PICC置管患者运动恐惧评估量表的编制及应用

doi:10.3761/j.issn.0254-1769.2025.09.012

摘要/Abstract

摘要：

目的编制PICC置管患者运动恐惧评估量表，检验其信效度并进行初步应用，为护士准确评估PICC置管患者的运动恐惧程度、制订针对性的干预措施提供有效工具。方法以心理想象信念模型为理论基础，通过文献回顾、半结构式访谈、专家函询及预调查形成初始版量表。2024年2月—4月，采用便利抽样法，选取在武汉市某三级甲等综合医院就诊的211例PICC置管患者进行调查，并进行项目分析和信效度检验。2024年5月—7月，采用便利抽样法，选取在武汉市3所三级甲等综合医院就诊的256例PICC置管患者进行调查，以进一步验证量表的结构效度并进行初步应用。结果 2024年2月—4月共回收有效问卷203份，2024年5月—7月共回收有效问卷228份。PICC置管患者运动恐惧评估量表包括危险感知、恐惧信念、运动回避及功能紊乱4个维度，共17个条目。总量表的Cronbach’s α系数为0.922，折半信度为0.867，重测信度为0.958。条目水平的内容效度指数为0.867~1.000，量表水平的内容效度指数为0.951；探索性因子分析及平行分析均提取出4个因子，累计方差贡献率为61.348%。验证性因子分析结果显示，模型拟合良好。初步应用结果显示，PICC置管患者运动恐惧得分为（53.95±11.08）分，处于中等偏高水平。结论 PICC置管患者运动恐惧评估量表具有良好的测量学属性，可用于评估PICC置管患者的运动恐惧程度。

关键词: 经外周静脉置入中心静脉导管, 运动恐惧, 量表, 信度, 效度, 护理

Abstract:

Objective To develop and test the reliability and validity of a Fear of Movement Assessment Scale for patients with peripherally inserted central catheters（PICC），and to make a preliminary application. The aim is to provide an effective tool for nurses to accurately assess the level of fear of movement in patients with PICC and to develop targeted interventions. Methods Based on the psychological imagination belief model，the initial version of the scale was formed through literature review，semi-structured interviews，expert correspondence and a pre-survey. From February to April 2024，211 patients with PICCs were recruited from a tertiary hospital in Wuhan by convenience sampling for project analysis and reliability and validity test. From May to July 2024，256 patients with PICCs from 3 tertiary hospitals in Wuhan were selected by convenience sampling method for further validating the structural validity of the scale and for preliminary application. Results A total of 203 valid questionnaires were collected in February to April 2024，228 valid questionnaires were collected in May to July 2024. The fear of movement assessment scale for patients included 4 dimensions，including the perception of risk，belief of fear，avoidance of movement，and dysfunction，with a total of 17 items. The Cronbach’s α coefficient was 0.922；the split-half reliability was 0.867；the test-retest reliability was 0.958. The content validity index at the item level was 0.867~1.000，and the content validity index at the scale level was 0.951. Both exploratory factor analysis and parallel analysis extracted 4 factors. The cumulative variance contribution rate was 61.348%. Confirmatory factor analysis showed that the model fitted well. The preliminary application results showed that the score of fear of movement in patients with PICCs was 53.95±11.08，which was moderately high. Conclusion The Fear of Movement Assessment Scale for patients with PICCs has good measurement properties，and can be used to assess the degree of fear of movement in patients with PICCs.

Key words: Peripherally Inserted Central Catheter, Fear of Movement, Scale, Reliability, Validity, Nursing Care

李子崴, 冯丽娟, 陈旭升, 黄毅, 杨洁. PICC置管患者运动恐惧评估量表的编制及应用[J]. 中华护理杂志, 2025, 60(9): 1099-1106.

LI Ziwei, FENG Lijuan, CHEN Xusheng, HUANG Yi, YANG Jie. Development and application of a Fear of Movement Assessment Scale for patients with peripherally inserted central catheters[J]. Chinese Journal of Nursing, 2025, 60(9): 1099-1106.

