张慧慧　　胡月红　　周尧英

[关键词] 疼痛行为量表;危重症;机械通气;信度;效度

[中图分类号] R473.6          [文献标识码] B          [文章编号] 1673-9701（2021）14-0174-04

Research on the reliability and validity of pain behavior scale in evaluating pain status of critically ill patients with mechanical ventilation

ZHANG Huihui   HU Yuehu   ZHOU Yaoying

Intensive Care Unit， Shaoxing People′s Hospital in Zhejiang Province， Shaoxing   312000， China

[Abstract] Objective To investigate the applicability of behavioral pain scale （BPS） in evaluating pain status of critically ill patients with mechanical ventilation. Methods A total of 90 critically ill patients with mechanical ventilation admitted to our hospital from January 2018 to March 2019 were randomly selected as the research objects， and the pain self-assessment of Chinese version of GPS scale was carried out. The applicability evaluation of the scale includes item analysis， reliability and validity evaluation of the scale. Results The results of item analysis showed that there were statistically significant differences between high and low scores in each item score （P<0.05）. The scores of each item were all highly correlated with the total BPS score（P<0.05）. Chronbach′s α coefficient of the total questionnaire was 0.902. The I-CVI value of each item was greater than 0.78， and the S-CVI value was 0.92 （greater than 0.8）. In the evaluation of discrimination validity， the BPS score of patients when changing body position was significantly higher than that when measuring body temperature（P<0.05）. Conclusion The Chinese version of GPS scale has good reliability and validity， and has good applicability of BPS in evaluating pain status of critically ill patients with mechanical ventilation.

[Key words] Pain behavior scale; Critical illness; Mechanical ventilation; Reliability; Validity

臨床收治的危重症患者经常由于自身基础疾病或需要接受侵入性操作，而遭受来自于身体不同部位的疼痛，若不得到及时有效的处理，会成为引起危重症患者生理和（或）心理应激的主要因素[1]。疼痛为一种主观感受，国际疼痛研究协会将疼痛定义为“由真正存在或潜在的身体组织损伤所引起的不舒服的知觉和心理感觉”[2]。中华医学会疼痛学分会在《临床诊疗指南》[3]中指出，疼痛是病理生理、心理、文化修养和生活环境等诸多因素，经神经中枢对这些信息的调整和处理，最终得出的主观感受。可见，疼痛是一种主观感受。疼痛评估包括定性评估和定量评估。定性评估即确定疼痛的性质、分类、部位等[4]。定量评估即评估疼痛的强度，是疾病治疗过程中的重要参考依据[5]。本研究评估的危重症机械通气患者的疼痛状况主要是指疼痛的定量评估，目的为临床给予危重症患者实施有效的疼痛管理提供参考依据，现报道如下。

1 资料与方法

1.1 一般资料

为避免总体样本数量较多、内部差异较大带来的偏倚，本研究采用分层随机抽样的方法，选取2018年1月至2019年3月期间在本院进行机械通气治疗的危重症患者为研究对象。具体抽样方法为将2018年1月至2019年3月期间在本院进行机械通气治疗的所有危重症患者设为样本总体，根据呼吸衰竭的严重程度（中、重度）进行分层，按照随机原则在各层样本中抽取的实际入组病例数基本一致，共计入组90例危重症患者。……