Li Yi-Min, Lee Henry Hsin-Chung, Lo Yu-Ling, Chao Hui-Lin
Yi-Min Li, Cathay General Hospital, Taipei, Taiwan. Henry Hsin-Chung Lee, PhD, Hsinchu Cathay General Hospital, Hsinchu, Taiwan; Graduate Institute of Translational and Interdisciplinary Medicine, College of Health Sciences and Technology, National Central University, Taoyuan, Taiwan; and School of Medicine, Fu Jen Catholic University, New Taipei, Taiwan. Yu-Ling Lo, Cathay General Hospital, Taipei, Taiwan. Hui-Lin Chao, Cathay General Hospital, Taipei, Taiwan.
J Wound Ostomy Continence Nurs. 2019 Mar/Apr;46(2):150-153. doi: 10.1097/WON.0000000000000510.
The purpose of this study was to evaluate content validity and feasibility of the Chinese language perineal assessment tool (PAT-C), to assess its use in the clinical setting, and establish an optimal cut point for identifying patients at high risk for incontinence-associated dermatitis (IAD).
Psychometric evaluation of existing instrument.
The sample comprised 440 patients managed in intensive care units of 3 hospitals across the island of Taiwan and an affiliated home care service. One hundred three nurses practicing throughout Taiwan participated in the workshops in the third phase of the experiment.
The content validity of the PAT-C was evaluated by 3 experienced nurses using the content validity index statistic. We calculated a receiver operating characteristics (ROC) curve to determine a cut point of high-risk IAD. The curve was based on assessment of patients from receiving care from the intensive care unit and home care service of Cathay General Hospital (located in Taipei, New Paipei and Hsinchu). Nurse perceptions on the feasibility of PAT-C were assessed using an investigator-developed survey.
Three experienced nurses rated the PAT-C and gave a robust overall content validity index score of 97.22%. The cut point for identifying patients at high risk for developing IAD via ROC curve analysis of 440 patients was 7.5 (sensitivity: 0.85; specificity: 0.79, area under curve: 0.82, P value < .001). One hundred three enrolled nurses attended the workshops and evaluated the feasibility using the PAT-C. Most of the participants considered the PAT-C as necessary (97.90%), 49.7% of participants suggested IAD risk assessment should be implemented by first-line (generalist) nurses, and 40% of participants recommended assessment on a daily basis.
Study findings indicate robust content validity, and results of the investigator survey of nurse perceptions of the PAT-C indicate the potential for its widespread use in the clinical setting. We found that a cut point score 8 or more indicates a high risk for developing IAD.
本研究旨在评估中文版会阴评估工具（PAT-C）的内容效度和可行性，评估其在临床环境中的应用，并确定识别失禁相关性皮炎（IAD）高危患者的最佳切点。
对现有工具进行心理测量评估。
样本包括台湾岛3家医院重症监护病房及附属居家护理服务机构管理的440例患者。全台湾103名护士参加了实验第三阶段的研讨会。
由3名经验丰富的护士使用内容效度指数统计法评估PAT-C的内容效度。我们计算了受试者工作特征（ROC）曲线以确定IAD高危切点。该曲线基于国泰综合医院（位于台北、新北和新竹）重症监护病房和居家护理服务机构接受护理患者的评估。使用研究者自行编制的调查问卷评估护士对PAT-C可行性的看法。
3名经验丰富的护士对PAT-C进行评分，总体内容效度指数得分为97.22%。通过对440例患者进行ROC曲线分析，识别IAD高危患者的切点为7.5（灵敏度：0.85；特异度：0.79，曲线下面积：0.82，P值<0.001）。103名登记护士参加了研讨会，并使用PAT-C评估可行性。大多数参与者认为PAT-C是必要的（97.90%），49.7%的参与者建议应由一线（普通）护士进行IAD风险评估，40%的参与者建议每天进行评估。
研究结果表明内容效度良好，研究者对护士对PAT-C看法的调查结果表明其在临床环境中具有广泛应用的潜力。我们发现切点分数为8分及以上表明发生IAD的风险较高。