图/表 1

参考文献 21

[1]	Fu JQ, Cai WF, Zeng BW, et al. Development and validation of a predictive model for peripherally inserted central catheter-related thrombosis in breast cancer patients based on artificial neural network:a prospective cohort study[J]. Int J Nurs Stud, 2022,135:104341.
[2]	Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy stan-dards of practice,8th edition[J]. J Infus Nurs, 2021, 44(Suppl 1):S1-S224.
[3]	刘建萍, 郭卫婷, 高伟, 等. 心脏康复患者运动恐惧体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(4):474-481. DOI
	Liu JP, Guo WT, Gao W, et al. Meta-synthesis of qualitative research on the experience of kinesiophobia in patients with cardiac rehabilitation[J]. Chin J Nurs, 2024, 59(4):474-481. DOI
[4]	梁秋婷, 杨丽, 周溢, 等. PICC置管肿瘤患者恐动症现状及影响因素分析[J]. 护理学杂志, 2023, 38(6):59-62.
	Liang QT, Yang L, Zhou Y, et al. Analysis of kinetophobia and its influencing factors in cancer patients with PICC cathete-rization[J]. J Nurs Sci, 2023, 38(6):59-62.
[5]	Henriksson A, Johansson B, Radu C, et al. Is it safe to exercise during oncological treatment? A study of adverse events during endurance and resistance training-data from the Phys Can study[J]. Acta Oncol, 2021, 60(1):96-105. DOI PMID
[6]	Parás-Bravo P, Paz-Zulueta M, Santibañez M, et al. Living with a peripherally inserted central catheter:the perspective of cancer outpatients:a qualitative study[J]. Support Care Cancer, 2018, 26(2):441-449. DOI PMID
[7]	李雪萍, 魏文武, 武艳, 等. 经外周置入中心静脉导管患者肩关节活动状况的调查[J]. 中华护理杂志, 2019, 54(8):1220-1223. DOI
	Li XP, Wei WW, Wu Y, et al. Investigation of shoulder joint movement in patients with peripherally inserted central catheters[J]. Chin J Nurs, 2019, 54(8):1220-1223. DOI
[8]	Woby SR, Roach NK, Urmston M, et al. Psychometric properties of the TSK-11:a shortened version of the Tampa Scale for Kinesiophobia[J]. Pain, 2005, 117(1/2):137-144.
[9]	虎银凤, 周丽琼, 刘瑞卿, 等. 冠心病病人运动恐惧量表的汉化及信效度检验[J]. 护理研究, 2024, 38(2):287-292.
	Hu YF, Zhou LQ, Liu RQ, et al. Chinesization of Fear of Activity in Patients with Coronary Artery Disease and its re-liability and validity test[J]. Chin Nurs Res, 2024, 38(2):287-292.
[10]	雷梦杰, 刘婷婷, 熊司琦, 等. 心脏病患者运动恐惧量表的汉化及信度效度检验[J]. 中国护理管理, 2019, 19(11):1637-1642.
	Lei MJ, Liu TT, Xiong SQ, et al. Reliability and validity test of Chinese version of the Tampa Scale for Kinesiophobia Heart[J]. Chin Nurs Manag, 2019, 19(11):1637-1642.
[11]	Hoertel N, Peyre H, Lavaud P, et al. Examining sex differences in DSM-IV-TR narcissistic personality disorder symptom ex-pression using item response theory(IRT)[J]. Psychiatry Res, 2018,260:500-507.
[12]	Pfingsten M, Kröner-Herwig B, Leibing E, et al. Validation of the German version of the Fear-Avoidance Beliefs Question-naire(FABQ)[J]. Eur J Pain, 2000, 4(3):259-266. PMID
[13]	杨莉萍, 亓立东, 张博. 质性研究中的资料饱和及其判定[J]. 心理科学进展, 2022, 30(3):511-521. DOI
	Yang LP, Qi LD, Zhang B. Concepts and evaluation of satu-ration in qualitative research[J]. Adv Psychol Sci, 2022, 30(3):511-521.
[14]	文晓慧, 张强, 崔旭, 等. 基于德尔菲法构建冠心病患者心脏康复依从性评价量表[J]. 中国康复医学杂志, 2023, 38(3):348-355.
	Wen XH, Zhang Q, Cui X, et al. Development of an Adheren-ce of Cardiac Rehabilitation Assessment Scale in Patients with Coronary Heart Disease based on the Delphi method[J]. Chin J Rehabil Med, 2023, 38(3):348-355.
[15]	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 ML. Practice of questionnaire statistical analysis:SPSS ope-ration and application[M]. Chongqing: Chongqing University Press, 2010.
[16]	孔明, 卞冉, 张厚粲. 平行分析在探索性因素分析中的应用[J]. 心理科学, 2007, 30(4):924-925,918.
	Kong M, Bian R, Zhang HC. The application of parallel ana-lysis in exploratory factor analysis[J]. Psychol Sci, 2007, 30(4):924-925,918.
[17]	刘海婷, 王咏梅, 郑贝贝, 等. 冠心病合并糖尿病患者药物素养自评量表的编制及信效度检验[J]. 中华护理杂志, 2024, 59(9):1065-1072.
	Liu HT, Wang YM, Zheng BB, et al. Development and relia-bility and validity test of a Self-Assessment Scale for Medi-cation Literacy in Patients with Coronary Heart Disease Co-morbidity Diabetes[J]. Chin J Nurs, 2024, 59(9):1065-1072.
[18]	陈峰. 医用多元统计分析方法[M]. 3版. 北京: 中国统计出版社, 2018.
	Chen F. Medical multivariate statistical analysis method[M]. 3rd ed. Beijing: China Statistics Press, 2018.
[19]	Jiménez-Cebrián AM, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, et al. Kinesiophobia levels in patients with Parkinson’s disease:a case-control investigation[J]. Int J Environ Res Pub-lic Health, 2021, 18(9):4791.
[20]	胡勇. 聚类分析结果评价方法研究[D]. 包头: 内蒙古科技大学, 2014.
	Hu Y. Study on evaluation method of cluster analysis results[D]. Baotou: Inner Mongolia University of Science & Techno-logy, 2014.
[21]	陈钰妹, 赵惠芬, 赵晓珊, 等. 妊娠期糖尿病孕妇风险感知量表的编制及信效度检验[J]. 中华护理杂志, 2024, 59(6):677-684. DOI
	Chen YM, Zhao HF, Zhao XS, et al. Development and reliabi-lity and validity test of a Risk Perception Scale for Pregnant Women with Gestational Diabetes Mellitus[J]. Chin J Nurs, 2024, 59(6):677-684.