基于改良德尔菲法的儿童神经心理行为检查量表(2016版)的应用及项目反应度研究

Application and item responsiveness study of Children Neuropsychological and Behavioral Scale-Revision 2016 based on the modified Delphi method

摘要

目的 改良更新儿童神经心理行为检查量表(2016版)条目内容,澄清量表使用疑惑,为量表优化和临床应用提供科学依据。方法 2024年10—12月期间,采用改良德尔菲法开展三轮专家函询,通过组建专家团队、设计问卷、多轮征询及数据统计分析,评估量表项目合理性及应用问题。结果 三轮专家积极系数分别为 94.74%、95.12%、100.00%,权威系数分别为 0.81、0.83、0.84,均达到较高水平;第二轮函询肯德尔和谐系数为 0.701(P＜0.01),专家意见协调性良好;三轮函询后,问卷各题目变异系数均＜25%,符合通过标准。“穿扣项目采用黑红混合纽扣”评价结果的意见更统一(通过率81.82%,变异系数15.91%);24 图指认项目中砚台、管钳需替换为儿童熟悉图片,替换图片首选勺子、叉子(通过率82.05%)。结论 儿童神经心理行为检查量表(2016版)函询项目设计科学合理,专家高度认可其应用价值,研究结果可为量表改良提供参考依据。

Abstract

Objective To revise and update selected item contents of the Children Neuropsychological and Behavioral Scale-Revision 2016 (CNBS-R2016),and to clarify practical concerns regarding its use,so as to provide scientific reference for scale refinement and clinical application. Methods From October to December 2024, a modified Delphi method was used to conduct three rounds of expert consultation. By establishing an expert panel, designing questionnaires, carrying out multiple rounds of consultation, and performing statistical analyses, the rationality of scale items and issues related to scale application were evaluated. Results The expert response rates in the three rounds were 94.74%, 95.12%, and 100.00%, and the authority coefficients were 0.81, 0.83, and 0.84, respectively. In the second round, Kendall's coefficient of concordance was 0.701 (P<0.01), indicating good agreement among experts. After three rounds of consultation and revision, the coefficients of variation for the relevant items were all below 25%, meeting the passing standard. Greater agreement was reached on the use of mixed black-and-red buttons in the button-threading task (approval rate: 81.82%; coefficient of variation: 15.91%). In the 24-picture identification task, experts suggested replacing the inkstone and forceps with pictures more familiar to children, preferably a spoon and a fork (approval rate: 82.05%). Conclusion The consultation items designed for the CNBS-R2016 are scientifically sound and reasonable, and experts highly recognize its application value, which may provide a reference for further refinement of the scale.

关键词

儿童保健 / 改良德尔菲法 / 儿童神经心理行为检查量表(2016版) / 反应度

Key words

child healthcare / modified Delphi method / Children Neuropsychological and Behavioral Scale-Revision 2016 / responsiveness

