关键词: 自体动静脉内瘘；穿刺风险；测评工具；信度；效度

Abstract: Objective: To establish the Arteriovenous Fistula puncture risk assessment scale and test its reliability and validity. Methods: The assessment scale was first developed according to the pre-established indicator system for evaluating autologous Arteriovenous Fistula puncture risk. Then after consulting 5 experts and a pilot study, 198 patients from a hemodialysis center of a third-grade hospital in Dalian were selected for investigation and evaluation. The reliability and validity of the assessing tool and the ROC curve based on the survey results were obtained to figure out the diagnostic boundary value. Results: Finally, the Arteriovenous Fistula puncture risk assessment form with 4 dimensions and 24 items was established. 4 common factors were extracted using exploratory factor analysis with the accumulated variance contribution rate being 70.484%, and the factor loads of all items were beyond 0.4. The content validity index of items (I-CVI)was 0.866-1.000 and the content validity index of scale (S-CVI) was 0.942. The Cronbach's α coefficient of the scale was 0.823, and the test-retest reliability was 0.783. The ROC curve area was 0.813 and the standard error was 0.070 with the 95% confidence interval being (0.677, 0.950), which was statistically significant (P=0.001). The Yoden index reached the highest of 0.493 when the score was 10. The predicted sensitivity of the scale was 70.00% and the specificity was 79.30%. The diagnostic threshold of the evaluation scale was 10 points. Conclusion: The self-designed Arteriovenous Fistula evaluation scale has practical significance for clinical work. With a good reliability and validity in the primary test, it can be used as an assessment tool for nurses before autologous Arteriovenous Fistula puncture.

Key words: Arteriovenous Fistula; puncture risk; evaluation tool; reliability; validity