一种用于比较护士对危重症儿童疼痛的评估和干预选择的虚拟人物案例的开发与验证
Development and validation of a virtual human vignette to compare nurses' assessment and intervention choices for pain in critically ill children.
作者信息
LaFond Cynthia M, Van Hulle Vincent Catherine, Lee Sangyoon, Corte Colleen, Hershberger Patricia E, Johnson Andrew, Park Chang G, Wilkie Diana J
机构信息
From the College of Nursing, University of Iowa (C.M.L.), Iowa City, IA; Center of Excellence for End-of-Life Transition Research, Department of Biobehavioral Science, College of Nursing, University of Iowa (D.J.W.), Department of Women, Children, & Family Health Science, College of Nursing, University of Illinois at Chicago (C.V.H.V.), Electronic Visualization Laboratory, Computer Science, University of Illinois at Chicago (A.J.), Department of Health Systems Science, College of Nursing, University of Illinois at Chicago (C.C., P.E.H., C.G.P.), Chicago, IL; and Computer Science, Connecticut College (S.L.), New London, CT.
出版信息
Simul Healthc. 2015 Feb;10(1):14-20. doi: 10.1097/SIH.0000000000000061.
INTRODUCTION
As virtual experiences are increasingly used in health care training and research, it is important that adequate processes are applied for developing valid scenarios. We describe the development and validation of virtual human (VH) vignettes, computer-generated scenarios with animated patients and clinical information, for a mixed-methods study regarding nurses' assessment and intervention choices for critically ill children's pain.
METHODS
We followed the case development and review process for high-fidelity simulation case scenarios, including the use of validated written vignettes and content experts. Forty nurses described their pain assessment and intervention choices for the newly derived VH vignettes and completed a pain questionnaire. Nurses' reports of VH vignette consistency with their professional experience and recognition of VH facial expressions were evaluated to establish face validity. Their pain ratings for the VH and written (questionnaire) vignettes were evaluated for convergent validity. Qualitative content analysis, descriptive statistics, correlations, and paired t tests were used.
RESULTS
Most nurses (68.4%) supported vignette consistency with their professional experience. Facial expression recognition was 98.4%. Smiling children's pain was rated significantly lower than grimacing children in both VH and written vignettes. Pain was rated significantly lower for grimacing children in the VH vignettes than the written vignettes. Virtual human vignette pain ratings were strongly correlated with their written counterparts.
CONCLUSIONS
This process was effective for developing VH vignettes that demonstrated good face validity with participants and convergent validity with written vignettes. Virtual human vignettes may be useful in studying the influence of facial actions on nurses' choices for children's pain assessment and treatment.
引言
随着虚拟体验在医疗培训和研究中的应用越来越广泛，应用适当的流程来开发有效的场景非常重要。我们描述了虚拟人（VH） vignettes的开发和验证过程，这是一种带有动画患者和临床信息的计算机生成场景，用于一项关于护士对危重症儿童疼痛评估和干预选择的混合方法研究。
方法
我们遵循了高保真模拟案例场景的案例开发和审查流程，包括使用经过验证的书面vignettes和内容专家。40名护士描述了他们对新生成的VH vignettes的疼痛评估和干预选择，并完成了一份疼痛问卷。评估护士关于VH vignettes与他们专业经验的一致性报告以及对VH面部表情的识别，以建立表面效度。评估他们对VH和书面（问卷）vignettes的疼痛评分，以确定收敛效度。使用了定性内容分析、描述性统计、相关性分析和配对t检验。
结果
大多数护士（68.4%）支持vignettes与他们的专业经验一致。面部表情识别率为98.4%。在VH和书面vignettes中，微笑儿童的疼痛评分均显著低于 grimacing儿童。VH vignettes中 grimacing儿童的疼痛评分显著低于书面vignettes。虚拟人vignettes的疼痛评分与书面评分高度相关。
结论
这个过程对于开发VH vignettes是有效的，该vignettes对参与者显示出良好的表面效度，与书面vignettes具有收敛效度。虚拟人vignettes可能有助于研究面部动作对护士儿童疼痛评估和治疗选择的影响。
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