Development And Reliability And Validity Test Of The Risk Assessment Form Of Arteriovenous Fistula Thrombus

ObjectiveTo construct the evaluation form of risk screening for arteriovenous fistula thrombus test its reliability and validity and explore its clinical applicability.Method1.Construct a risk assessment form for arteriovenous fistula thrombus.Based on the preliminary literature study,the risk assessment form of arteriovenous fistula thrombus was preliminarily formed,and on this basis,the expert consultation form was formed.17 experts from Liaoning province were consulted by Delphi method for statistical analysis.After two rounds of consultation,experts’ opinions tend to be consistent.Assessment items are screened out in order to form a risk evaluation form for arteriovenous fistula thrombus.By analyzing the coefficient of variation and CI value,the consistency of the Delphi expert consultation method was determined.2.Reliability and validity test and clinical applicability test of arteriovenous fistula thrombus risk assessment form.A survey was carried out on 617 patients who met the criteria of inclusion and exclusion.According to clinical data,its reliability,validity and clinical applicability were analyzed.Use consistency analysis,retest reliability,and split half reliability test to evaluate the reliability of the form;Use content validity and structure validity to test and evaluate the validity of the form.ROC curve analysis was used to test the ability of risk assessment form to screen patients with arteriovenous fistula thrombus.Result1.The risk assessment form for the initial formation of arteriovenous fistula thrombus: There were 6 first level index items,13 second level index items and 57 third level indicators.After two rounds of expert consultation,all primary,secondary and tertiary indexes were assigned 1,2,3,4,5,with CV 0.33 ～ 0.73.The remaining 6first-level indicators,12 second-level indicators and 53 third-level indicators.The recovery rate for the first round is 100%;in the second round,100%;the authority coefficient is 0.875 and 0.893;There was statistical difference in Kendall coefficient between two rounds(P < 0.01).2.The Cronbach’s α coefficient of the evaluation form is 0.969 in total,and the Cronbach’s α coefficient of each dimension is 0.898,0.968,0.924,0.976,0.949 and0.929,respectively.The retest reliability was 0.848.Spearman-Brown’s broken half reliability was 0.840,and Guttman Split-Half’s reliability index was 0.839.Analysis of expert authority,expert opinion concentration and coordination degree,it shows that the evaluation form had good content validity.In factor analysis,the maximum variance rotation method(varimax)was used for rotation.The Principal component analysis extracted 6 common factors with eigenvalue > 1.The cumulative variance contribution rate is 74.016%.It is in good agreement with the original framework.ROC curve analysis of influencing factors showed that: for "general situation of patients","autologous arteriovenous fistula related factors","nursing related factors","comorbidities","clinical indicators" and "other factors",the corresponding AUC values were 0.867,0.935,0.841,0.834,0.836 and 0.787(P<0.01),respectively.It indicates that "general situation of patients","autologous arteriovenous fistula related factors","nursing related factors","comorbidities","clinical indicators" and "other factors" have high diagnostic value for arteriovenous fistula thrombus.ROC curve analysis of the overall score showed that the AUC value corresponding to the total score was 0.947(P<0.01),indicating that the total score had a very high diagnostic value for arteriovenous fistula thrombus.Conclusion1.After two rounds of expert consultation,arteriovenous fistula thrombus risk evaluation forms were established: 6 first-level indicators,12 second-level indicators and 53 third-level indicators;experts’ enthusiasm and authority were high;experts’ opinions were concentrated;experts were better coordinated and consistent.The compilation of evaluation form entries are reliable and representative.2.The developed risk assessment form of arteriovenous fistula thrombus has good reliability and validity,and risk prediction ability.The application of this evaluation form can improve nurses’ identification of risk factors for arteriovenous fistula thrombus,improve the implementation of preventive measures for arteriovenous fistula thrombus,reduce the incidence of arteriovenous fistula thrombus,and improve patients’ quality of life.