收敛效度出乎意料地低（所有相关性均≤0.3），尽管模式符合预期。区分效度良好。用户对 SPARK 感到满意，并确定了一些需要改进的主题。
结论
SPARK 可区分具有高，增加和低育儿和发育问题风险的儿童。它以可靠的方式做到了这一点，但需要在其他人群中进一步研究有效性的各个方面。
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