Development and psychometric validation of the Post-Intensive Care Syndrome-Family Symptom Assessment Scale: a cross-sectional study

Wan Tengfei; Shi Yu; Qu Jingrui; Liu Junli; Lin Lin; Song Caiping

doi:10.16016/j.2097-0927.202607092

您当前的位置：

首页 >

文章列表页 >

Development and psychometric validation of the Post-Intensive Care Syndrome-Family Symptom Assessment Scale: a cross-sectional study

Evidence-Based Nursing Horizons | 更新时间：2026-10-19

- Development and psychometric validation of the Post-Intensive Care Syndrome-Family Symptom Assessment Scale: a cross-sectional study
- Journal of Army Medical University Vol. 48, Issue 19, Pages: 2790-2799(2026)
- 作者机构：
  
  1.陆军军医大学（第三军医大学）第二附属医院，护理处，重庆
  2.陆军军医大学（第三军医大学）第二附属医院，护理教研室，重庆
  5.陆军军医大学（第三军医大学）第二附属医院，院办：，重庆
  3.北部战区总医院，神经内科，辽宁沈阳
  4.北部战区总医院，重症医学科，辽宁沈阳
- 作者简介：
  
  Song Caiping，E-mail： luyonghui@tmmu.edu.cn
- 基金信息：
  
  the Project of Joint Science and Technology Program of Liaoning Province(2024-MSLH-521)
- DOI：10.16016/j.2097-0927.202607092
  CLC： R-05;R395.6
- Received：22 July 2026，
  
  Revised：2026-08-17，
  
  Accepted：27 August 2026，
  
  Published：15 October 2026
- 稿件说明：
移动端阅览
万腾飞，石钰，瞿靖瑞，等.家属ICU后综合征症状评估量表的研制及信效度检验：一项横断面研究［J］.陆军军医大学学报，2026，48（19）：2790-2799.DOI：10.16016/j.2097-0927.202607092.

Wan T F，Shi Y，Qu J R，et al.Development and psychometric validation of the Post-Intensive Care Syndrome-Family Symptom Assessment Scale： a cross-sectional study［J］.J Army Med Univ，2026，48（19）：2790-2799.DOI：10.16016/j.2097-0927.202607092.
万腾飞，石钰，瞿靖瑞，等.家属ICU后综合征症状评估量表的研制及信效度检验：一项横断面研究［J］.陆军军医大学学报，2026，48（19）：2790-2799.DOI：10.16016/j.2097-0927.202607092. DOI：

Wan T F，Shi Y，Qu J R，et al.Development and psychometric validation of the Post-Intensive Care Syndrome-Family Symptom Assessment Scale： a cross-sectional study［J］.J Army Med Univ，2026，48（19）：2790-2799.DOI：10.16016/j.2097-0927.202607092. DOI：

摘要

目的

家属ICU后综合征（Post Intensive Care Syndrome-Family，PICS-F）指受亲人病情危重影响，家属在患者ICU住院期及转出监护病房后产生新发或加重的生理、心理、社会活动功能多方面障碍，可影响其身心健康、决策与照护能力及患者结局，而现有工具对转出后家属适用性有限。本研究基于症状管理理论编制PICS-F症状评估量表，并在ICU转出后1个月内家属中检验其信效度，为早期临床评估提供工具。

方法

通过范围综述、家属半结构化访谈构建家属ICU后综合征评估量表条目池，经德尔菲专家函询、预调查修订后形成量表预试版。随后采用横断面研究设计开展量表验证工作：分两个阶段在陆军军医大学第二附属医院和北部战区总医院便利抽取ICU转出后1个月内的患者家属进行调查：第一阶段（2026年3—5月）纳入190例，运用项目分析和探索性因子分析（exploratory factor analysis， EFA）筛选条目并确定维度结构；第二阶段（2026年5—6月）纳入201例，进行验证性因子分析（confirmatory factor analysis， CFA）验证模型拟合度。同时检验聚合效度、区分效度及内部一致性信度。

结果

最终版家属ICU后综合征症状评估量表包含情绪症状、生理症状、认知症状和社会功能困扰4个维度、20个条目。通过EFA得到4个因子，累计方差贡献率为70.209%，各条目因子载荷为0.527~0.939，形成4个一阶维度。CFA模型拟合良好，χ²/

=2.377，近似误差均方根（root mean square error of approximation，RMSEA）=0.083，比较拟合指数（comparative fit index，CFI）=0.916，塔克-刘易斯指数（Tucker-Lewis Index，TLI）=0.902，标准化残差均方根（standardized root mean squared residual，SRMR）=0.063。各维度平均方差抽取量（average variance extracted，AVE）

