Chenier Christophe, Raiche Gilles, Talbot Nadine, Carignan Bianca, Gelinas Celine
Christophe Chenier, 10 741 Boulevard Saint-Laurent, Apt. 1, Montreal, QC, Canada, H3L 2P8,
J Appl Meas. 2017;18(1):28-42.
Patients hospitalized in the intensive care unit (ICU) are often unable to report their pain, which is a problem since untreated pain is associated with negative health outcomes. The use of behavioral pain scales are recommended for the detection of the presence of pain in this vulnerable population. Previous validation studies have used classical techniques, and several psychometrics properties remain unknown. In this paper, data obtained from a behavioral checklist of dichotomized items was utilized to evaluate the instrument's dimensionality, its construct validity and its capacity to distinguish between levels of pain by using Rasch measurement. A sample of 239 ICU patients was used to collect the data. Results showed that, while unidimensionality was acceptable, concerns remained about the local independence and item fit indices. A third of the items showed misfit. Finally, while items had a great reliability (0.97), persons' measures had a rather low reliability (0.62) and only 1.28 strata of pain could be distinguished. The narrow range of pain levels in the sample could explain this poor performance and further study is needed, with a sample exhibiting a wider range of pain levels.
入住重症监护病房（ICU）的患者往往无法报告自己的疼痛情况，而这是个问题，因为未经治疗的疼痛会带来不良健康后果。建议使用行为疼痛量表来检测这一脆弱群体是否存在疼痛。以往的效度验证研究采用的是经典技术，一些心理测量学特性仍不为人知。在本文中，从二分项目的行为清单中获取的数据被用于评估该工具的维度、结构效度以及通过使用拉施测量法区分疼痛程度的能力。抽取了239名ICU患者作为样本收集数据。结果显示，虽然单维性是可以接受的，但对局部独立性和项目拟合指数仍存在担忧。三分之一的项目显示不拟合。最后，虽然项目具有很高的信度（0.97），但个体测量的信度相当低（0.62），并且只能区分出1.28个疼痛层次。样本中疼痛水平范围较窄可以解释这种不佳表现，需要进一步开展研究，采用疼痛水平范围更广的样本。
