| Objective: The purpose of this study was to construct a risk assessment scale for incontinence-associated dermatitis in patients with ICU by Delphi method,and to analyze the items,evaluate the reliability and validity of the scale,and determine the diagnostic cutoff value of the scale.Methods: In the first stage of this study,through literature search,we summarized the related risk factors of incontinence-associated dermatitis in ICU patients,referred to the conceptual framework of Brown perineal risk factors,combined with the characteristics of clinical nursing work and the specificity of ICU patients,the group discussion formed alternative indicators and expert correspondence tables,and Delphi expert consultation method was used to conduct two rounds of consultation to form a risk assessment scale.In the second stage,the convenient sampling method was used to evaluate the risk of the patient use scale which was admitted to a third-class hospital in Shenyang from July to December 2020 and met the standard of nano-platoon.The items of the scale were analyzed and the reliability and validity of the scale were tested.The diagnostic threshold of the scale was determined according to the curve coordinate diagram of the subjects’ working characteristics.Results: 1.The result of Delphi expert letter inquiry: in the first round of expert consultation,13 experts participated in the letter inquiry,and the effective recovery rate was 92.31%.In the second round,12 experts participated in the letter inquiry,and the effective recovery rate is 100%.The authoritative coefficients of the two rounds of expert opinions are greater than 0.9.the importance score range of the first round risk assessment index was between 3.33 and 4.92,and that of the second round was between3.83 and 4.92.The coefficient of variation of the items in the first round of the scale ranged from 0 to 0.26,with an average of 0.13,while that of the second round ranged from 0.06 to 0.29,with an average of 0.15.The coordination coefficients of the two rounds of expert consultation were 0.462 and 0.337,respectively.2.The incontinence-associated dermatitis risk assessment scale for ICU patients constructed in this study contains 12 items: skin environment,incontinence factors and toilet ability.3.During the survey with the scale,135 patients were actually evaluated,and 134 effective scales were recovered.19 cases of incontinence-related dermatitis occurred,with an incidence of 14.2%,of which 17 cases were mild and 2 cases were severe.4.Evaluation results of the scale: 12 items were retained through project analysis.In the validity evaluation,the content validity index(S-CVI)of the scale level was 0.933,and the content validity index(I-CVI)of the scale item level was 0.800-1.00.In the construct validity evaluation,three common factors were extracted by exploratory factor analysis,which cumulatively explained 71.849% of the total variance.In the predictive validity evaluation,the area under the working characteristic curve of the scale subjects was0.974(P <0.001).The results of reliability analysis showed that the total Cronbach’s αcoefficient of the scale was 0.879,the Cronbach’s α coefficients among the three dimensions were 0.867,0.800 and 0.929 respectively,and the inter-rater reliability was0.985.when the diagnostic cutoff value of the scale was 26.5,the sensitivity and specificity of the scale were 100% and 90.4%,respectively.Conclusion: The risk assessment scale for incontinence-associated dermatitis in ICU patients constructed in this study has good reliability,validity and predictive ability,and it is time-saving,simple and easy to evaluate.It can be used as a screening tool for ICU medical staff to evaluate whether patients have the risk of incontinence-related dermatitis. |
