Localization And Application Of ICU Activity Scale In China

Objective1.Sinicization and cross-cultural debugging of the ICU Mobility Scale(IMS)was conducted to verify the reliability and validity of the Chinese version of the IMS Scale.The MRC-score < 48 was considered as the standard.To explore the application value of Chinese version IMS scale in the diagnosis of ICU-AW and determine its threshold,so as to provide reference for the evaluation tool of ICU acquired frailness.2.The Chinese version of IMS scale was used to investigate the status quo of patients with acquired weakness in ICU,and the influencing factors were analyzed to explore the practicability and clinical response of the scale.MethodsThis study consists of two parts: The first part is the localization,reliability and validity test and diagnostic threshold of IMS scale.The second part is the current situation investigation of ICU patients with acquired frailty and analysis of influencing factors.The first part is the localization of the English version of IMS scale.Firstly,the original author of the scale was approved by email.After cross-cultural debugging of the scale,the Chinese version of the English version of IMS scale was finally determined through expert consultation and pre-experimental investigation according to the Brislin double translation and translation method.A total of 200 ICU patients from a level-A hospital in Hubei Province were selected as the research subjects.In terms of reliability research,the inter-evaluator reliability of the Chinese version of IMS scale was tested.In terms of validity research,item content validity index(I-CVI)and scale content validity index(S-CVI)were used to measure the content validity of the scale,and the Chinese IMS scale and the Medical Research Council Score scale(MRC-SCORE)were used to test the correlation validity of the criteria.As for the determination of diagnostic threshold,the MRC-score < 48 was used to determine the application value of the Chinese version of IMS scale in diagnosing ICU-AW and its threshold by calculating the area under the ROC curve and Youden index.The second part is a cross-sectional study.A total of 192 ICU patients from a Grade A hospital in Hubei province were selected by convenience sampling method.The general data questionnaire,Chinese IMS scale,MRC-SCORE scale,and acute physiological and chronic health assessment Ⅱ(APACHE Ⅱ)were used to investigate the status of ICU acquired frailty and analyze its influencing factors.Statistical data were analyzed using SPSS23.0.Statistical methods included statistical description,homogeneity test of variance,normality test,and non-parametric Mann-Whitney U test.Multiple linear regression analysis was conducted for statistically significant variables in univariate analysis.ResultsThe results of the first part show that the Chinese version of the IMS scale,which is suitable for China’s cultural background,is finally formed through Brislin double translation and translation,expert consultation and pre-experimental research on the IMS scale.The Chinese version of the IMS scale is determined to include 11 items.The interevaluator weighted Kappa coefficient of the Chinese version of IMS scale was 0.856(P < 0.05),the content validity I-CVI was between 0.86-1.00,and the mean S-CVI was 0.98.Spearman correlation coefficient of the Chinese version of IMS scale and the MRC-SCORE scale was 0.874(P < 0.01).MRC-Score< 48 divided into standard,to explore Chinese IMS scale sensitivity and specificity in the diagnosis of ICU-AW Chinese IMS scale the best cutoff value is 5.5,the area under the ROC curve was 0.945(95% CI: 0.917 0.972),the sensitivity was 95.9%,76.2%,the Kappa consistency test method for MRC-Score scale and the Chinese version of IMS scale diagnostic test in the ICU-AW consistency,The results showed that Kappa=0.671(P <0.01),which was statistically significant,indicating that the two scales had good consistency in diagnosing ICU-AW within their respective thresholds.The second part of the results showed that on 192 ICU patients in ICU-AW,analyzing the present situation investigation and influencing factors of ICU-AW incidence was 36%,the evaluation of age,hospitalization days,the time of mechanical ventilation,the Chinese version of APACHE Ⅱ score,IMS rating scale,sedative drugs,insulin,enteral nutrition and parenteral nutrition,constraints,shock and other factors in the Mann-Whitney U test analysis,the results show that the differences were statistically significant(P < 0.05).Multiple linear regression analysis showed that the major influencing factors were shock,Chinese IMS scale score,hospital stay,and mechanical ventilation duration,which accounted for 70.5% of the variation in ICU-AW patients,with statistical significance(P < 0.05).Conclusions1.The Chinese version of IMS scale is simple and convenient to operate,and has good inter-evaluator reliability,content validity and criterion correlation validity.The best cutoff value of the Chinese version of IMS scale in diagnosing ICU-AW is 5.5 points,with good sensitivity and specificity,which is worthy of promotion and application in the field of critical care medicine.2.According to the current situation investigation of ICU-AW,the incidence of ICU-AW patients is high,which is related to shock,Chinese IMS scale score,hospital stay,mechanical ventilation time and other major factors.Early assessment of the activity and function of ICU patients should be carried out,and active preventive and treatment measures should be taken to reduce the occurrence of ICU-AW.As a better screening tool,Chinese version of IMS scale has important clinical application value in accurately identifying and evaluating the activity and function of ICU-AW patients.