The Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity of a revised assessment of neuropsychiatric symptoms in dementia.
The Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity of a revised assessment of neuropsychiatric symptoms in dementia.
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DOI：
10.1017/s1041610210000876
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发表时间：
2010-09
影响因子：
7
通讯作者：
Lyketsos C
中科院分区：
文献类型：
--
作者：
de Medeiros K;Robert P;Gauthier S;Stella F;Politis A;Leoutsakos J;Taragano F;Kremer J;Brugnolo A;Porsteinsson AP;Geda YE;Brodaty H;Gazdag G;Cummings J;Lyketsos C
神经精神症状（NPS）几乎影响所有痴呆症患者，是研究和治疗的主要焦点。通过有效、敏感和可靠的措施对NPS进行准确评估至关重要。虽然目前的国家养老金计划措施有许多优势，但也有一些局限性（例如，数据的获取仅限于作为受访者的举报人或护理人员，针对中度痴呆症的具体项目深度有限）。因此，我们开发了NPI的修订版本，称为NPI- c。NPI-C包括扩展的领域和项目，以及临床医生评级方法。本研究评估了NPI-C在10个国际站点（7种语言）的信度和收敛效度。通过德尔菲面板对78个新条目进行了面效度测试。来自三种痴呆严重程度类别（轻度= 58，中度= 49，重度= 21）的128对夫妇（护理人员/患者）分别由两名训练有素的评分员使用两种评分方法进行访谈：原始NPI访谈和临床医生评分法。评判员1还管理了另外四个既定的测量方法：冷漠评估量表、简短精神病学评定量表、科恩-曼斯菲尔德躁动指数和康奈尔痴呆症抑郁量表。用类内相关性来确定类间信度。四个相关NPI-C域及其相应的外部测量之间的Pearson相关性用于收敛效度。大多数项目的评鉴者间信度都很强。在NPI-C领域的临床医生评分中，趋同效度为中度（冷漠和躁动）到重度（幻觉和妄想；躁动和异常发声；抑郁）。总的来说，NPI-C显示出作为一种多功能工具的潜力，它可以准确地测量NPS，并使用统一的尺度系统来促进研究之间的数据比较。
Neuropsychiatric symptoms (NPS) affect almost all patients with dementia and are a major focus of study and treatment. Accurate assessment of NPS through valid, sensitive and reliable measures is crucial. Although current NPS measures have many strengths, they also have some limitations (e.g. acquisition of data is limited to informants or caregivers as respondents, limited depth of items specific to moderate dementia). Therefore, we developed a revised version of the NPI, known as the NPI-C. The NPI-C includes expanded domains and items, and a clinician-rating methodology. This study evaluated the reliability and convergent validity of the NPI-C at ten international sites (seven languages). Face validity for 78 new items was obtained through a Delphi panel. A total of 128 dyads (caregivers/patients) from three severity categories of dementia (mild = 58, moderate = 49, severe = 21) were interviewed separately by two trained raters using two rating methods: the original NPI interview and a clinician-rated method. Rater 1 also administered four additional, established measures: the Apathy Evaluation Scale, the Brief Psychiatric Rating Scale, the Cohen-Mansfield Agitation Index, and the Cornell Scale for Depression in Dementia. Intraclass correlations were used to determine inter-rater reliability. Pearson correlations between the four relevant NPI-C domains and their corresponding outside measures were used for convergent validity. Inter-rater reliability was strong for most items. Convergent validity was moderate (apathy and agitation) to strong (hallucinations and delusions; agitation and aberrant vocalization; and depression) for clinician ratings in NPI-C domains. Overall, the NPI-C shows promise as a versatile tool which can accurately measure NPS and which uses a uniform scale system to facilitate data comparisons across studies.