自杀相关心理健康服务倾向问卷的编制及信效度检验

doi:10.3761/j.issn.0254-1769.2022.19.010

摘要/Abstract

摘要：

目的编制自杀相关心理健康服务倾向问卷并检验其信效度。方法基于计划行为理论,在文献分析及半结构式访谈的基础上,通过专家函询、预调查形成问卷初稿。2020年5月—7月选取542名医护人员进行调查,检验问卷的信效度。结果问卷包括4个维度、26个条目。探索性因子分析提取4个公因子,累计方差贡献率为65.525%。验证性因子分析结果显示,拟合指数卡方自由度比值为2.584,近似误差均方根为0.074,比较拟合指数为0.904,拟合优度指数为0.875,调整拟合优度指数为0.881,问卷的平均内容效度指数为0.924。问卷的Cronbach’s α系数为0.930,分半信度为0.910,重测信度为0.905。结论该研究编制的自杀相关心理健康服务倾向问卷具有较好的信效度,可作为测评医护人员为自杀患者实施心理健康服务倾向的工具。

关键词: 自杀未遂, 心理健康服务, 急诊科, 问卷编制, 行为倾向, 护理

Abstract:

Objective To develop a suicide-related mental health service behavioral tendencies questionnaire and to test its reliability and validity. Methods Based on the theory of planned behavior,on the basis of literature analysis and semi-structured interviews,the initial questionnaire was formed through expert correspondence and pre-surveys. From May 2020 to July 2020,542 medical staff were selected for a survey to test the reliability and validity of the questionnaire. Results The questionnaire included 4 dimensions and 26 items;exploratory factor analysis extracted 4 common factors,and the cumulative variance contribution rate was 65.525%;confirmatory factor analysis showed that the fitting index of the questionnaire structure model was good. The content validity index of the questionnaire was 0.924. The Cronbach’s alpha coefficient of the total questionnaire was 0.942,and the split-half reliability was 0.910,and the test-retest reliability was 0.905. Conclusion The suicide-related mental health service behavioral tendencies questionnaire has good reliability and validity,and it can be used as a behavioral tendencies tool to evaluate the mental health services provided by medical staff to suicide patients.

Key words: Suicide Attempts, Mental Health Services, Emergency Department, Questionnaire Development, Behavioral Tendencies, Nursing Care

刘玉娥, 胡德英, 谭蓉, 梅婷, 王莉. 自杀相关心理健康服务倾向问卷的编制及信效度检验[J]. 中华护理杂志, 2022, 57(19): 2371-2377.

LIU Yu’e, HU Deying, TAN Rong, MEI Ting, WANG Li. Development of Suicide-related Mental Health Service Tendencies Questionnaire and the test of its reliability and validity[J]. Chinese Journal of Nursing, 2022, 57(19): 2371-2377.

图/表 2

表1 自杀相关心理健康服务倾向问卷专家函询和探索性因子分析结果（n=255）

Table 1 Expert consultation and exploratory factor analysis of Suicide-related Mental Health Service Tendencies Questionnaire（n=255）

图1 自杀相关心理健康服务倾向问卷验证性因子分析标准化参数估计值模型图

Figure 1 Model diagram of the standardized parameter estimates for the confirmatory factor analysis of the Suicide-related Mental Health Service Tendencies Questionnaire

