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Development and Testing Research on Obstructive Sleep Apnea Syndrome Scale for Elder Adults

Author: LaiWenJuan
Tutor: LiuXueQin
School: Southern Medical University,
Course: Nursing
Keywords: Obstructive sleep apnea syndrome Improved version of the Berlin Questionnaire Reliability Validity Assessment Scale
CLC: R473.76
Type: Master's thesis
Year: 2008
Downloads: 230
Quote: 3
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Abstract

【Background】 obstructive sleep apnea syndrome (Obstructive Sleep Apnea Syndrome; OSAS) is a group for repeated episodes during sleep, low oxygen saturation, hypercapnia, which can cause heart and brain and other organ damage comprehensive clinical sign. OSAS is a certain potentially harmful diseases common in the elderly, prevalence, comorbidity and more prone to disease progression and death at night. Some data indicate that people over the age of 65 more than half have a sleep disorder, SAS incidence as high as 20% to 40% and increases with age. Currently, OSAS diagnosis single way, complex, expensive proposition, so the SAS diagnosis and treatment has not been well developed and spread. Screening of OSAS attention abroad earlier. Literature review using the Epworth sleepiness scale there (EpworthSleepiness Scale; ESS) for screening for OSAS research reports. 1996, held in Berlin, Germany on meeting basic hospital sleep, sleep experts put forward by the Berlin questionnaire, as OSAS-specific assessment tools. The questionnaire was published ten years, the United States, Germany, Canada, Italy and other countries have begun to be used does not have overnight polysomnography monitor (Overnight Polysomnography; PSG) primary hospital examination as a screening tool for OSAS . In 2006, India's SKsharam professor questionnaire has been revised to Berlin, the questionnaire BMI (Body Mass Index; BMI) and lethargy survey conducted cultural contexts and circumstances of debugging, forming a modified version of the Berlin Questionnaire (Modified Berlin Questionnaire; MBQ). The questionnaire is considered more suitable for Asians use. China's current research on OSAS are more concentrated in influencing factors and therapeutic tools, etc., and insufficient attention to the assessment of the disease. Only studies reported using ESS OSAS during PSG monitoring carried out before the screening, but because ESS score information from abroad, has not been debugging situation, but most of the domestic elderly do not drive their own cars, so can not \when the red light is asleep, \Currently, there is no domestic OSAS risk assessment scales specifically. Therefore it is necessary to study in a foreign country, based on the introduction and study MBQ, and the development suited to China's elderly to use assessment scales sleep apnea syndrome, OSAS screening high-risk populations, to reduce OSAS blindness prevention and interventions to reduce OSAS The risk is of great significance. 【Objective】 1 introduction and translation of foreign mature scale, suitable for our elderly to use for the development of obstructive sleep apnea syndrome screening scales to provide research base. 2 According to China's national culture and the physical condition of the elderly, preparing for China's elderly to use the obstructive sleep apnea syndrome risk assessment scale, aimed at elderly people in China to provide comprehensive OSAS risk measurement tool for taking effective prevention and intervention measures provide a strong basis. [Methods] 1 MBQ author translator in obtaining authorization to use the MBQ the introduction and translation. After discussion, and two respondents, the formation of the Chinese version MBQ, visits Chinese version MBQ equivalence with the original scale. 2 to cluster sampling method, the March 2007 ~ September 2007 in Guangzhou Institute of Respiratory Diseases, Zhujiang Hospital Sleep Center and Respiratory sleep chamber, Shenzhen Nanshan Hospital Respiratory sleeping room, American special new medical supplies Limited PSG monitoring 136 60 years and older using the Chinese version of the MBQ questionnaire. According to the experimental results of scale reliability and validity analysis, evaluation scale use value. All data were analyzed using SPSS11.5 statistical software. Examine scale with the correlation coefficient test-retest reliability, Cronbach's alpha coefficient between entries used to evaluate internal consistency reliability, principal component analysis and factor analysis and evaluation of the construct validity of the questionnaire, by analyzing the entries, dimensions, between the total score The correlation coefficient rating scale content validity, the gold standard diagnostic test evaluation of the sensitivity and specificity of the predictive validity of the questionnaire. 