Lee Yi-Chen, Hsu Ya-Chuan, Chiang Hui-Ying
Department of Nursing, Chi Mei Medical Center, Taiwan, ROC.
School of Nursing, Chang Jung Christian University, Taiwan, ROC.
Hu Li Za Zhi. 2017 Apr;64(2):66-75. doi: 10.6224/JN.000025.
Current oral assessment scales are designed to assess the severity of oral health in cancer patients who have undergone radiotherapy or chemotherapy. Currently, no scale is available that assesses the overall oral health situation of patients. However, this type of scale is critical for guiding nursing staff to understand the oral status of postoperative patients and for facilitating the development of patient-centered oral nursing treatments.
To develop the oral assessment scale for post-operational patients with oral cancer (OASPOCa) and establish its psychometric properties.
The ten associated items of the OASPOCa were determined using a series of five professional council meetings and two verifications of content validity by 5 experts in the field of oral cancer care. A pilot study was conducted on 30 participants and a formal study was conducted on 100 participants at the ICU and the oral and maxillofacial surgery ward at a medical center in southern Taiwan. All of the participants were oral cancer patients who had been admitted to excise tumors of oral cancer. None of the participants had been treated previously for oral cancer using chemotherapy or radiotherapy. The intraclass correlation coefficient (ICC), internal consistency reliability, and concurrent validity of the OASPOCa were evaluated.
A content validity of 1.0 was obtained. The inter-rater reliability assessment in the pilot study yielded ICCs of .97 for two assessment items ("lips" and "tongue") and 1.0 for the remaining eight items. The Cronbach's α coefficient was .72 for the OASPOCa. Further, a statistically significant negative relationship was found between overall oral status and oral comfort level (r = -.93, p < .001).
CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The oral assessment scale for post-operational patients with oral cancer was found to have good reliability and validity. This scale is a reliable tool for assessing the oral status of postoperative oral cancer patients.
目前的口腔评估量表旨在评估接受过放疗或化疗的癌症患者的口腔健康严重程度。目前,尚无用于评估患者整体口腔健康状况的量表。然而,这类量表对于指导护理人员了解术后患者的口腔状况以及促进以患者为中心的口腔护理治疗的开展至关重要。
开发口腔癌术后患者口腔评估量表(OASPOCa)并确定其心理测量特性。
通过一系列五次专业委员会会议以及口腔癌护理领域的5位专家进行的两次内容效度验证,确定了OASPOCa的十个相关项目。在台湾南部一家医疗中心的重症监护病房以及口腔颌面外科病房,对30名参与者进行了预试验研究,并对100名参与者进行了正式研究。所有参与者均为因口腔癌肿瘤切除术入院的口腔癌患者。所有参与者此前均未接受过口腔癌化疗或放疗治疗。对OASPOCa的组内相关系数(ICC)、内部一致性信度和同时效度进行了评估。
内容效度为1.0。预试验研究中的评分者间信度评估得出,两个评估项目(“嘴唇”和“舌头”)的ICC为0.97,其余八个项目的ICC为1.0。OASPOCa的Cronbach's α系数为0.72。此外,发现总体口腔状况与口腔舒适度之间存在统计学上显著的负相关(r = -0.93,p < 0.001)。
结论/对实践的启示:口腔癌术后患者口腔评估量表具有良好的信度和效度。该量表是评估口腔癌术后患者口腔状况的可靠工具。