The Evaluation And Analysis Of The Normative Nature Of Measurement Process Of Bayley Scales Of Infant Development-Revised Edition Of Chinese Cities

ObjectivesThis study intends to evaluate the normative during clinical evaluation process of the current Bayley scales of infant development-revised edition of Chinese cities(BSID-CR),to explore the influencing factors of BSID-CR evaluation normative,and to provide evidence for clinical evaluation of BSID-CR quality supervision and improvement work.Methods1.Quantitative research:infants,including their parents and clinical evaluators,who were assessed with BSID-CR in Child Healthcare Department and Rehabilitation Medicince Department of some Maternal and Child Healthcare Hospital were confirmed as research subjects with a convenient sampling method from October 2016 to January 2017.This survey tool were the normative of BSID-CR clinical evaluation checklist and general data questionnaire,which were both self-made.The normative of BSID-CR clinical evaluation checklist includes 147 entries,total score of 100 points.The general data questionnaire,collecting demographic data of subjects,contains 10 entries.This study used field observation method and checklist method for observation and evaluation of the testing process of BSID-CR.All quantitative data were recorded and analysised statistically by using Microsoft Excel 2010 and SPSS22.0.Firstly,basic descriptinve analysis for numerical variables and frequency/composition ratio for categorical varialbes was used to analysis demographic characteristics of subjects.Then,univariate analysis was used to select appropriate independent variables.Thirdly,multivariate Logistic regression was used to confirmed the factors that may affect the normative of the measurement.2.Qualitative research:using the phenomenological research method as the starting point,we explored perspective and influence factors of BSID-CR test normative,applying semi-structured interviews.A purposive sample of infants and their parents in a total of 21 depth interviews,of which were parents of infants in 16 copie,5 copies of the BSID-CR tester.Colazzi7 step analysis was used to analyze the data of in-depth interviews.Results1.A total of 205 BSID-CR clinical test questionnaires were recruited in this study,which contains the normative of BSID-CR clinical evaluation checklist and general data questionnaire.And valid questionnaires were 203;the effective response rate was 99.0%.Of them,103 were one year old,and 100 were two years old.2.The 1 year old group BSID-CR clinical checklist assessment test scores were from 27 to 76,the average score was(49.03±12.01),56 cases(54.37%)were qualified.The number of observations of different titles and different professional surveying and different culture degree of observations and different days measured there were statistically significant differences(P?0.05);the 2 years old group BSID-CR clinical checklist assessment test scores were from 30 to 90,the average score was(71.00±13.59),the number of cases(68 cases of qualified 68%).And there were significant differences between the evaluators who have participated in professional training and the evaluators who did not participate in the professional training assessment(P?0.05).3.According to the semi-structured interview data from the 5 clinical evaluators of BSID-CR and 16 parents,we concluded that the influence factors of the normative of the BSID-CR clinical measurement process includes the following four aspects:the factors from subjects of infants and parents,measurement factors,test equipments factors,the environmental factors,management factors and factors derived from the scale itself.Conclusion1.The normative of BSID-CR clinical test needs to be improved,the normative of 1 year old group compared with the normative of 2 years old group was not ideal,2 years old group normative had been acceptable,which proves the necessity of BSID-CR clinical testing quality supervision work to strengthen and improve.2.Quantitative research showed that the influence factors of the normative of clinical BSID-CR test were the number of people applying for the BSID-CR test and the evaluators’ professional training.The measured number was no more than 2 people/day,the normative of evaluation during clinical BSID-CR test process was not bad.When the measured number reached 6-7people/day,the.BSID-CR clinical test normative,to some degree,declined.The operation of BSID-CR evaluators who had participated in professional training was significantly standardized than the operation of BSID-CR test standard did not participate in the professional training.Qualitative research showed that the influence factors of the normative during clinical BSID-CR test includes six major themes:1)the factors of BSID-CR evaluators;2)the factors of infant subjects and their parents;3)test equipments factors;4)environmental factors;5)management factors;6)factors derived from the scale itself.The theme of the factors of BSID-CR evaluators included:age of evaluators;gender of evaluators;the operation proficiency of evaluators;the dress during the process(wearing the white uniform);the test evaluators’ attitude to the infants;attending regular training;the behavior that test evaluators have urged infant.The theme of the factors of infant subjects and their parents included :infant personality;the infants growth environment;social adaptability;state before testing the infant(physiological and emotional);the behavior that parents have urged infant with an infant testing process;whether their parents were the primary caregivers or not.The theme of test equipment factors included the design of testing equipments were in dispute;The fancy design of tools(transfer infants’ attention during the test);the test tools equipped is not complete;the test pictures that used in the set of items”name painting” were difficult to distinguish.The theme of environmental factors included the test room should keep quiet and safe;the room space size and layout;the light of the outdoor environment(waiting area environment);the temperature and humidity of the outdoor environment(waiting area environment);the design of indoor wall;the design of indoor space.The theme of management factors included scheduling and workload.The theme of scale itself included a long test time;the guide description of some test items is vague;and the test sequence guided in the scale itself conflict with the actual clinical work.