肺移植患者居家肺康复自我管理行为量表的构建与信效度检验

doi:10.3761/j.issn.0254-1769.2026.11.008

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (11): 1496-1503.DOI: 10.3761/j.issn.0254-1769.2026.11.008

肺移植患者居家肺康复自我管理行为量表的构建与信效度检验

王姗¹(), 蔡英华²(), 周海琴³, 黄珂瑶³, 张莹湘³

1.郑州大学第一附属医院胸外科郑州市 450000
2.南京医科大学附属无锡人民医院护理部无锡市 214023
3.南京医科大学附属无锡人民医院肺移植中心无锡市 214023

收稿日期:2025-10-27 出版日期:2026-06-10 发布日期:2026-06-10
*通讯作者: 蔡英华，E-mail：yhcai26@163.com
作者简介:王姗：女，硕士，护师，E-mail：2090951824@qq.com
作者贡献声明
王姗：实施研究、采集及分析数据、撰写论文；蔡英华：酝酿和设计研究、指导研究、撰写及修改论文、经费支持；周海琴：指导研究、撰写及修改论文；黄珂瑶、张莹湘：实施研究、修改论文
基金资助:
无锡市医学重点学科建设项目(CXTD2021021)

Development，reliability and validity of the Self-Management Behavior Scale for Home-Based Pulmonary Rehabilitation in Lung Transplant Recipients

WANG Shan¹(), CAI Yinghua²(), ZHOU Haiqin³, HUANG Keyao³, ZHANG Yingxiang³

1. Department of Thoracic Surgery，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450000，China
2. Department of Nursing，the Affiliated Wuxi People’s Hospital of Nanjing Medical University，Wuxi 214023，China
3. Lung Transplant Center，the Affiliated Wuxi People’s Hospital of Nanjing Medical University，Wuxi 214023，China

Received:2025-10-27 Online:2026-06-10 Published:2026-06-10
* Corresponding author: CAI Yinghua，E-mail：yhcai26@163.com
Funding program:
Supported by Medical Key Discipline Program of Wuxi Health Commission(CXTD2021021)

摘要/Abstract

摘要：

目的构建肺移植患者居家肺康复自我管理行为量表，并验证其信效度，为临床医护人员评价肺移植患者居家肺康复自我管理行为水平提供科学、规范的工具。方法基于自我管理理论，通过文献分析、半结构式访谈、专家小组会议、专家函询及小样本预试验形成初始版量表。采用便利抽样法，选取2023年10月至2024年1月江苏省某三级甲等综合医院随访的231例居家肺移植患者为调查对象，通过项目分析及探索性因子分析进一步筛选量表条目，并验证其信效度。结果回收有效问卷217份，有效问卷回收率为93.94%。肺移植患者居家肺康复自我管理行为量表包括康复训练管理、症状管理、用药管理、生活与环境管理、情绪管理、监测管理6个维度，共23个条目。量表总的Cronbach’s α系数为0.892，折半信度为0.813，重测信度为0.901，量表水平的平均内容效度为0.973。经3次探索性因子分析后显示，累计方差贡献率为65.27%。结论构建的肺移植患者居家肺康复自我管理行为量表具有较好的信度和效度，可为评价肺移植患者居家肺康复自我管理行为水平提供合适的测量工具。

关键词: 肺移植, 居家, 肺康复, 自我管理, 量表编制, 信度, 效度, 护理

Abstract:

Objective To develop and validate the Home-Based Pulmonary Rehabilitation Self-Management Be-havior Scale（HPR-SMBS） for lung transplant recipients，thereby providing clinicians with a scientific instrument to evaluate recipients’ self-management behaviors. Methods The scale was developed based on self-management theory through a comprehensive process including a literature review，semi-structured interviews，Delphi expert consulta-tions，and pilot testing. Psychometric validation was conducted with 231 home-based lung transplant recipients from a tertiary hospital in Jiangsu Province between October 2023 and January 2024. Item refinement was carried out using critical ratio analysis，exploratory factor analysis（EFA），and reliability testing. Results 217 valid question-naires were recovered，and the validity recovery rate was 93.94%. The final 23-item HPR-SMBS comprises 6 domains，including rehabilitation training，symptom management，medication adherence，lifestyle/environmental adaptation，psychological adjustment，monitoring management. The psychometric properties showed excellent internal consistency（Cronbach’s α=0.892），split-half reliability（0.813），test-retest reliability（ICC=0.901），and content validity（S-CVI/Ave=0.973）. Exploratory factor analysis revealed 6 factors，explaining 65.27% of the cumulative variance. Conclusion The HPR-SMBS demonstrates strong reliability and validity，making it a valuable tool for assessing self-management behaviors in home-based pulmonary rehabilitation for lung transplant recipients.

