患者-护士评定者间信度和 Richards-Campbell 睡眠问卷的一致性。
Patient-nurse interrater reliability and agreement of the Richards-Campbell sleep questionnaire.
机构信息
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
出版信息
Am J Crit Care. 2012 Jul;21(4):261-9. doi: 10.4037/ajcc2012111.
BACKGROUND
The Richards-Campbell Sleep Questionnaire (RCSQ) is a simple, validated survey instrument for measuring sleep quality in intensive care patients. Although both patients and nurses can complete the RCSQ, interrater reliability and agreement have not been fully evaluated.
OBJECTIVES
To evaluate patient-nurse interrater reliability and agreement of the RCSQ in a medical intensive care unit.
METHODS
The instrument included 5 RCSQ items plus a rating of nighttime noise, each scored by using a 100-mm visual analogue scale. The mean of the 5 RCSQ items comprised a total score. For 24 days, the night-shift nurses in the medical intensive care unit completed the RCSQ regarding their patients' overnight sleep quality. Upon awakening, all conscious, nondelirious patients completed the RCSQ. Neither nurses nor patients knew the others' ratings. Patient-nurse agreement was evaluated by using mean differences and Bland-Altman plots. Reliability was evaluated by using intraclass correlation coefficients.
RESULTS
Thirty-three patients had a total of 92 paired patient-nurse assessments. For all RCSQ items, nurses' scores were higher (indicating "better" sleep) than patients' scores, with significantly higher ratings for sleep depth (mean [SD], 67 [21] vs 48 [35], P = .001), awakenings (68 [21] vs 60 [33], P = .03), and total score (68 [19] vs 57 [28], P = .01). The Bland-Altman plots also showed that nurses' ratings were generally higher than patients' ratings. Intraclass correlation coefficients of patient-nurse pairs ranged from 0.13 to 0.49 across the survey questions.
CONCLUSIONS
Patient-nurse interrater reliability on the RCSQ was "slight" to "moderate," with nurses tending to overestimate patients' perceived sleep quality.
背景
Richards-Campbell 睡眠问卷 (RCSQ) 是一种简单、经过验证的工具，用于测量重症监护病房患者的睡眠质量。虽然患者和护士都可以完成 RCSQ，但评分者间信度和一致性尚未得到充分评估。
目的
评估重症监护病房患者-护士间 RCSQ 的评分者间信度和一致性。
方法
该工具包括 5 个 RCSQ 条目和夜间噪声评分，每项均采用 100mm 视觉模拟评分量表进行评分。5 个 RCSQ 条目的平均值构成总分。在 24 天内，重症监护病房的夜班护士对其患者的夜间睡眠质量进行 RCSQ 评估。当患者醒来时，所有清醒、无谵妄的患者均完成 RCSQ。护士和患者均不知道对方的评分。通过平均差值和 Bland-Altman 图评估患者-护士间的一致性。通过组内相关系数评估信度。
结果
33 例患者共有 92 对患者-护士评估。对于所有 RCSQ 条目，护士的评分（表示“更好”的睡眠）高于患者的评分，在睡眠深度（平均[标准差]，67[21]比 48[35]，P=.001）、觉醒（68[21]比 60[33]，P=.03）和总分（68[19]比 57[28]，P=.01）方面的评分显著更高。Bland-Altman 图也表明，护士的评分普遍高于患者的评分。患者-护士对的组内相关系数在调查问题上的范围为 0.13 至 0.49。
结论
RCSQ 上患者-护士间评分者间信度为“轻度”至“中度”，护士倾向于高估患者感知的睡眠质量。
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