Construction And Analysis Of Reliability And Validity Of Physical Restraint Assessment Scale With Patients In Intensive Care Units

Objective: To construct an instrument for ICU health care personnel to assess physical restraint with patients in ICU.Methods:(1)The item pool established based on the literature review and translation of the related assessment tools abroa.(2)Delphi and AHP methods for two rounds consultation were applied in 22 nursing experts selected from 14 provinces.The consultation results were cacluated by the questionnaire response rates,the authority coefficient and the harmony coefficient.The mean and standard deviation,the coefficient of variation and expert's opinions were used to item selection.The weight of dimension and items were empowered by analytic hierarchy process.The final scale was formed by the preliminary experiment of pretest scale.(3)3 general hospitals in Chongqing were investigated by final scale.The scale's internal consistency and interevaluator reliability were tested by Cronbach'? coefficient and intraclass correlation coefficient.Content validity and structure validity were used to test the validity.Sensitivity,specificity,Youden index and Area under ROC curve were used to determine the evaluation threshold.Results:(1)The initial construction of the scale includes behaviour Level,device Level and myodynamia level of 3 dimensions(first grade indexs),11 items(second grade indexs)and 34 indicator descriptions.(2)The expert's positive coefficients of 2 rounds were 95.5% and 100% respectively,the authority coefficients of were 0.91 and 0.925 and the harmony coefficients of were 0.359 respectively,P<0.05,in the 2 rounds of Delphi with 22 experts.The final scale included 3 dimensions and 8 items was constructed by selection of indicators and expert opinions.The analytic hierarchy process(AHP)was empowered the dimensions and items,the weight of the dimensions were 0.7182,0.1906 and 0.0912 respectively.(3)The Cronbach'? coefficient was 0.704.The correlation coefficient(ICC)was 0.948(P=0.000 < 0.01)and the correlation coefficient of Spearman was 0.923(P=0.000 < 0.01).The content validity index I-CVI of the scale was 0.9575,and the S-CVI was 0.9583.When the evaluation threshold was 25,the sensitivity was 0.532(sensitivity),specificity(specificity)was 0.833 and the Youden index was in a maximum value of 0.365,the area under ROC curve was 0.759(P=0.000 = 0.05,95%CI:0.667-0.852).Conclusion: The scale analyzed by Delphi and AHP has good reliability and validity.It can be used for patient in ICU as an assessment tool.