中文版血液透析患者自我管理评估工具测量属性的系统评价

doi:10.3761/j.issn.1672-9234.2023.07.016

摘要/Abstract

摘要：

目的采用基于共识选择健康测量工具遴选标准对中文版血液透析（hemodialysis，HD）患者自我管理评估工具进行评价，为医护人员选择适宜的评估工具提供循证依据。方法检索国内外数据库中公开发表的HD患者自我管理评估工具的相关研究，检索时限为数据库建立至2022年6月8日。2名研究者各自完成文献筛选、数据提取及质量评价。使用基于共识选择健康测量工具遴选标准系统评价指南和改良版定量系统评价证据分级方法对纳入工具进行评价，并对纳入评估工具形成最终推荐意见。结果共纳入8项研究，涉及7个中文版HD患者自我管理量表，包括血液透析病患自我管理量表（Hemodialysis Self-Management Instrument，HDSMI）、血液透析自我管理工具（HDSMI-18）、血液透析患者自我管理量表、血液透析患者自我管理水平问卷、血透患者自我管理行为评定量表、糖尿病肾病血液透析患者自我管理量表、老年血液透析患者自我管理量表。7个中文版HD患者自我管理评估工具均未报告跨文化效度、假设检验、反应度；证据分级结果显示血液透析病患自我管理量表、HDSMI-18、血液透析患者自我管理量表、老年血液透析患者自我管理量表质量等级为高或中，其他均为低或极低；HDSMI为A类推荐，其他均为B类推荐。结论 HDSMI适用于评估我国血液透析的自我管理水平，其余量表测量属性质量尚不完善，有待于进一步探究。

关键词: 血液透析, 自我护理, 测量属性, 系统评价

Abstract:

Objective To identify the most commonly used instruments measuring self-management of hemodialysis（HD） patient based on the Consensus-based Standards for the Selection of Health Measurement Instruments（COSMIN） guidelines so as to provide proper instrument for nurses. Methods Published studies on HD patients self-management assessment tools in international and Chinese databases were searched，with a search period from the establishment of the database to June 8，2022. Two researchers completed literature screening，data extraction and quality evaluation independently. The methodological quality and measurement attributes of the included tools were evaluated by using the COSMIN systematic evaluation guideline and revised GRADE evidence grading method. Results Eight studies were included，involving seven Chinese version of the self-management scales for patients with HD（HDSMI，HDSMI-18，Hemodialysis Self-Management Instrument，Self-management Behavior Questionnaire for Hemodialysis Patients，Self-Management Behavior Questionnaire of HD Patients，Self-Management Scale for Hemodialysis Patients with Diabetic Nephropathy，Self-Management Scale for elderly Hemodialysis Patients）. None of the seven Chinese versions of self-management assessment tools for HD patients reported cross-cultural validity，hypothesis test of structural validity and responsiveness. The results of evidence grading show that the quality of HDSMI，HDSMI-18，Hemodialysis Self-Management Instrument and Self-Management Scale for Elderly Hemodialysis Patients are high or medium，while the others are low or extremely low. HDSMI is recommended as A，while others are recommended as B. Conclusion HDSMI was recommended as the most suitable measurement tools for evaluating the self-management level of HD patients in China，while the qualities of the measurement attributes of the remaining scales are still not perfect and need to be further explored.

Key words: Hemodialysis, Self Care, Psychometric, Systematic review

陈婷婷, 侯朝铭, 高静, 陈欢, 罗欢, 陈昕羽. 中文版血液透析患者自我管理评估工具测量属性的系统评价[J]. 中华护理教育, 2023, 20(7): 857-863.

CHEN Tingting, HOU Chaoming, GAO Jing, CHEN Huan, LUO Huan, CHEN Xinyu. Chinese version of the self-management scale for patients with hemodialysis：a systematic review[J]. Chinese Journal of Nursing Education, 2023, 20(7): 857-863.

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