[1] 赵瑾,张云婷,宋映泉,等.中国儿童早期发展指数工具及常模制定[J].中国儿童保健杂志,2023,31(8):858-863.
Zhao J, Zhang YT, Song YQ, et al. Development of the Chinese early childhood development index and its norm[J]. Chin J Child Health Care,2023,31(8):858-863.(in Chinese)
[2] Ke JC, Hayati Rezvan P, Vanderbilt D, et al. Similar early intervention referral rates following in-person administration of the Bayley Scales of Infant and Toddler Development, 4th Edition versus Telehealth Administration of the Developmental Assessment in Young Children, 2nd Edition in the high-risk infant population[J].Early Hum Dev,2024(190):105971.
[3] Wilson JC, Bowden CS, Vannier LC, et al. Measurement invariance of the Wechsler Intelligence Scale for children, fifth edition, in Australian and New Zealand and U.S. standardization samples[J].Psychol Assess,2023,35(6):510-521.
[4] Gesell Institute of Child Development/Gesell Institute of Development. Gesell Developmental Diagnosis Scale[EB/OL].(2024-05)[2024-05-20].https://www.gesellinstitute.org.
[5] 黄亨桦,于广军.婴幼儿早期神经发育评估诊断量表的综述[J].中国儿童保健杂志,2023,31 (2):162-166.
Huang HH, Yu GJ. Review of early neurodevelopmental assessment and diagnostic scales for infants and young children[J]. Chin J Child Health Care,2023,31 (2):162-166.(in Chinese)
[6] 刘晓莉,王建红,许琪,等.语音障碍儿童神经心理发育特征及影响因素分析[J].中华预防医学杂志,2023,57 (3):356-361.
Liu XL, Wang JH, Xu Q, et al. Analysis of neuropsychological development characteristics and influencing factors of children with speech disorders[J].Chin J Prev Med,2023,57(3):356-361.(in Chinese)
[7] 许琪,王建红,周波,等.儿童屏幕暴露对语言能力的影响[J].中华儿科杂志,2023,61(4):328-332.
Xu Q, Wang JH, Zhou B, et al. Influence of children's screen exposure on language ability[J].Chin J Pediatr,2023,61(4):328-332.(in Chinese)
[8] 张丽丽,李向飞,李甦,等.北京城区孤独症谱系障碍儿童普通话词汇及短语习得特点分析[J].中华实用儿科临床杂志,2022,37(15):1161-1166.
Zhang LL, Li XF, Li S, et al. Analysis of Mandarin vocabulary and phrase acquisition characteristics of children with autism spectrum disorder in Beijing urban area[J].Chin J Appl Clin Pediatr,2022,37 (15):1161-1166.(in Chinese)
[9] 陈淑玲.《儿心量表 2016 版》在孤独症谱系障碍中的应用研究[D].武汉:华中科技大学,2020.
Chen SL. Application research of "Children's Mental Scale 2016 Edition" in autism spectrum disorder [D]. Wuhan:Huazhong University of Science and Technology,2020. (in Chinese)
[10] Li HH, Feng JY, Wang B, et al. Comparison of The Children Neuropsychologicaland Behavior Scale and The Griffiths Mental Development Scales when assessing the development of children with autism[J]. Psychol Res Behav Manag,2019,12:973-981.
[11] 晏祥森,刘海红,申倩革.3～6 岁幼儿家庭劳动教育现状分析[J].教师,2023,6:72-74.
[12] 郑瑞璇,章丽丽,周自云,等.婴幼儿孤独症筛查问卷的初步编制和信效度分析[J].中国儿童保健杂志,2022,30 (4):376-380.
Zheng RX, Zhang LL, Zhou ZY, et al. Preliminary development and reliability and validity analysis of the Infant Autism Screening Questionnaire[J]. Chin J Child Health Care,2022,30(4):376-380.(in Chinese)
[13] Smith AG, Brainard JC, Campbell KA. Development of an undergraduate medical education critical care content outline utilizing the Delphi method[J]. Crit Care Med,2020,48(1):98-103.
[14] 张明雄,秦婉莹,黄健,等.重点监控药品合理用药管理指标体系的构建[J].中国药房,2025,36 (7):784-788.
Zhang MX, Qin WY, Huang J, et al.Construction of management index system for rational use of key monitored drugs[J].China Pharm,2025,36 (7):784-788.(in Chinese)
[15] 罗伯特·费尔德曼.发展心理学-人的毕生发展(第六版)[M].苏彦捷,邹丹,译.北京:世界图书出版公司北京公司,2013:4-374.
Feldman R. Developmental psychology: Human lifespan development (6th Edition)[M]. Su YJ, Zou D, Trans. Beijing: World Publishing Corporation Beijing Company,2013:4-374.(in Chinese)
[16] 张厚粲.韦氏儿童智力量表第四版(WISC-IV)中文版的修订[J].心理科学,2009,32 (5):1177-1179.
Zhang HC. Revision of the Chinese version of Wechsler Intelligence Scale for Children-Fourth Edition (WISC-Ⅳ)[J]. Psychol Sci,2009,32 (5):1177-1179.(in Chinese)
[17] 任宁,梁政波,夏玮,等.贝利婴幼儿发展量表的临床应用进展[J].护理学杂志,2017,32 (15):99-102.
Ren N, Liang ZB, Xia W, et al. Clinical application progress of Bayley Scales of Infant and Toddler Development[J].J Nurs Sci,2017,32 (15):99-102.(in Chinese)
[18] 张秀玲,李寄平,秦明镜,等.Gesell发展诊断量表3.5～6岁北京修订本的制定[J].中国临床心理学杂志,1994,2 (3):148-150,191-192.
Zhang XL, Li JP, Qin MJ, et al. Development of Beijing revised version of Gesell Developmental Diagnosis Scale for 3.5-6 years old[J]. Chin J Clin Psychol,1994,2 (3):148-150,191-192.(in Chinese)
[19] Tso WWY, Wong VCN, Xia X, et al. The Griffiths Development Scales-Chinese (GDS-C): A cross-cultural comparison of developmental trajectories between Chinese and British children[J].Child Care Health Dev,2018,44(3):378-383.
[20] Niederberger M, Köberich S,Members of the DeWiss Network. Coming to consensus: The Delphi technique[J]. Eur J Cardiovasc Nurs,2021,20(7):692-695.
[21] 阳莉,甘秀妮,吴太琴,等.基于德尔菲法构建ICU护理缺失评估量表[J].护理研究,2024,38 (15):2757-2762.
Yang L, Gan XN, Wu TQ, et al. Construction of ICU nursing omission assessment scale based on Delphi method[J].Nurs Res,2024,38 (15):2757-2762.(in Chinese)
[22] Yang Y, Yang Y, Yao M, et al. Home-based medication safety: Constructing health education for community-dwelling older adults with chronic diseases in China[J].Ann Med,2025,57(1):2522978.
[23] Guo J, Zeng L, Dai Y, et al. Shared-care management standards of palliative care in Chinese adults: A Delphi study[J].Asia Pac J Oncol Nurs,2025,12:100702.
[24] Niederberger M, Deckert S. Das Delphi-Verfahren: Methodik, varianten und anwendungsbeispiele [The Delphi technique: Methodology, variants and usage examples][J].Z Evid Fortbild Qual Gesundhwes,2022,174:11-19.

基金资助

首都儿科研究所临床培育专项(LCYJ-2025-39)