终末期患者居家社会照护需求评估工具的构建及信效度检验

doi:10.3761/j.issn.0254-1769.2025.01.014

摘要/Abstract

摘要：

目的构建终末期患者居家社会照护需求评估工具，并检验其信效度。方法以社会生态系统理论为框架，基于终末期患者居家社会照护需求的半结构式访谈、参与式观察及文献分析结果，形成条目池。通过3轮专家函询，形成初始版评估工具。采用方便抽样法，于2023年4月—12月，选取5个省（市）22所医院收治的504例终末期患者作为调查对象，对评估工具进行信效度检验。结果终末期患者居家社会照护需求评估工具包括微观、中观、宏观3个维度，共34个条目。评估工具的Cronbach’s α系数为0.966、折半信度系数为0.877；条目水平的内容效度指数为0.875~1.000，量表水平的平均内容效度指数为0.989；探索性因子分析结果显示，各维度下条目的因子载荷值均>0.4；验证性因子分析结果显示，模型拟合度较好。结论该研究构建的终末期患者居家社会照护需求评估工具的信度与效度较好，可为医护人员评估终末期患者的居家社会照护需求提供有效工具。

关键词: 居家, 终末期, 社会照护, 需求, 评估工具, 信效度, 安宁疗护

Abstract:

Objective A Social Care Needs Assessment Tool for Terminal Patients at Home is constructed and tested for its reliability and validity. Methods In view of the Social Ecosystem Theory，based on the semi-structured interviews，participatory observation and literature analysis of the social care needs of terminal patients at home，a questionnaire item pool was formed. Through 3 rounds of Delphi expert consultations，the initial version of the tool was formed. From April to December 2023，a convenient sampling method was used to select 504 terminal patients from 22 hospitals in 5 provinces as the research subjects. The reliability and validity of the tool were tested. Result The constructed tool in this study contained 3 dimensions：micro，meso，macro，with a total of 34 items. Cronbach’s α of the tool was 0.966 and split-half reliability was 0.877；I-CVI at the item level was 0.875~1.000 and S-CVI/Ave was 0.989；the exploratory factor analysis results showed that the factors load of each dimension were greater than 0.4；the results of confirmatory factor analysis showed that the tool had good fitting degree. Conclusion The reliability and validity of the nursing-based social care needs assessment tool for terminal patients at home constructed in this study are good，and it can provide a valid tool for healthcare professionals to assess the home-based social care needs of terminal patients.

Key words: Home, Terminal Period, Social Care, Needs, Assessment Tool, Reliability and Validity, Palliative Care

肖瑶, 张晓天, 魏永婷, 马迎辉, 龚霓, 杨晶, 王梓珅, 岳鹏. 终末期患者居家社会照护需求评估工具的构建及信效度检验[J]. 中华护理杂志, 2025, 60(1): 99-105.

XIAO Yao, ZHANG Xiaotian, WEI Yongting, MA Yinghui, GONG Ni, YANG Jing, WANG Zishen, YUE Peng. Study of an Assessment Tool for Social Care Needs of Terminal Patients at Home and its reliability and validity[J]. Chinese Journal of Nursing, 2025, 60(1): 99-105.

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