目的 研究家庭视频反馈量表(FVFS)的信度,并探讨该量表在0~6月龄高危儿家庭早期干预中的临床应用。方法 1)内部一致性信度研究:纳入2017年5月-2018年3月期间,在复旦大学附属儿科医院康复中心接受家庭早期干预指导并提交家庭视频的130名高危儿的130段家庭训练视频。2)评估者间信度、重测信度:纳入2017年12月-2018年3月期间接受家庭早期干预指导的高危儿30例及其前后对比视频共60段(第1次视频30段和第2次对应视频30段),由两位评估者应用FVFS量表对30段第1次视频进行评估,7 d后再次评估,统计评估者间信度和重测信度(以组内相关系数ICC值表示)。3)临床应用:应用FVFS量表评估第1次视频后,治疗师将结果反馈给家长,家长根据要求调整训练后再次拍摄第2次视频,比较前后两次60段视频的得分情况。结果 量表第一部分“视频拍摄质量评估”的内部一致性信度为0.603,评估者间信度总项目ICC值0.970,亚类ICC值0.903~0.983,重测信度总项分ICC值0.966,亚类ICC值0.840~0.966。第二部分“早期干预质量评估”的内部一致性信度为0.519,评估者间信度总项目ICC值0.909,亚类ICC值0.697~1.000,重测信度的总项目ICC值0.988,亚类ICC值0.869~1.000。第1次30段视频第一、二部分总分平均6.57,12.30,量表总分平均18.87分;第2次30段视频第一、二部分总分平均7.37,15.97,量表总分平均23.33分,差异具有统计学意义(P<0.05)。结论 FVFS量表具有很好的评估者间信度及重测信度。通过视频反馈,临床运用该量表评估前后对比视频后发现家庭早期干预质量有所提高,因此该量表在0~6月龄高危儿家庭早期干预中有运用价值。

Objective To study the reliability of Family-Video-Feedback Scale (FVFS), and to explore the clinical application of the scale in early intervention for high-risk infants at 0 to 6 months old. Methods 1) Internal consistency reliability:Totally 130 videos and clinical materials were collected from 130 families accepting intervention guidance in Rehabilitation Department of Children's Hospital from May, 2017 to March, 2018.2) Inter-raters reliability and test-retest reliability:30 high-risk infants and their 60 videos (30 pre-videos and 30 post-videos) were included into study.Two raters evaluated the 30 pre-videos with FVFS and evaluated again after 7 days.The inter-raters reliability and test-retest reliability were represented by interclass correlation coefficient (ICC).3) Clinical application:After evaluated the pre-videos, therapist delivered to parents, and then parents took videos again after adjustment.The score of the pre-videos and post-videos were compared. Results The internal consistency reliability of subscale 1(video quality assessment) was 0.603.The inter-rater reliability (ICC values) of the total score of subscale 1(video quality assessment) was 0.970,and subgroups' ICC values ranged from 0.903 to 0.983.The test-retest reliability of subscale 1(video quality assessment) was 0.966,and subgroups' ICC values ranged from 0.840 to 0.966.The internal consistency reliability of subscale 1(intervention quality assessment) was 0.519.The inter-rater reliability (ICC values) of the total score of subscale 2(intervention quality assessment) was 0.909,and subgroups' ICC values ranged from 0.697 to 1.000.The test-retest reliability of subscale 1(intervention quality assessment) was 0.988,and subgroups' ICC values ranged from 0.869 to 1.000.The mean score of the 30 pre-videos and post-videos on the total score of video quality assessment, intervention quality assessment and the whole scale were 6.57 vs.7.37,12.30 vs.15.79,18.87 vs.23.33,respectively, and the differences were significant(P<0.05). Conclusions The FVFS has high inter-raters reliability and test-retest reliability, with good internal consistency reliability of the video quality assessment and acceptable internal consistency reliability of the intervention quality assessment.It is valuable for clinic to evaluate videos with FVFS to improve the quality of family early intervention.