0.5、组合信度（construct reliability，CR）

0.7，区分效度良好。总量表Cronbach’s α系数为0.942；折半信度为0.857，表明量表信度良好。

结论

本研究编制的家属ICU后综合征症状评估量表具有良好的信效度，可较全面评估家属ICU后综合征相关症状负担水平，为制定个体化干预方案提供参考依据。

Abstract

Objective

Post-Intensive Care Syndrome-Family(PICS-F) refers to the new-onset or aggravated multidimensional impairments in physical

psychological

and social functioning that family members may develop during and after the patient's intensive care unit(ICU) stay

which can affect their physical and mental health

decision-making and caregiving capacity

and even patient outcomes. However

the existing tools have limited applicability to family members after ICU discharge. Based on the symptom management theory

this study aims to develop a symptom assessment scale for PICS-F and test its reliability and validity among family members within 1 month after ICU discharge

thereby providing a tool for early clinical assessment.

Methods

An item pool for the scale was constructed through a scoping review and semi-structured interviews with family members

and a preliminary version of the scale was formed after Delphi expert consultation and revision following a pilot survey. A cross-sectional design was then adopted for scale validation. Two-phase validation study was carried out. Family members of patients transferred out of ICU within 1 month were conveniently sampled from the Second Affiliated Hospital of Army Medical University and the General Hospital of Northern Theater Command. In Phase 1(March–May 2026)

190 participants were enrolled

and item analysis and exploratory factor analysis(EFA) were performed to screen items and determine the dimensional structure. In Phase 2(May—June 2026)

201 participants were enrolled

and confirmatory factor analysis(CFA) was applied to verify model fit. Convergent validity

discriminant validity

and internal consistency reliability were also examined.

Results

The final version of the PICS-F symptom assessment scale comprised 20 items across 4 dimensions: emotional symptoms

physiological symptoms

cognitive symptoms

and social functioning distress. EFA extracted 4 common factors with a cumulative variance contribution rate of 70.209%

and the factor loadings of individual items ranged from 0.527 to 0.939

forming 4 first-order dimensions. CFA demonstrated adequate model fit

with χ²/df=2.377

root mean square error of approximation(RMSEA)=0.083

comparative fit index(CFI)=0.916

Tucker-Lewis index(TLI)=0.902

and standardized root mean squared residual(SRMR)=0.063. All dimensions achieved acceptable convergent validity

with average variance extracted(AVE)>0.5 and composite reliability(CR)>0.7

indicating satisfactory discriminant validity. The total scale exhibited excellent internal consistency(Cronbach’s α=0.942) and split-half reliability(0.857)

indicating good scale reliability.

Conclusion

The PICS-F symptom assessment scale developed in this study demonstrates satisfactory reliability and validity

and can serve as a comprehensive instrument for evaluating PICS-F-related symptom burden in family members

providing a reference for formulating individualized intervention strategies.

关键词

Keywords

references

Joo Y ， Jang Y ， Kwon O Y . Contents and effectiveness of patient- and family-centred care interventions in adult intensive care units： a systematic review ［J］. Nurs Crit Care ， 2024 ， 29 （ 6 ）： 1290 - 1302 . DOI： 10.1111/nicc.13105 http://dx.doi.org/10.1111/nicc.13105 .

Needham D M ， Davidson J ， Cohen H ， et al . Improving long-term outcomes after discharge from intensive care unit： report from a stakeholders’ conference ［J］. Crit Care Med ， 2012 ， 40 （ 2 ）： 502 - 509 . DOI： 10.1097/CCM.0b013e318232da75 http://dx.doi.org/10.1097/CCM.0b013e318232da75 .

于文帆，谭亚鹏，官雪燕，等 . 家属ICU后综合征概念的范围综述［J］. 全科护理， 2024 ， 22 （ 2 ）： 209 - 214 . DOI： 10.12104/j.issn.1674-4748.2024.02.003 http://dx.doi.org/10.12104/j.issn.1674-4748.2024.02.003 .

Yu W F ， Tan Y P ， Guan X Y ， et al . The concept of post-intensive care syndrome family： a scoping review ［J］. Chin Gen Pract Nurs ， 2024 ， 22 （ 2 ）： 209 - 214 . DOI： 10.12104/j.issn.1674-4748.2024.02.003 http://dx.doi.org/10.12104/j.issn.1674-4748.2024.02.003 .

Zhang X Y ， Mao S L ， Wang S H ， et al . Relationship between decision regret， anxiety， and depression in surrogate decision-makers for neurocritical patients with prolonged disorders of consciousness： a cross-lagged analysis ［J］. BMC Psychol ， 2026 ， 14 （ 1 ）： 834 . DOI： 10.1186/s40359-026-04870-2 http://dx.doi.org/10.1186/s40359-026-04870-2 .

