婴儿疼痛行为指征量表的汉化及信效度检验

Reliability and validity of the Chinese version of Behavior Indicators of Infant Pain for neonates

摘要:

目的：对婴儿疼痛行为指征量表（Behavior Indicators of Infant Pain, BIIP）进行汉化，形成中文版婴儿疼痛行为指征量表（Chinese Version of BIIP, C-BIIP）并检验其信效度。方法：首先，对BIIP进行翻译、回译和语义分析，形成C-BIIP。其次，便利抽样选取符合标准的199 例足月儿和197 例早产儿作为研究对象。2名新生儿重症监护室护士观看新生儿采血过程的视频并使用C-BIIP和中文版FLACC量表（Facial Expression, Legs, Activity, Crying, and Consolability Scale, FLACC）在操作前、中、后进行独立疼痛评分。最后，采用统计学方法评价量表信效度。结果：该量表的内部一致性Cronbach’ α系数为0.895（足月儿）和0.904（早产儿）；相隔2周后的重测Spearman相关系数分别为0.938（足月儿）和0.947（早产儿）；评分者信度在致痛性操作前、中、后三个阶段分别为0.961～0.988（足月儿）和0.921～0.959（早产儿）。C-BIIP的条目水平内容效度和平均量表水平内容效度均为1.000；与FLACC量表的Spearman相关系数为0.896（足月儿）和0.948（早产儿）；探索性因子分析结果显示提取的2个公因子的累计总方差贡献率为80.876%（足月儿）和77.740%（早产儿），纳入因子分析的7 个条目的因子载荷量均大于0.4；操作前、中、后3 个阶段间的评分均不同（P < 0.001）。结论：C-BIIP具有较好的信度和效度，可用于评估新生儿患者操作性疼痛。

Abstract:

Objective: to transform the Behavior Indicators of Infant Pain (BIIP) into the Chinese version of BIIP (C-BIIP), and to test its effectiveness including reliability and validity in neonates treated in Neonatal Intensive Care Unit (NICU). Method: The procedure of chinesization included translation, back-translation and semantic adaption. A convenient sample of 199 term infants and 197 preterm infants was selected. Video recorded the process of neonatal blood collection. Then two trained NICU nurses using the C-BIIP and Chinese version of FLACC to assess pain before, during and after the blood collection process. Results: the scale included 3 dimensions and 13 items. The Internal Consistency Cronbach's coefficient were 0.895 in term and 0.904 in preterm. The Test-retest Reliability were 0.938 in term and 0.947 in preterm. And Interclass Correlation Coefficients was from 0.961 to 0.988 (term) and from 0.921 to 0.959 (preterm). The Content validity was excellent which I-CVI and S-CVI were 1. The correlations between the scale and Chinese vision of FLACC were 0.896 in term and 0.948 in preterm. The accumulative contribution rate of two common factors produced by the factor analysis reached 80.876% in term and 77.740% in preterm. The factor loadings in most items were greater than 0.4. The scores of three phases are different with each other (P < 0.001). Conclusion: C-BIIP has a good reliability and validity, which can be used to evaluate the neonatal patients’ operational pain.