参考文献 22

[1]	WHO. Suicide worldwide in 2019:global health estimates[M]. Geneva: World Health Organization, 2021.
[2]	Tong YS, Phillips MR, Yin Y, et al. Relationship of the high proportion of suicidal acts involving ingestion of pesticides to the low male-to-female ratio of suicide rates in China[J]. Epidemiol Psychiatr Sci, 2020, 29:e114. DOI URL
[3]	赵晓晖, 李涛, 洪霞, 等. 急诊科为自杀未遂患者提供精神卫生服务的障碍[J]. 中华医学杂志, 2015, 95(23):1833-1836.
	Zhao XH, Li T, Hong X, et al. Survey on the barriers in providing the mental health services to the suicide attempters in ED[J]. Natl Med J China, 2015, 95(23):1833-1836.
[4]	Claassen CA, Pearson JL, Khodyakov D, et al. Reducing the bur-den of suicide in the US:the aspirational research goals of the National Action Alliance for Suicide Prevention Research Prioritization Task Force[J]. Am J Prev Med, 2014, 47(3):309-314. DOI PMID
[5]	Miller IW, Camargo CA Jr, Arias SA, et al. Suicide prevention in an emergency department population:the ED-SAFE study[J]. JAMA Psychiatry, 2017, 74(6):563-570. DOI PMID
[6]	Ahmedani BK, Simon GE, Stewart C, et al. Health care contacts in the year before suicide death[J]. J Gen Intern Med, 2014, 29(6):870-877. DOI PMID
[7]	中共中央国务院. 《“健康中国2030”规划纲要》[EB/OL].(2016-10-25)[2022-05-08]. http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.
	The State Council of the Central Committee of the Communist Party of China. “Healthy China 2030” Planning Outline[EB/OL].(2016-10-25)[2021-04-02]. http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.
[8]	肖水源, 杨洪, 董群惠, 等. 自杀态度问卷的编制及信度与效度研究(自杀系列研究之一)[J]. 中国心理卫生杂志, 1999, 13(4):250-251.
	Xiao SY, Yang H, Dong QH, et al. The development,reliability and validity of suicide attitude inventory[J]. Chin Ment Heal J, 1999, 13(4):250-251.
[9]	司敏, 谭继平, 杨珊, 等. 社区护士自杀相关态度及教育干预研究[J]. 护理学杂志, 2015, 30(10):98-100,105.
	Si M, Tan JP, Yang S, et al. Community nurses’ suicide related attitudes and an educational intervention program[J]. J Nurs Sci, 2015, 30(10):98-100,105.
[10]	许珂, 胡德英, 谭蓉, 等. 患者自杀风险筛查与评估的研究进展[J]. 中华护理杂志, 2019, 54(3):467-471. DOI URL
	Xu K, Hu DY, Tan R, et al. Research progress on patient suicide risk screen and assessment in foreign countries[J]. Chin J Nurs, 2019, 54(3):467-471.
[11]	Ajzen I. The theory of planned behavior[J]. Organ Behav Hum Decis Process, 1991, 50(2):179-211. DOI URL
[12]	Francis J, Eccles M P, Johnston M, et al. Constructing questionnaires based on the theory of planned behaviour:a manual for health services researchers[M]. Newcastle upon Tyne,UK: Centre for Services Research,University of Newcastle upon Tyne. 2004.
[13]	Michael A, Stuart B, et al. Caring for adult patients with suicide risk—a consensus guide for emergence department[M]. Newton,MA: Education Development Center. 2015:14-15.
[14]	Colaizzi PF. Psychological research as the phenomenologist views it[M]. New York: Oxlord University Press. 1978:48-71.
[15]	陈平雁. 临床试验中样本量确定的统计学考虑[J]. 中国卫生统计, 2015, 32(4):727-731,733.
	Chen PY. Statistical consideration of sample size determination in clinical trials[J]. Chin J Heal Stat, 2015, 32(4):727-731,733.
[16]	谭蓉, 胡德英, 刘义兰, 等. 住院患者自杀风险评估量表的编制及信效度检验[J]. 中华护理杂志, 2018, 53(9):1096-1099.
	Tan R, Hu DY, Liu YL, et al. Development of an indicator sys-tem for evaluating mental health in inpatients[J]. Chin J Nurs, 2018, 53(9):1096-1099.
[17]	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 ML. Statistical consideration of sample size determination in clinical trials[M]. 2nd ed. Chongqing: Chongqing University Press, 2010.
[18]	Ajzen I. The theory of planned behaviour:reactions and reflections[J]. Psychol Health, 2011, 26(9):1113-1127. DOI PMID
[19]	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):49-52.
	Shi JC, Mo XK, Sun ZQ. Content validity index in scale development[J]. J Central South Univ Med Sci, 2012, 37(2):49-52.
[20]	曾桂珍, 胡媛, 李东娜, 等. 268名急诊医护人员对自杀患者的态度调查[J]. 护理学报, 2017, 24(20):38-40.
	Zeng GZ, Hu Y, Li DN, et al. Attitude of 268 emergency me-dical staff towards suicide patients[J]. J Nurs China, 2017, 24(20):38-40.
[21]	刘玉娥, 胡德英, 滕芬, 等. 急诊医护人员接诊自杀未遂患者心理体验的质性研究[J]. 中华护理杂志, 2021, 56(8):1133-1137. DOI URL
	Liu YE, Hu DY, Teng F, et al. Psychological experience of emer-gency medical staff in the treatment of attempted suicide patients:a qualitative study[J]. Chin J Nurs, 2021, 56(8):1133-1137.
[22]	许珂. 护理人员对住院患者自杀预防的知识—态度—行为研究[D]. 武汉: 华中科技大学, 2019.
	Xu K. An investigation about nurses’ knowledge,attitude and behavior of inpatients suicide prevention[D]. Wuhan: Huazhong University of Science and Technology, 2019.