Li Benhong,Ren Zongyan,Tang Wenxiang,et al.Development and application of a discharge scoring scale for pediatric day surgery[J].Journal of Clinical Pediatric Surgery,2024,(10):918-923.[doi:10.3760/cma.j.cn101785-202406067-004]
儿童日间手术离院评分量表的编制及应用
- Title:
- Development and application of a discharge scoring scale for pediatric day surgery
- Keywords:
- Day Surgery; Discharge Score Scale; Reliability; Validity; Child
- 摘要:
- 目的 编制儿童日间手术离院评分量表, 并进行信效度检验和临床应用, 为日间手术患儿安全离院提供有效的评估工具。方法 本研究为回顾性研究, 根据全身麻醉术后离院评分系统(post anesthetic discharge scoring system, PADSS)的相关指标, 结合儿童患者的生理和心理特点, 编制适用于儿童的日间手术离院评分量表, 进行信效度检验, 并在昆明市儿童医院日间手术中心应用。选取2023年1月至2023年12月接受日间手术的5 843名儿童作为研究对象, 应用自行编制的儿童日间手术离院评分量表对患儿进行离院评估, 并与2022年同期日间手术质量控制指标进行对比分析。结果 本研究编制的儿童日间手术离院评分量表共包括5个维度、15个条目, 量表总体Cronbach’s α系数为0.809, 重测信度系数为0.916;量表水平内容效度为0.930, 条目水平内容效度为0.900~1.000;探索性因子分析结果显示:各条目在相应因子上的因子负荷为0.748~0.891;验证性因子分析结果显示:卡方自由度比为1.490, 均方根误差近似值为0.050, 各拟合指数均＞0.8。2023年与2022年日间手术质量控制指标对比:术后不良反应或并发症的发生率[1.33%(78/5 843)比2.46%(127/5 171)]、非计划再就诊率[0.10%(6/5 843)比0.27%(14/5 171)]、非计划延迟出院率[0.09%(5/5 843)比0.37%(19/5 171)]、非计划转科率[0.39%(23/5 843)比0.68%(35/5 171)]的差异均有统计学意义(P<0.05)。结论 儿童日间手术离院评分量表设计合理, 信效度良好, 具有较高的实用性和安全性, 可作为日间手术患儿安全离院的评价标准。
- Abstract:
- Objective To develop a discharge scoring scale for pediatric day surgery, assess its reliability and validity, and implement it in clinical practice, providing an effective tool for assessing the safe discharge of pediatric day surgery patients. Methods This retrospective study was based on the indicators of the Post Anesthetic Discharge Scoring System (PADSS), incorporating the unique physiological and psychological characteristics of pediatric patients.A discharge scoring scale tailored for pediatric day surgery was developed, tested for reliability and validity, and applied in the Day Surgery Center at Kunming Children’s Hospital, Yunnan Province.A total of 5, 843 children who underwent day surgery between January 2023 and December 2023 were selected as study subjects.The newly developed pediatric day surgery discharge scoring scale was used to evaluate the patients’ readiness of discharge, and the results were compared with the quality control indicators for day surgery from 2022. Results The pediatric day surgery discharge scoring scale included 5 dimensions and 15 items.The overall Cronbach’s alpha coefficient for the scale was 0.809, with a test-retest reliability coefficient of 0.916.The content validity index at the scale level was 0.930, while the item-level content validity index ranged from 0.900 to 1.000.Exploratory factor analysis showed that the factor loadings for each item on the corresponding factors ranged from 0.748 to 0.891.Confirmatory factor analysis revealed a chi-square/degrees of freedom ratio of 1.490, a root mean square error of approximation of 0.050, and all fit indices were greater than 0.8.Comparing the 2023 data with the 2022 day surgery quality control indicators, there were statistically significant differences in the incidence of postoperative adverse reactions or complications [1.33%(78/5 843) vs.2.46%(127/5 171)], unplanned re-admission rates [0.10%(6/5 843) vs.0.27%(14/5 171)], unplanned delayed discharge rates [0.09%(5/5 843) vs.0.37%(19/5 171)], and unplanned transfer rates [0.39%(23/5 843) vs.0.68% (35/5 171)] (P<0.05). Conclusions The pediatric day surgery discharge scoring scale is well-designed, reliable, and valid, with high practicality and safety.It can serve as a standard for evaluating the safe discharge of pediatric day surgery patients.
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备注/Memo
收稿日期:2024-6-29。
基金项目:云南省昆明市卫生健康委员会卫生科研课题项目(2020-06-02-112)
通讯作者:窦红昆,Email:douhongkun@163.com