Development And Quality Evaluation Of The TCM Five-viscera Deficiency Syndrome Differentiation Assessment Scale For Frail Elderly Peopl

ObjectiveEstablish the diagnosis and evaluation scale of TCM five viscera deficiency in the frail elderly and evaluate the quality of the scale,so as to provide objective and standard evaluation tools for TCM diagnosis and treatment system in the frailty.Methods1.Literature investigation:Through the search of CNKI,Wanfang data,Chinese science and technology journal database(VIP),finding documents of which main research contents are five viscera deficiency and related syndrome,while the type of documents is required to be diagnosis criteria or expert consensus.Searching TCM monograph syndrome in the Wenjin database.The frequency analysis of the syndrome types,main characters and signs of the five viscera deficiency was performed,and a research team was set up to initially screen the items of the syndrome types,characters and signs,and then the item pool was constructed preliminarily.2.Expert consultation Delphi method:On the basis of the preliminary item pool,construct the expert consultation questionnaire and conduct it,and then modify,supplement and delete the items according to results.3.Clinical investigation:On the basis of the results of expert consultation,the clinical questionnaire was formulated.Through clinical research,the scale items were quantified by marks,determined critical values and graded score degree,and further screened,so that the diagnosis and evaluation scale of TCM five viscera deficiency in the frail elderly was initially formed.4.Quality evaluation:After the scale was formed,evaluate the feasibility,reliability and validity of the scale.Rusults1.Literature investigation results:A total of 4179 documents were searched in the three databases,and 21 documents were finally included in the analysis;26 monographs of TCM syndrome study were retrieved,and 5 monographs were included in the analysis.After the selection of characters and signs,there were 5 viscera dimensions and 15 syndrome dimensions of " Diagnosis and evaluation scale of TCM five viscera deficiency in the elderly" were formed,and 524 items were extracted,and left 78 items after the research team preliminary screening,then the item pool was formed.2.Expert consultation Delphi method:A total of 32 experts were included for expert questionnaire consultation,The positive factor of experts were 100%;The coefficient of authority in the total scale was 0.78;The coefficient of coordination in necessity and availability of each item was<0.25;Item necessity Kendall coefficient of concordance=0.041,chi-square value=72.990,and Chi-square test P=0.000(<0.05),Item availability Kendall coefficient of concordance=0.016,chi-square value=28.366,and Chi-square test P=0.013(<0.05).After selecting the items by expert consultation,54 items finally remained.3.Clinical investigation results:83 cases were investigated,2 items were excluded after further screening,and the remaining 52 items were authorized;Fisher discriminant was used to quantify items by marks,critical values of items were determined by ROC curve and Youden index,and quartile method was used to grade score degree.The scale of 5 viscera dimensions,15 syndrome dimensions and 52 items was formed initially.4.Quality evaluation results:A total of 127 cases were quality assessed.The acceptance rate and completion of the scale were 100%,and the completion time was 15-25min;the overall Kronbach a coefficient was 0.882;In the viscera dimension,the coefficient of liver deficiency dimension was 0.447,and the others were greater than 0.5;In the syndrome dimension,the Kronbach a coefficient of Spleen-Yang deficiency dimension is 0.356,and the others were greater than 0.6;the GuttmanSpilit-Half of the scale was 0.792.The P-value of the character dimension,syndrome-type dimension,viscera dimension,and total table were less than 0.01;the KMO value was 0.792,11 common factors were extracted,the cumulative contribution of variance is 75.143%,all items attributable factor load value were>0.4;The t-test ranked all 127 cases according to total score,the highest 27%individuals form high group,the 27%individuals with the lowest score form low group,and the P-value of syndrome dimension,viscera dimension and scale were<0.05.ConclusionThis study through the literature investigation,expert consultation,clinical investigation developed the diagnosis and evaluation scale of TCM five viscera deficiency in the frail elderly,and evaluate the feasibility,reliability,validity,evaluation results show that the scale has good feasibility,reliability and validity,can be used as the frail elderly TCM deficiency syndrome evaluation tools.