内部一致性，最小可检测的变化，以及对西班牙语版Barthel指数在重症监护病房出院和三个月后变化的敏感性

IF 1.1 Q3 NURSING

Enfermeria Intensiva Pub Date : 2025-04-01 DOI:10.1016/j.enfi.2025.500539

Esther Cecilia Wilches-Luna PT, PhD , Vilma Eugenia Muñoz-Arcos PT, MSc , Paula Benavides-Candezano PT , José Julián Bernal-Sánchez PT, PhD, MSc , Ada Clarice Gastaldi PT, PhD

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引用次数: 0

摘要

目的探讨ICU出院时和出院后3个月Barthel指数（BI）的内部一致性（IC）、最小可检测变化（MDC）和变化敏感性。方法于2016年11月至2017年7月在某内科-外科重症监护病房（ICU）进行前瞻性纵向研究。共纳入149例18岁以上患者，入院前BI评分为90分。使用COSMIN检查表评估测量性能。分析临床和人口变量、BI评分、IC、MDC和对变化的敏感性。计算Cronbach's α系数（α），以确定BI的IC的领域和整体规模。采用效应大小（ES）指标和标准化平均反应（SMR）指标评价变化敏感性。使用基于分布的方法确定MDC，计算测量的标准误差（SEM）。对地板和天花板的影响进行了评估，低于15%的阈值被认为是可以接受的。结果141例患者出院时接受评估。其中，男性77例（41.7%），平均年龄58.5±16.8岁；N = 62（41.6%）需要有创机械通气。112例患者出院后3个月重新评估。ICU出院时总IC为α = 0.70, 3个月时为α = 0.96。92% （n = 103）患者的得分大于或等于MDC 10分，在脱机类型、气管造口术和ICU住院时间方面差异有统计学意义(p <；0.005)。结论西班牙语版BI项目显示ICU出院时可接受的IC。MDC为10分，验证了其在ICU出院时和出院后三个月监测重症患者功能独立性的响应性和实用性。

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Internal consistency, minimal detectable change, and sensitivity to change of the Spanish version of the Barthel Index at intensive care unit discharge and three months later

Objective

To determine the internal consistency (IC), minimal detectable change (MDC), and sensitivity to change of the Barthel Index (BI) at ICU discharge and three months post-hospital discharge.

Methods

A prospective longitudinal study was conducted between November 2016 and July 2017 in a medical-surgical intensive care unit (ICU). A total of 149 patients over 18 years with a BI score >90 prior to ICU admission were included. The COSMIN checklist was utilized to evaluate the measurement properties. Clinical and demographic variables, BI scores, IC, MDC, and sensitivity to change were analyzed. The Cronbach's alpha coefficient (α) was calculated to determine the IC of the BI by domain and for the overall scale. Effect size (ES) indices and standardized mean response (SMR) were used for sensitivity to change. The MDC was identified using a distribution-based method, calculating the standard error of measurement (SEM). Floor and ceiling effects were assessed, with a threshold of less than 15% considered acceptable.

Results

A total of 141 patients were evaluated at discharge from the ICU. Of these, n = 77 (41.7%) were men, with a mean age of 58.5 ± 16.8 years; n = 62 (41.6%) required invasive mechanical ventilation. One hundred twelve patients were reassessed three months after discharge. The overall IC was: α = 0.70 at ICU discharge and α = 0.96 at three months. Ninety two percent (n = 103) of the patients showed values greater than or equal to the MDC of 10 points, with statistically significant differences identified in the type of weaning, tracheostomy, and length of stay in the ICU (p < 0.005).

Conclusions

The items of the Spanish version of the BI demonstrate acceptable IC at ICU discharge. The MDC was 10 points, validating its responsiveness and utility for monitoring the functional independence of critically ill patients at ICU discharge and three months after hospital discharge.

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来源期刊

Enfermeria Intensiva NURSING-

CiteScore

2.50

自引率

23.10%

发文量

期刊介绍： Enfermería Intensiva es el medio de comunicación por antonomasia para todos los profesionales de enfermería españoles que desarrollan su actividad profesional en las unidades de cuidados intensivos o en cualquier otro lugar donde se atiende al paciente crítico. Enfermería Intensiva publica cuatro números al año, cuyos temas son específicos para la enfermería de cuidados intensivos. Es la única publicación en español con carácter nacional y está indexada en prestigiosas bases de datos como International Nursing Index, MEDLINE, Índice de Enfermería, Cuiden, Índice Médico Español, Toxline, etc.