Leonard K ， Turner E ， Douglas M E ， et al . Factors affecting perceived caregiver burden： caregivers of trauma patients discharged from the intensive care unit ［J］. Proc（Bayl Univ Med Cent）， 2024 ， 37 （ 5 ）： 717 - 724 . DOI： 10.1080/08998280.2024.2374126 http://dx.doi.org/10.1080/08998280.2024.2374126 .

Mao S L ， Cao Q Q ， Li Q H ， et al . Experiences of conflicting decision-making by surrogate decision-makers in neurocritical care in China： a descriptive qualitative study ［J］. BMJ Open ， 2026 ， 16 （ 1 ）： e097266 . DOI： 10.1136/bmjopen-2024-097266 http://dx.doi.org/10.1136/bmjopen-2024-097266 .

Cameron J I ， Chu L M ， Matte A ， et al . One-year outcomes in caregivers of critically ill patients ［J］. N Engl J Med ， 2016 ， 374 （ 19 ）： 1831 - 1841 . DOI： 10.1056/NEJMoa1511160 http://dx.doi.org/10.1056/NEJMoa1511160 .

国家卫生健康委办公厅，教育部办公厅，国家中医药局综合司，等 . 关于印发医学人文关怀提升行动方案（ 2024 — 2027 年）的通知：国卫办医急发〔2024〕 18 号［EB/OL］.（ 2024-09-29 ）［ 2026-05-13 ］. https：//www.gov.cn/zhengce/zhengceku/202410/content_6979036.htm https://www.gov.cn/zhengce/zhengceku/202410/content_6979036.htm .

General Office of the National Health Commission ， General Office of the Ministry of Education ， General Office of the National Administration of Traditional Chinese Medicine ， et al . Notice on the issuance of the action plan for promoting humanistic care in medicine （ 2024 – 2027 ）： Guo Wei Ban Yi Ji Fa ［2024］No. 18［EB/OL］.（ 2024-09-29 ）［ 2026-05-13 ］. https：//www.gov.cn/zhengce/zhengceku/202410/content_6979036.htm https://www.gov.cn/zhengce/zhengceku/202410/content_6979036.htm .

Anderson J ， Nohra E A ， Liveris A ， et al . Post-intensive care syndrome（PICS）： an American association for the surgery of trauma critical care committee consensus guideline–defining， recognizing， and managing PICS associated physical impairment， cognitive dysfunction， and thromboinflammatory dysregulation ［J］. Trauma Surg Acute Care Open ， 2026 ， 11 （ 2 ）： e002172 . DOI： 10.1136/tsaco-2025-002172 http://dx.doi.org/10.1136/tsaco-2025-002172 .

文佳祺，胡桢璟，刘于，等 . 家属ICU后综合征症状自我报告量表的编制及信效度检验［J］. 中华护理杂志， 2025 ， 60 （ 14 ）： 1723 - 1729 . DOI： 10.3761/j.issn.0254-1769.2025.14.010 http://dx.doi.org/10.3761/j.issn.0254-1769.2025.14.010 .

Wen J Q ， Hu Z J ， Liu Y ， et al . Development and reliability and validity test of a Self-Report Scale of Symptoms for Post Intensive Care Syndrome-Family ［J］. Chin J Nurs ， 2025 ， 60 （ 14 ）： 1723 - 1729 . DOI： 10.3761/j.issn.0254-1769.2025.14.010 http://dx.doi.org/10.3761/j.issn.0254-1769.2025.14.010 .

Dodd M ， Janson S ， Facione N ， et al . Advancing the science of symptom management ［J］. J Adv Nurs ， 2001 ， 33 （ 5 ）： 668 - 676 . DOI： 10.1046/j.1365-2648.2001.01697.x http://dx.doi.org/10.1046/j.1365-2648.2001.01697.x .

Fletcher B A S ， Dodd M J ， Schumacher K L ， et al . Symptom experience of family caregivers of patients with cancer ［J］. Oncol Nurs Forum ， 2008 ， 35 （ 2 ）： E23 - E44 . DOI： 10.1188/08.onf.e23-e44 http://dx.doi.org/10.1188/08.onf.e23-e44 .

Linder L . Analysis of the UCSF symptom management theory： implications for pediatric oncology nursing ［J］. J Pediatr Oncol Nurs ， 2010 ， 27 （ 6 ）： 316 - 324 . DOI： 10.1177/1043454210368532 http://dx.doi.org/10.1177/1043454210368532 .

Wei J J ， Yan H X ， Xiang Y Q ， et al . The effectiveness of symptom management theory in guiding clinical practice-a systematic review ［J］. Altern Ther Health Med ， 2024 ， 30 （ 8 ）： 108 - 114 .

郭秀花 . 实用医学调查分析技术［M］. 北京：人民军医出版社， 2005 .

