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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
宋彩萍,E-mail:scp1974@163.com
收稿:2026-07-22,
修回:2026-08-17,
录用:2026-08-27,
纸质出版:2026-10-15
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:
目的
2
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
2
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
2
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/
df
=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
2
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。
Objective
2
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
2
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
2
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
2
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.
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