一种用于精神疾病中运动障碍的护士执行筛查工具的开发与临床测量评估
Development and clinimetric assessment of a nurse-administered screening tool for movement disorders in psychosis.
作者信息
Balint Bettina, Killaspy Helen, Marston Louise, Barnes Thomas, Latorre Anna, Joyce Eileen, Clarke Caroline S, De Micco Rosa, Edwards Mark J, Erro Roberto, Foltynie Thomas, Hunter Rachael M, Nolan Fiona, Schrag Anette, Freemantle Nick, Foreshaw Yvonne, Green Nicholas, Bhatia Kailash P, Martino Davide
机构信息
Neurologist, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, UK and Department of Neurology, University of Heidelberg, Germany.
Psychiatrist, Division of Psychiatry, Department of Primary Care and Population Health, University College London and Priment Clinical Trials Unit, University College London, UK.
出版信息
BJPsych Open. 2018 Sep 27;4(5):404-410. doi: 10.1192/bjo.2018.55. eCollection 2018 Sep.
BACKGROUND
Movement disorders associated with exposure to antipsychotic drugs are common and stigmatising but underdiagnosed.
AIMS
To develop and evaluate a new clinical procedure, the ScanMove instrument, for the screening of antipsychotic-associated movement disorders for use by mental health nurses.
METHOD
Item selection and content validity assessment for the ScanMove instrument were conducted by a panel of neurologists, psychiatrists and a mental health nurse, who operationalised a 31-item screening procedure. Interrater reliability was measured on ratings for 30 patients with psychosis from ten mental health nurses evaluating video recordings of the procedure. Criterion and concurrent validity were tested comparing the ScanMove instrument-based rating of 13 mental health nurses for 635 community patients from mental health services with diagnostic judgement of a movement disorder neurologist based on the ScanMove instrument and a reference procedure comprising a selection of commonly used rating scales.
RESULTS
Interreliability analysis showed no systematic difference between raters in their prediction of any antipsychotic-associated movement disorders category. On criterion validity testing, the ScanMove instrument showed good sensitivity for parkinsonism (90%) and hyperkinesia (89%), but not for akathisia (38%), whereas specificity was low for parkinsonism and hyperkinesia, and moderate for akathisia.
CONCLUSIONS
The ScanMove instrument demonstrated good feasibility and interrater reliability, and acceptable sensitivity as a mental health nurse-administered screening tool for parkinsonism and hyperkinesia.
DECLARATION OF INTEREST
None.
背景
与抗精神病药物暴露相关的运动障碍很常见且令人感到耻辱，但诊断不足。
目的
开发并评估一种新的临床程序——ScanMove工具，用于精神科护士筛查抗精神病药物相关运动障碍。
方法
由一组神经科医生、精神科医生和一名精神科护士对ScanMove工具进行项目选择和内容效度评估，他们实施了一项包含31个项目的筛查程序。通过10名精神科护士对30例精神病患者的程序视频记录评分来测量评分者间信度。将13名精神科护士基于ScanMove工具对635名社区精神卫生服务患者的评分与一名运动障碍神经科医生基于ScanMove工具及包括一系列常用评定量表的参考程序做出的诊断判断进行比较，测试效标效度和同时效度。
结果
评分者间信度分析显示，评分者在预测任何抗精神病药物相关运动障碍类别方面无系统差异。在效标效度测试中，ScanMove工具对帕金森症（90%）和运动增多（89%）显示出良好的敏感性，但对静坐不能（38%）不敏感，而对帕金森症和运动增多的特异性较低，对静坐不能的特异性中等。
结论
ScanMove工具作为一种由精神科护士实施的用于筛查帕金森症和运动增多的工具，显示出良好的可行性和评分者间信度，以及可接受的敏感性。
利益声明
无。
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