改良耶鲁术前焦虑量表的汉化及信效度评价(硕士)

•中文摘要•
改良耶鲁术前焦虑量表的汉化及信效度评价(硕士)(论文25000字)
摘 要
研究目的：
1.采用科学的方法引进国外改良耶鲁术前焦虑量表（the Modified Yale Preoperative Anxiety Scale, m-YPAS)，经过翻译、回译及文化调试的汉化程序，形成中文版改良耶鲁术前焦虑量表，为建立适用于我国儿童术前焦虑的测评工具提供研究基础。
2.评价中文版改良耶鲁术前焦虑量表的信度和效度，探索量表在评估中国儿童术前焦虑程度的适用性。
研究方法：
1.在获得量表原作者Zeev N. Kain同意的前提下，按照科学的Brislin双人双译法对英文版的m-YPAS量表进行翻译、回译及文化调适，形成中文版改良耶鲁术前焦虑量表（the Chinese Version of the Modified Yale Preoperative Anxiety Scale, Cm-YPAS）。
2.于2017年7月至2017年10月采用方便抽样法在XX市XXXXXXXXXX医院耳鼻喉科、眼科选取2～12岁接受择期手术的患儿31名。在术前一日进行患儿基本信息资料收集，研究者当场检查调查表，确保项目无缺失。手术当日，在患儿进入术前等待区直至麻醉诱导期进行全程视频录像。
3.请9位不同资质和专业的专家观看视频，使用中文版Cm-YPAS量表对患儿在术前等待区、走向手术室、进入手术室、麻醉诱导期4个时间点的焦虑程度进行评分；2周后请9位专家再次观看视频对患儿焦虑程度进行重新评分。
4.所得资料运用SPSS23.0进行统计分析，用内部一致性信度、评定者间信度、重测信度、内容效度及结构效度等对中文版Cm-YPAS量表测试结果进行评价，检验量表的信度和效度。
研究结果：
1.经过对英文版m-YPAS量表的翻译、回译及文化调试，形成中文版Cm-YPAS量表；
2.量表信度：中文版Cm-YPAS量表内部一致性Cronbach’s α系数为0.936～0.943，不同评定者间相关系数为 ？（P＜0.05），折半信度的Spearman 相关系数rxx 为0.935～0.951（P<0.01），重测信度中各时间点两次测量值的Pearson相关系数为0.9～0.947（P＜0.05）；综合评价中文版Cm-YPAS量表的信度较好。
3.量表效度：采用专家法评价量表的内容效度，得出内容效度指数（Content Validity Index，CVI）为 0.67～1.00，平均值为0.91；量表的结构效度采用因子分析的方法进行考察，用探索性因素分析在各个时间点均提取了特征值大于 1 的公因子1个，其累积方差贡献率均大于82 %，表明该量表只有一个维度是单量表，结构稳定；综合评价中文版Cm-YPAS量表的效度较好。
研究结论：
1.中文版Cm-YPAS量表简洁易懂、使用方便，能够较好地评估儿童手术前各个时间点的焦虑程度，可以作为临床用于儿童术前焦虑的筛查工具。
2.中文版Cm-YPAS量表具有较好的信度及效度，稳定性好、可靠性高，符合计量学标准，可以应用于我国儿童术前焦虑评估。
关键词：儿童 术前焦虑 量表 汉化 评价

•英文摘要•
The Reliability and Validity of the Chinese Version of the Modified
Abstract
Purposes:
1.Using the scientific method to introduce foreign modified Yale preoperative anxiety scale (m-YPAS), through the translation, back translation, cultural adaptation finished the program, forming the Chinese version modified Yale preoperative anxiety scale.To provide a basis for the establishment of anxiety assessment tools for children before operation in China.
2. To evaluate the reliability and validity of the Chinese version of the modified Yale preoperative anxiety scale, and to explore the applicability of the scale in assessing the anxiety level of Chinese children before operation.                  
Methods:
With the permission from the author of m-YPAS, Kain ZN, according to the scientific Brislin translation method, the English version of the m-YPAS scale is translated, to form the Chinese version of modified Yale preoperative anxiety scale (Cm-YPAS).From July 2017 to October 2017, 31 children who were 2~12 years old who received selective operation were obtained from Department of ENT and ophthalmology in a three grade hospital in Dalian by convenience sampling. The basic information of the children was collected on the day before the operation, and the investigators examined the questionnaire to ensure that the items were not missing. On the day of the operation, the child entered the waiting area of the operation until  the induction period of the anesthesia was videotaped. 9 experts with different qualifications and professional qualifications were asked to score the anxiety degree of children in 4 time points by watching videos, and then 9 experts were asked to reassess videos after 2 weeks. Cm-YPAS was used to score the anxiety level of children at different time points. Data were statistically analyzed by SPSS23.0 and Cm-YPAS was evaluated by content validity, construct validity and internal consistency reliability, so as to verify its validity and reliability.          
Results:
1.After the translation, back translation and evaluation of the content validity of the English version of the scale, the Chinese version of the scale is formed. The CVI value of the scale is 0.67 to 1, the average value is 0.91 ;           
2. reliability:          
3.content validity:           
4. structure validity:
Conclusions:
1. Cm-YPAS is simple, easy to understand, easy to use, and easy to be accepted by Chinese medical staff. At the same time, it also provides a more convenient assessment tool for preoperative anxiety in children, so as to provide a theoretical basis for effective interventions for children's preoperative anxiety.           
2. Cm-YPAS has good content validity and construct validity, and has good internal consistency reliability. The scale has good stability: high reliability and compliance with the metrology standard, which can be applied to the preoperative anxiety assessment of children in China.           
3. Cm-YPAS can be used to assess the anxiety degree of children before surgery at different time points.In order to evaluate the effectiveness of children to reduce negative experience and improve the quality of nursing interventions, that scale can be used as a clinical screening tool for children with anxiety before surgery, through reliable assessment of children's anxiety, can timely and accurately take targeted interventions. By using the same measuring tools, interventions in different locations and cultures can be compared.                 
Key Words: Preoperative Anxiety  Children  Scale  Reliability  Validity

目    录
一、摘 要    1
（一）中文摘要    1
（二）英文摘要    4
二、正 文    8
（一）前  言    8
1.研究背景............................................... 8
2.相关概念................................................9
3.国内外研究现状..........................................9
4.研究目的.............................................. 11
5.研究意义.............................................. 11
（二）研究对象和方法    12
1.研究对象    12
 2.研究方法    12
 3.质量控制    14
 4.统计学分析方法    15
 5.伦理学原则    15
（三）结 果    17
（四）讨 论    26
（五）结 论    35
（六）研究的局限性和改进措施    36
（七）参考文献    37
三、综 述    43
（一）综述    43
（二）参考文献    48
四、附 录    52
五、攻读学位期间发表文章情况    58
六、致 谢................................................. 59