Guo X H . Practical techniques of medical survey and analysis ［M］. Beijing ： People’s Military Medical Press ， 2005 .

关勋强 . 医学研究生教育评价研究与实践［M］. 北京：军事医学科学出版社， 2001 ： 80 - 84 .

Guan X Q . Research and practice of medical postgraduate education evaluation ［M］. Beijing ： Military Medical Science Press ， 2001 ： 80 - 84 .

王克芳，徐东娟，王雅琦 . 护理领域量表类论文问题分析及建议［J］. 中华护理杂志， 2024 ， 59 （ 3 ）： 287 - 291 . DOI： 10.3761/j.issn.0254-1769.2024.03.006 http://dx.doi.org/10.3761/j.issn.0254-1769.2024.03.006 .

Wang K F ， Xu D J ， Wang Y Q . Analysis and recommendations for issues in scale-based research papers in the field of nursing ［J］. Chin J Nurs ， 2024 ， 59 （ 3 ）： 287 - 291 . DOI： 10.3761/j.issn.0254-1769.2024.03.006 http://dx.doi.org/10.3761/j.issn.0254-1769.2024.03.006 .

吴明隆 . 结构方程模型： AMOS的操作与应用［M］. 2版 . 重庆：重庆大学出版社， 2010 .

Wu M L . Structural equation modeling： operation and application of AMOS ［M］. 2nd ed . Chongqing ： Chongqing University Press ， 2010 .

吴明隆 . 问卷统计分析实务： SPSS操作与应用［M］. 重庆：重庆大学出版社， 2010 .

Wu M L . Practical questionnaire statistical analysis： operation and application of SPSS ［M］. Chongqing ： Chongqing University Press ， 2010 .

史静琤，莫显昆，孙振球 . 量表编制中内容效度指数的应用［J］. 中南大学学报（医学版）， 2012 ， 37 （ 2 ）： 152 - 155 . DOI： 10.3969/j.issn.1672-7347.2012.02.007 http://dx.doi.org/10.3969/j.issn.1672-7347.2012.02.007 .

Shi J C ， Mo X K ， Sun Z Q . Content validity index in scale development ［J］. J Cent South Univ Med Sci ， 2012 ， 37 （ 2 ）： 152 - 155 . DOI： 10.3969/j.issn.1672-7347.2012.02.007 http://dx.doi.org/10.3969/j.issn.1672-7347.2012.02.007 .

Fornell C ， Larcker D F . Evaluating structural equation models with unobservable variables and measurement error ［J］. J Mark Res ， 1981 ， 18 （ 1 ）： 39 . DOI： 10.2307/3151312 http://dx.doi.org/10.2307/3151312 .

Wang S ， Allen D ， Perkins A ， et al . Validation of a new clinical tool for post-intensive care syndrome ［J］. Am J Crit Care ， 2019 ， 28 （ 1 ）： 10 - 18 . DOI： 10.4037/ajcc2019639 http://dx.doi.org/10.4037/ajcc2019639 .

Polit D F ， Beck C T . The content validity index： Are you sure you know what’s being reported？ critique and recommendations ［J］. Res Nurs Health ， 2006 ， 29 （ 5 ）： 489 - 497 . DOI： 10.1002/nur.20147 http://dx.doi.org/10.1002/nur.20147 .

Humphreys J ， Janson S ， Donesky D A ， et al . Theory of symptom management ［M］// Middle Range Theory for Nursing . New York ： Springer Publishing Company ， 2014 ： 141 - 164 .

Herdman N . NANDA International Nursing Diagnoses： Definitions and Classification 2021-2023 ［M］. New York ： Georg Thieme Verlag Stuttgart， New York ， 2021 . DOI： 10.1055/b000000515 http://dx.doi.org/10.1055/b000000515 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

亲子疏离问卷在军人群体中的修订、信效度检验和常模初步构建

Development of a basic palliative care competency assessment scale for generalist nurse and evaluation of its reliability and validity

Construction and reliability and validity of the Chinese revised vascular quality of life questionnaire

Psychometric properties of different pain measuring scales in patients during perioperative period of lung resection

Development and analysis of a urinary retention risk assessment scale for patients after primary hip arthroplasty

Related Author

TAN Jieying

SUN Xiaoxiao

DAI Zongpei

JIN Chenxuan

XIANG Wenjun

DAI Qin

Yuqi WU

Lei LEI

Related Institution

Department of Thoracic Surgery, Army Medical Center of PLA, Army Medical University (Third Military Medical University)

Department of Health Statistics, Faculty of Military Preventive Medicine, Army Medical University (Third Military Medical University)

School of Nursing, Army Medical University (Third Military Medical University)

Department of Vascular Surgery, the First Affiliated Hospital of Chongqing Medical University

⁰