一种用于评估康复期中风患者中风后抑郁症状的临床测量方法的开发与初步验证。

Development and initial validation of a clinical measure to assess symptoms of post-stroke depression in stroke patients at the rehabilitation stage.

作者信息

Chen Junya, Liu Jing, Zeng Yawei, Li Ruonan, Wang Yucui, Ding Weiwei, Guo Junyi, Lin Haiyun, Li Jufang

机构信息

School of Nursing, Wenzhou Medical University, Wenzhou, China.

Division of Emergency Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

Front Psychol. 2022 Jul 28;13:928257. doi: 10.3389/fpsyg.2022.928257. eCollection 2022.

DOI:10.3389/fpsyg.2022.928257

PMID:35967723

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9369669/

Abstract

BACKGROUND

The high incidence of post-stroke depression (PSD) during rehabilitation exerts a negative effect on the treatment and functional recovery of patients with stroke and increases the risk of mortality. It is necessary to screen PSD in the rehabilitation stage and thus provide effective intervention strategies. However, existing measurements used to assess PSD in the rehabilitation stage in patients with stroke lack specificity. This study aimed to develop a clinical measure to assess symptoms of PSD in the rehabilitation stage.

METHODS

The research team created the initial items through a literature review and semi-structured interviews of patients with stroke. Then, the symptom-related items were estimated by three panels: healthcare professionals ( = 41), Delphi experts ( = 15), and patients with stroke in the rehabilitation stage ( = 30).

RESULTS

The literature review and semi-structured interview produced 51 symptom-related items including six domains, and the items were reduced to 47 by the healthcare professionals. The symptom-related items were further reduced to 33 items by a two-round Delphi consultation. The initiative coefficients of the two Delphi rounds were 71.4 and 100%, the expert authority coefficients were both 0.85, Kendall's were 0.152 and 0.408 ( < 0.01), and the coefficient of variation (CV) were 0.05-0.32 and 0.00-0.18, respectively. The item-level content validity index (I-CVI) was 0.53-1.00, the scale-level CVI/universal agreement (S-CVI/UA) was 0.26, and the S-CVI/average (S -CVI/Ave) was 0.85 for the first found Delphi consultation; the I-CVI was 0.67-1.00, the S-CVI/UA was 0.61, and the S-CVI/Ave was 0.97 for the second round Delphi consultation. All content validity indicators have been significantly improved compared with the first round. Using mean ≥ 4 and full score ≥ 0.5, combined with CV ≤ 0.16 as the item criteria, a clinical measure of PSD with 33 items and 6 dimensions (cognition, sleep, behavior, emotion, body, and guilt) was finally formed after two rounds. The patients with stroke made no further revisions after evaluation.

CONCLUSION

The research team developed a specific tool with good content validity to assess the symptoms of PSD in the rehabilitation stage.

摘要

背景

中风后抑郁（PSD）在康复期间的高发病率对中风患者的治疗和功能恢复产生负面影响，并增加了死亡风险。在康复阶段筛查PSD并提供有效的干预策略很有必要。然而，目前用于评估中风患者康复阶段PSD的测评方法缺乏特异性。本研究旨在开发一种临床测评方法以评估康复阶段PSD的症状。

方法

研究团队通过文献综述和对中风患者的半结构式访谈创建了初始条目。然后，由三个小组对与症状相关的条目进行评估：医疗保健专业人员（n = 41）、德尔菲专家（n = 15）和康复阶段的中风患者（n = 30）。

结果

文献综述和半结构式访谈产生了51个与症状相关的条目，包括六个领域，医疗保健专业人员将这些条目减少到47个。经过两轮德尔菲咨询，与症状相关的条目进一步减少到33个。两轮德尔菲的积极系数分别为71.4%和100%，专家权威系数均为0.85，肯德尔和谐系数分别为0.152和0.408（P < 0.01），变异系数（CV）分别为0.05 - 0.32和0.00 - 0.18。第一轮德尔菲咨询的条目水平内容效度指数（I-CVI）为0.53 - 1.00，量表水平CVI/全体一致（S-CVI/UA）为0.26，S-CVI/平均值（S-CVI/Ave）为0.85；第二轮德尔菲咨询的I-CVI为0.67 - 1.00，S-CVI/UA为0.61，S-CVI/Ave为0.97。与第一轮相比，所有内容效度指标均有显著改善。以均值≥4且满分≥0.5，并结合CV≤0.16作为条目标准，经过两轮最终形成了一个包含33个条目、6个维度（认知、睡眠、行为、情绪、身体和内疚）的PSD临床测评方法。中风患者在评估后未提出进一步修改意见。