新生儿口腔运动评估量表在临床应用中的研究-第三军医大学学报.doc

新生儿口腔运动评估量表在临床应用中的研究 张崇芳，尹华英 重庆医科大学附属儿童医院，400014 摘要：目的 检验新生儿口腔运动评估量表（NOMAS）在临床应用中的测量学特性及测评时间对测评结果的影响，为早产儿口腔运动功能评估工具的选择及应用提供依据。方法 将91名早产儿最初2分钟的吸吮过程录制成录像，应用NOMAS对录像进行评估。结果 NOMAS在早产儿胎龄小于35周具有良好的内部一致性（Cronbach’s a＞0.7）；NOMAS评分与早产儿喂养效率在胎龄小于35周具有较好的相关性（正常吸吮r=0.58，吸吮紊乱r=-0.61）；NOMAS的反应度较低（SRM=0.02~0.49）；NOMAS测评时间30秒与测评时间2分钟的评估结果不一致，前者的评分较高。结论 NOMAS在评估胎龄小于35周的早产儿中应用具有良好的信效度，NOMAS的测评时间以2分钟最为合适。 关键词：早产儿；新生口腔运动量表；信度；效度；反应度；评估时间 Psychometric characteristics of the Neonatal Oral-motor Assessment Scale in the clinical application Zhang Chongfang Yin Huaying (Children’s Hospital of Chongqing Medical University， 400014， China) Abstract: Objective To examine the psychometric properties of the Neonatal Oral-motor Assessment Scale (NOMAS) and evaluation time on the influence of the assessment result using a cohort of preterm infants, and to provide useful information for oral-motor measurement in their settings. Methods Following Palmer’s method, a video recording was made of the infants at different age during the first 2 min of NS. We stored the recordings on a digital videodisc and two NOMAS assessors assessed each recording. Results The NONAS had acceptable internal consistency (Cronbach’s a＞0.7）for less than 35 weeks’ PMA. Moderate correlation were found between scores on the NOMAS and feeding performance for less than 35 weeks’ PMA .The NOMAS demonstrated low responsiveness to changes in oral-motor skill in every week period, ranging from 33 to 36 weeks’ PMA（SRM=0.11~0.49）. Evaluation time 30 seconds and evaluation time 2 minutes of NOMAS scores are not consistent, the former is higher. Conclusion The NOMAS is useful, with acceptable reliability and validity ,in assessing oral-motor function in preterm infants for less than 35weeks’PMA. NOMAS ought to be administered for 2 min. Key word: preterm infant； Neonatal Oral-Motor Assessment Scale; reliability; validity; responsiveness Corresponding author: Yin Huaying, E-mail: Sarah6524@126.com. Supported by the health bureau of Chong