中文版饮食能力分级系统在学龄前脑性瘫痪儿童中的信度与效度研究

关键词：脑瘫  饮食  分级  信度  效度

Keywords:cerebral palsy  eating and drinking  classification  reliability  validity

摘要：

      摘要 目的：确定中文版脑瘫（CP）患儿饮食能力分级系统（EDACS）在学龄前脑瘫儿童中的信度与效度。 方法：通过分析现场评估和录像评估结果之间的一致性确定中文版EDACS及协助水平的重测信度；分析不同评估者间（照顾者，熟悉患儿情况的言语治疗师ST1和对患儿熟悉度一般的言语治疗师ST2）的评估结果确定中文版EDACS的评估者间信度；以吞咽障碍调查表（DDS）的分值为效标确定EDACS的平行效度。 结果：ST1的现场评估与录像评估结果显示， EDACS具有良好的重测信度，Kw=0.762（95%CI：0.590—0.884），协助水平的评估结果Kw=0.807（95%CI：0.656—0.9035）。同时EDACS具有良好的评估者间信度，2名言语治疗师间的中文版EDACS评估结果Kw=0.741（95%CI：0.553—0.879），协助水平的评估结果Kw=0.808（95%CI：0.696—0.935）。ST1与家长间的中文版EDACS评估结果Kw=0.590（95%CI：0.457—0.732），协助水平评估结果Kw=0.635（95%CI：0.509—0.754）。EDACS与DDS分值间具有良好的平行效度， Spearman相关系数为0.889。 结论：中文版EDACS在学龄前脑瘫患儿中具有良好的评估者间信度和平行效度， 可以有效的对学龄前脑瘫患儿进行饮食功能分级。

Abstract:

      Abstract　 Objective： To determine the reliability and validity of Chinese eating and drinking ability classification system in preschool children with cerebral palsy. Method： The test-retest reliability of EDACS and assistance level was determined by analyzing the relationship between the results of locale assessment and video assessment by the most familiar with the Children. The assessment results of different evaluators (parents， speech therapists of the most familiar with children (ST1) and the other speech therapists(ST2) were analyzed to determine the interrater reliability of EDACS and assistance level. The convergent validity of EDACS was determined by the score of the Dysphagia Disorders Survey(DDS). Result： Chinese version of EDACS was found to possess satisfactory test-retest reliability(EDACS：Kw=0.762，EDACS level of assistance：Kw=0.807)， Interrater reliability proved substantial between STs (EDACS： Kw=0.741; EDACS level of assistance： Kw=0.808) and was moderate STs and parents (EDACS： Kw=0.590; EDACS level of assistance：Kw=0.635). The EDACS levels correlated strongly with the DDS (Spearman： 0.889). Conclusion： Chinese version of EDACS has good interrater reliability and convergent validity in preschool children with cerebral palsy， which can effectively assess the eating and drinking ability of preschool children with cerebral palsy.