摘要目的:建立中文版用药合理性指数（MAI）量表，并试用于老年住院患者用药合理性的评价。方法:依据Brislin跨文化翻译原则，经过翻译-回译-文化调适-预调查4个步骤对MAI量表进行汉化。采用方便抽样法，选取2019年7—12月在南京鼓楼医院老年医学科住院的300例患者作为研究对象，利用中文版MAI量表对其用药合理性进行评价。采用Cronbach α系数和组内相关系数（ICC）评价MAI量表的信度；采用4级评分法和探索性因子分析法分别评价量表的内容效度与结构效度。通过分析MAI分值及不合理项的分布对300例老年住院患者用药合理性进行评价。结果:中文版MAI量表包含10个条目。对300例老年住患者的评价结果进行统计分析，结果显示量表的Cronbach α系数为0.892；14 d后选取20例患者进行复测，结果显示量表的ICC为0.876。MAI量表各条目的内容效度指数（I-CVI）为0.86~1.00，量表平均内容效度指数（S-CVI/Ave）为0.96。探索性因子分析提取4个公因子，累计方差贡献率为58.132%，8个条目的因子载荷量>0.4。对300例患者用药合理性的评价结果显示，患者MAI平均值为2.6分，其中非0分者198例，患者用药不合理率为66.0%，平均每种药物的MAI值为0.2分；患者数排在前3位的用药不合理条目是药物-疾病/异常状态相互作用（88例，29.3%）、重复用药（69例，23.0%）和剂量不正确（67例，22.3%）。结论:中文版MAI量表具有良好的信度和效度。南京鼓楼医院老年医学科住院患者的不合理用药项主要为药物-疾病/异常状态相互作用、重复用药和剂量不正确。

abstractsObjective:To establish the Chinese version of Medication Appropriateness Index (MAI) and evaluate the appropriateness of medication in elderly inpatients on trial.Methods:According to Brislin′s translation model for cross-cultural research, the MAI was translated into Chinese through 4 steps: translation, back translation, cultural adaptation, and pre-survey. Using convenient sampling method, 300 elderly inpatients in the Department of Geriatrics, Nanjing Drum Tower Hospital from July to December 2019 were selected as the research subjects, and the Chinese version of MAI was used to evaluate the appropriateness of medication. Reliability of the Chinese version of MAI was evaluated using Cronbach′s α coefficient and intraclass correlation coefficient (ICC); the content validity and structural validity of the Chinese version of MAI were evaluated using 4-level scoring method and exploratory factor analysis, respectively. The appropriateness of medication in 300 elderly inpatients was evaluated by analyzing the MAI scores and the distribution of irrational items.Results:The Chinese version of MAI contained 10 items. The evaluation results of 300 elderly inpatients were statistically analyzed. The Cronbach′s α coefficient of the scale was 0.892 and the ICC of the scale was 0.876 when 20 patients were selected for re-testing 14 days later. The item-level content validity index (I-CVI) of the Chinese version of MAI was 0.86 to 1.00 and the scale-level content validity index/average (S-CVI/Ave) was 0.96. A total of 4 common factors were extracted by exploratory factor analysis, the cumulative variance contribution rate was 58.132%, and the factor loading of 8 items was more than 0.4. The evaluation results of appropriateness of medication showed that the average MAI score in 300 patients was 2.6, of which 198 patients did not score 0; inappropriate medication counted 66.00% and the average MAI score of each drug was 0.2. The top 3 items with more inappropriate medication were drug-disease/abnormal condition interaction (88 cases, 29.3%), duplication (69 cases, 23.0%), and incorrect dosage (67 cases, 22.3%).Conclusions:The Chinese version of MAI had good reliability and validity. The items with more inappropriate medication in elderly inpatients in the Department of Geriatrics, Nanjing Drum Tower Hospital were mainly drug-disease/abnormal condition interaction, duplication, and incorrect dose.