The Reliability And Validity Of The Chinese Version Of The Modified Yale Preoperative Anxiety Scale

Objective1.Using the scientific method to introduce foreign modified Yale preoperative anxiety scale(m-YPAS),through the translation,back translation,cultural adaptation finished the program,forming the Chinese version modified Yale preoperative anxiety scale(Cm-YPAS).To provide a basis for the establishment of anxiety assessment tools for children before operation in China.2.To evaluate the reliability and validity of the Chinese version of the modified Yale preoperative anxiety scale,and to explore the applicability of the scale in assessing the anxiety level of Chinese children before operation.3.To find out the Cm-YPAS anxiety thresholds in the preoperative holding,walk to the operation room,entrance to the operation room,the degree of anxiety during the induction of anesthesia at 4 time points.Methods1.With the permission from the author of m-YPAS,Zeev N.Kain,according to the scientific Brislin translation method,the English version of the m-YPAS scale is translated,to form the Chinese version of modified Yale preoperative anxiety scale(Cm-YPAS).2.From July 2017 to October 2017,31 children aged 2~12 years undergoing selective operation were selected in a third class hospital at a provincial level.The basic information was collected on the day before operation,and the investigators checked the questionnaire on the spot to ensure that there was no missing item.On the day of operation,the children were videotaped in the preoperative holding,walk to the OR,entrance to the OR and introduction to the anesthesia mask.3.9 different qualified and professional evaluators were asked to watch the video,and the Cm-YPAS was used to evaluate the anxiety of the children at the 4 time points of the preoperative holding to the anesthesia induction period.At the same time,2 children's psychosocial experts evaluated the anxiety degree of their children based on their clinical experience,including "no","mild","moderate" and "severe" anxiety.4.The data were statistically analyzed by SPSS22.0.The validity of the Cm-YPAS was tested by surface validity,content validity and predictive validity.Internal consistency reliability and interrater reliability were used to test the reliability of the scale.Results1.Through the translation,back translation,cultural adaptation of the English version of m-YPAS,the Cm-YPAS is formed.2.Validity: The surface validity of the Cm-YPAS is better.The evaluator can correctly understand the meaning of each item and complete it in the 1min;the content validity index of the scale is 0.67~1,the average value is 0.91.3.Reliability: The internal consistency Cronbach's alpha coefficient of the Cm-YPAS was 0.990,0.987,0.987 and 0.984 at the time of T1 to T4,and the Kendall harmony coefficient Kendall' s W between the different assessors was 0.749 to 0.831(P = 0.000).4.The anxiety cutoff point of the scale: Based on the evaluation results of children's psychological and behavioral experts,the ROC curves were made for children's anxiety scores at each time point.The area AUC under ROC curve was 0.823~0.931,and the cutoff score of "no,mild anxiety" and "moderate and severe anxiety" at T1 to T4 time points were 42.78,51.97,47.54 and 49.77,respectively.Conclusions1.The chinesization process of Cm-YPAS is scientific,the finished result is reliable;the scale can be used to assess children in the preoperative holding,walk to the operation room,entrance to the operation room,the degree of anxiety during the induction of anesthesia at 4 time points,can be used as a clinical assessment tool for preoperative anxiety in children.2.Cm-YPAS has good reliability and validity,good stability,high reliability,simple items,easy to understand,and meets the metrology standards and clinical testing is feasible.It can be applied to the preoperative anxiety assessment of children in China.3.Cm-YPAS has a good application value.The diagnostic cut-off point at each time point from T1 to T4 is 42.78,51.97,47.54,and 49.77.When the score of the scale exceeds this score,it indicates that the degree of anxiety of the child is “medium or severe”,it is recommended to take appropriate interventions to reduce the degree of anxiety in children,and improve the prognosis.