Key words: Lung Transplantation, Home, Pulmonary Rehabilitation, Self-Management, Scale Development, Reliability, Validity, Nursing Care

王姗, 蔡英华, 周海琴, 黄珂瑶, 张莹湘. 肺移植患者居家肺康复自我管理行为量表的构建与信效度检验[J]. 中华护理杂志, 2026, 61(11): 1496-1503.

WANG Shan, CAI Yinghua, ZHOU Haiqin, HUANG Keyao, ZHANG Yingxiang. Development，reliability and validity of the Self-Management Behavior Scale for Home-Based Pulmonary Rehabilitation in Lung Transplant Recipients[J]. Chinese Journal of Nursing, 2026, 61(11): 1496-1503.

图/表 2

参考文献 28

[1]	Michel S, Schneider C, Ius F, et al. Lung transplantation:indications,follow-up care and long-term results[J]. Dtsch Arztebl Int, 2025, 122(2):43-48.
[2]	Paraskeva MA, Snell GI. Advances in lung transplantation:60 years on[J]. Respirology, 2024, 29(6):458-470.
[3]	张广健, 胡春晓, 陈静瑜, 等. 中国肺移植生物样本库构建临床指南(2025年版)[J]. 器官移植, 2025, 16(6):833-845.
	Zhang GJ, Hu CX, Chen JY, et al. Clinical guidelines for the construction of Chinese lung transplant biobank sample(2025 edition)[J]. Organ Transplant, 2025, 16(6):833-845.
[4]	Singh TP, Hsich E, Cherikh WS, et al. The international thoracic organ transplant registry of the International Society for Heart and Lung Transplantation:2025 annual report of heart and lung transplantation[J]. J Heart Lung Transplant, 2025, 44(12):1857-1873.
[5]	黄洁夫. 中国器官捐献和移植发展报告-2023[M]. 北京: 清华大学出版社, 2025.
	Huang JF. Report on the development of organ donation and transplatation in China-2023[M]. Beijing: Tsinghua University Press, 2025.
[6]	肖漓, 解立新, 石炳毅. 肺移植免疫学相关基础与临床研究进展[J]. 器官移植, 2021, 12(6):637-642.
	Xiao L, Xie LX, Shi BY. Progress on basic and clinical research of immunology in lung transplantation[J]. Organ Transplant, 2021, 12(6):637-642.
[7]	胡树菁, 孙菁, 彭复聪, 等. 肺移植受者居家护理需求质性研究的Meta整合[J]. 中华护理杂志, 2021, 56(10):1576-1583.
	Hu SJ, Sun J, Peng FC, et al. Care needs in lung transplant recipients at home:a Meta-synthesis of qualitative research[J]. Chin J Nurs, 2021, 56(10):1576-1583.
[8]	浙江省护理学会呼吸护理专业委员会. 肺移植患者术后肺康复护理专家共识[J]. 中华护理杂志, 2024, 59(1):10-15.
	Respiratory Nursing Committee of Zhejiang Nursing Association. Expert consensus on postoperative pulmonary rehabilitation nursing for lung transplant patients[J]. Chin J Nurs, 2024, 59(1):10-15.
[9]	吕秀霞, 陈瑞云, 魏立, 等. 肺移植患者肺康复的研究进展[J]. 中华护理杂志, 2019, 54(5):765-770.
	Lü XX, Chen RY, Wei L, et al. Research progress on pulmonary rehabilitation in patients underwent lung transplantation[J]. Chin J Nurs, 2019, 54(5):765-770.
[10]	胡树菁, 孙菁, 王奕, 等. 肺移植受者居家肺康复锻炼促进与障碍因素的质性研究[J]. 中华护理杂志, 2024, 59(17):2070-2077.
	Hu SJ, Sun J, Wang Y, et al. Facilitators and barriers of home pulmonary rehabilitation for lung transplant recipients:a qualitative study[J]. Chin J Nurs, 2024, 59(17):2070-2077.