3 MBQ in the Chinese version, based on the preparation of elderly patients with obstructive sleep apnea syndrome Risk Assessment Scale (Obstructive Sleep Apnea Syndrome Risk Assessment Sscale for the older; OSASRAS), by cluster sampling method, using OSASRAS for 2007 6 months to February 2008 in Guangzhou Institute of Respiratory Diseases, Zhujiang Hospital Sleep Center and Respiratory sleeping room, Shenzhen Nanshan Hospital Respiratory sleep chamber, the two special new medical supplies Limited PSG monitoring 142 over 60 years elderly questionnaire. According to the experimental results of scale reliability and validity analysis, evaluation scale use value. Data collated using SPSS11.5 statistical software for statistical analysis, socio-demographic data using descriptive statistics; investigate correlation coefficient scale test-retest reliability, Cronbach's alpha coefficient scale used to evaluate the internal consistency between entries reliability, item analysis used to evaluate each entry discrimination; principal component analysis and factor analysis and evaluation of the construct validity of the questionnaire, by analyzing the entries, dimensions, the correlation coefficient between total score rating scale content validity, two independent rank sum test samples investigated discriminant validity scales, using receiver operating characteristic (Receiver Operator Characteristic; ROC) curve analysis of the sensitivity and specificity of scale, select the appropriate diagnostic cutoff value. [Results] 1 Scale and the Chinese version of the original draft of the two responses result, the statistical treatment found that in addition S3, B2, B3 and C1 answer the same entry two differ, the remaining entries in the answer exactly. Of these four entries Spearman correlation analysis, have a positive correlation (r> 0.688, p <0.002): the part on two respondents Scale Full Scale total score and scores Spearman correlation analysis, in addition to part three score two identical answer result, the screening question scores, a total score column, columns two and full-scale total score had a positive correlation between scores (r> 0.725, p <0.001). The Chinese version of the draft thus identified as the Chinese version of the MBQ. 2 Chinese version MBQ effective rate was 91.18%. General Information The analysis shows that different sex incidence of OSAS among the elderly group were significantly different (χ ~ 2 = 4.544, P = 0.033), a high incidence in elderly men aged women, and different age, occupation, education, marriage incidence of elderly OSAS group showed no significant differences. Chinese version of the test-retest reliability MBQ 0.776 ~ 0.992 in between, the total scale α coefficient 0.6698. Project analysis showed that, in addition to B1 \p <0.013). Factor analysis and principal component analysis yielded four common factors, four factors explain the overall cumulative contribution rate of 61.520%. With the respective sections of each entry correlation coefficient greater than the entry with the other correlation coefficients between the columns. With the total score of each column is greater than the correlation coefficient between the column and the other sections of the correlation coefficient. Questionnaire assessment results with the gold standard for diagnosis of OSAS PSG monitoring results comparison, the sensitivity of the questionnaire was 82%, specificity of 54.16%. When the threshold is 25 BMI, girth ratio of 5.27, the sensitivity and specificity of more balanced, the predictive value for OSAS larger. 3 OSASRAS the effective rate of 91.89%. Retest reliability between the 0.798 to 0.997. Scale total α coefficient 0.9036. Project analysis, all entries differences between groups were significant (p <0.015). Content validity of the results, scores and score each dimension the correlation coefficient between them and the other dimensions are larger than the correlation coefficient between. Dimension it belongs among the entries were significantly associated (P <0.010), in addition to nine entries, the rest all entries dimension it belongs correlation coefficients were greater than the entry with the other dimensions of the correlation coefficient between. Construct validity using factor analysis and principal component analysis extracted four common factors, the overall explained variance of 66.412%. OSAS positive and negative scores of the elderly and the scale of the total score of the two independent samples rank sum test results show that the four dimensions scores and total score scales were statistically significant differences between the two groups (P <0.009), OSASRAS The total score of the area under the ROC curve (Area Under Curve; AUC) was 0.933, AUC 95% CI 0.895 ~ 0.971, overall assessment of the elderly OSAS risk scale was significant (P <0.001). Predict the critical value of 57, the sensitivity and specificity of more balanced sensitivity of 84.1% and a specificity of 81.2%. [Conclusions] 1 due to cultural, national conditions, physical and other reasons, the Chinese version of the MBQ for Chinese elderly OSAS screening to be further adapted and improved. We can MBQ, based on the relevant entry through additions, deletions and adjustments, research suitable for elderly people in China are using OSAS screening questionnaire. 2 preliminary study prepared OSASRAS, through reliability and validity testing to verify the scale dimension may reflect different aspects of the elderly OSAS prevalence of risk to the actual situation, not only has good reliability and stability, but also has a very good risk prediction performance. In general, older people can be more objectively assessed risk of OSAS. As the assessment tool development is a dynamic process of continuous improvement, so that the scale practical applications still need further validation and refinement.

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