新生儿戒断评估工具（NWAT）：评分者间信度和内容效度的初步研究
The Neonatal Withdrawal Assessment Tool (NWAT): pilot inter-rater reliability and content validity.
作者信息
Bektas Gonca, Soderborg Taylor, Slater Cheryl, Agarwal Joel, Racioppi Michelle, Hogan Trystan, Werler Martha M, Wachman Elisha M
机构信息
Boston Combined Residency Program in Pediatrics, Boston Medical Center and Boston Children's Hospital, Boston, MA, USA.
Department of Pediatrics, Boston Medical Center, Boston, MA, USA.
出版信息
J Perinatol. 2023 Jul;43(7):930-935. doi: 10.1038/s41372-023-01641-4. Epub 2023 Mar 13.
OBJECTIVE
There is no validated tool to assess iatrogenic opioid withdrawal in preterm infants in the newborn intensive care unit (NICU).
STUDY DESIGN
The Neonatal Withdrawal Assessment Tool (NWAT) was developed to address this gap in clinical practice. In this pilot study, the NWAT was assessed for inter-rater reliability (IRR) and content validity.
RESULT
Fifty-one NICU providers scored two standardized simulated cases, then 20 paired provider assessments were completed on 5 preterm infants. The overall IRR was 95.6% on the simulated cases, and 98.8% on the 5 pilot infants. A provider survey assessed for content validity; all of the provider participants strongly agreed/agreed that the NWAT adequately measures withdrawal in critically ill infants.
CONCLUSION
The NWAT demonstrated high IRR and content validity for assessment of iatrogenic opioid withdrawal in preterm infants in this pilot study. Further studies in a larger more diverse patient population are needed before wider adoption into clinical practice.
目的
在新生儿重症监护病房（NICU）中，尚无经过验证的工具可用于评估早产儿的医源性阿片类药物戒断情况。
研究设计
开发了新生儿戒断评估工具（NWAT）以填补这一临床实践空白。在这项试点研究中，对NWAT的评分者间信度（IRR）和内容效度进行了评估。
结果
51名NICU医护人员对两个标准化模拟病例进行了评分，然后对5名早产儿完成了20对医护人员的评估。模拟病例的总体IRR为95.6%，5名试点婴儿的IRR为98.8%。通过医护人员调查评估内容效度；所有参与调查的医护人员都强烈同意/同意NWAT能够充分衡量危重症婴儿的戒断情况。
结论
在这项试点研究中，NWAT在评估早产儿医源性阿片类药物戒断方面表现出较高的IRR和内容效度。在更广泛应用于临床实践之前，需要在更大、更多样化的患者群体中进行进一步研究。
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