Servicio Canario de la Salud, Gerencia de Atención Primaria, Tenerife, España.
Facultad de Ciencias de la Salud, Universidad Europea de Canarias, Tenerife, España.
Emergencias. 2018;30(2):105-114.
To validate a Spanish adaptation of the Mishel Uncertainty of Illness Scale for use with emergency-department (ED) patients and their accompanying relatives or friends (the UIS-ED).
We first developed a version of the questionnaire for Spanish ED situations. Next we assessed the content validity index for each of its items, revised it, and reassessed its face validity to produce a second version, which we then piloted in 20 hospital ED patients. A third revised version was then validated in a population of 320 adults (160 patients and 160 accompanying persons) who attended the ED between November 2015 and September 2016. The 12-item UIS-ED (60 points) was administered by 2 nurses while the patients and accompanying persons were in the ED. We gathered sociodemographic and clinical data as well as the subjects' perception about the information they were given.
The mean (SD) uncertainty score among patients was 29 (11) points. Accompanying persons had a mean score of 36 (13) points. Factorial analysis confirmed the instrument's construct validity, finding that both dimensions of the original Mishel scale (complexity and ambiguity) were present in 6 items each. Factorial analysis explained 60% of the total variance in the patient version and 67% of the variance in the version for accompanying persons. Reliability statistics were good, with Cronbach's α values ranging from 0.912 to 0.938. Split-half reliability statistics ranged from 0.901 to 0.933. Correlations were significant in the analysis of convergent validity.
The UIS-ED questionnaire may prove to be a simple, valid, and reliable way for assessing uncertainty in patients and their accompanying friends or relatives attending Spanish EDs.
验证用于急诊科（ED）患者及其陪同亲属或朋友的西班牙版米舍尔疾病不确定感量表（UIS-ED）。
我们首先开发了一种针对西班牙 ED 情况的问卷版本。然后评估其每个项目的内容效度指数，对其进行修订，并重新评估其表面效度，以产生第二版。随后在 20 名医院 ED 患者中进行了试点研究。然后，在 2015 年 11 月至 2016 年 9 月期间在 ED 就诊的 320 名成人（160 名患者和 160 名陪同人员）中对经过修订的第三版进行了验证。在 ED 期间，由 2 名护士对 12 项 UIS-ED（60 分）进行管理，同时对患者和陪同人员进行评估。我们收集了社会人口统计学和临床数据，以及患者和陪同人员对所提供信息的看法。
患者的平均（SD）不确定性评分为 29（11）分。陪同人员的平均评分为 36（13）分。因子分析证实了该工具的结构效度，发现原始米舍尔量表的两个维度（复杂性和歧义性）各有 6 项。因子分析解释了患者版本总方差的 60%和陪同人员版本方差的 67%。可靠性统计数据良好，克朗巴赫的α值范围为 0.912 至 0.938。分半可靠性统计数据范围为 0.901 至 0.933。在对会聚有效性的分析中，相关性具有统计学意义。
UIS-ED 问卷可能是一种简单，有效且可靠的方法，可用于评估西班牙 ED 患者及其陪同朋友或亲属的不确定性。