[11]	Singh D, Agusti A, Anzueto A, et al. Global strategy for the diagnosis,management,and prevention of chronic obstructive lung disease:the GOLD science committee report 2019[J]. Eur Respir J, 2019, 53(5):1900164.
[12]	Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement:key concepts and advances in pulmonary rehabilitation[J]. Am J Respir Crit Care Med, 2013, 188(8):e13-e64.
[13]	Hu CX, Chen WH, He JX, et al. Lung transplantation in China between 2015 and 2018[J]. Chin Med J, 2019, 132(23):2783-2789.
[14]	师晨曦, 王佳妮, 肖倩, 等. 基于移动健康平台的自我管理干预在慢性阻塞性肺疾病患者肺康复中的应用[J]. 中国康复理论与实践, 2019, 25(6):734-739.
	Shi CX, Wang JN, Xiao Q, et al. Application of a self-manage-ment mobile platform in rehabilitation of chronic obstructive pulmonary disease[J]. Chin J Rehabil Theory Pract, 2019, 25(6):734-739.
[15]	van Zanten R, van Dijk M, van Rosmalen J, et al. Nurse-led self-management support after organ transplantation:protocol of a multicentre,stepped-wedge randomized controlled trial[J]. Trials, 2022, 23(1):14.
[16]	DeVito Dabbs A, Song MK, Myers BA, et al. A randomized controlled trial of a mobile health intervention to promote self-management after lung transplantation[J]. Am J Transplant, 2016, 16(7):2172-2180.
[17]	Hu L, Lingler JH, Sereika SM, et al. Nonadherence to the medical regimen after lung transplantation:a systematic review[J]. Heart Lung, 2017, 46(3):178-186.
[18]	Dew MA, Dimartini AF, De Vito Dabbs A, et al. Adherence to the medical regimen during the first two years after lung transplantation[J]. Transplantation, 2008, 85(2):193-202.
[19]	Hu L, DeVito Dabbs A, Dew MA, et al. Patterns and correlates of adherence to self-monitoring in lung transplant recipients during the first 12 months after discharge from transplant[J]. Clin Transplant, 2017, 31(8):e13014.
[20]	王姗, 蔡英华, 周海琴, 等. 肺移植患者居家自我管理行为评估工具的范围综述[J]. 中华现代护理杂志, 2024, 30(16):2218-2227.
	Wang S, Cai YH, Zhou HQ, et al. Scoping review of home-based self-management behaviors assessment tools in patients with lung transplant[J]. Chin J Mod Nurs, 2024, 30(16):2218-2227.
[21]	Corbin J, Strauss A. Managing chronic illness at home:three lines of work[J]. Qual Sociol, 1985, 8(3):224-247.
[22]	Lorig K. Self-management education:more than a nice extra[J]. Med Care, 2003, 41(6):699-701.
[23]	周海琴, 黄珂瑶, 闵群惠, 等. 肺移植术后主要照顾者照顾知信行调查及影响因素分析[J]. 护理研究, 2022, 36(16):2880-2885.
	Zhou HQ, Huang KY, Min QH, et al. Investigation and influencing factors analysis of caring knowledge,belief,and behavior of primary caregivers of patients after lung transplantation[J]. Chin Nurs Res, 2022, 36(16):2880-2885.
[24]	李峥, 刘宇. 护理学研究方法[M]. 北京: 人民卫生出版社,2015:260-261.
	Li Z, Liu Y. Nursing research methods[M]. Beijing: People’s Medical Publishing House,2015:260-261.
[25]	方积乾. 生物医学研究的统计方法[M]. 北京: 高等教育出版社,2007:1.
	Fang JQ. Statistical methods for biomedical research[M]. Beijing: Higher Education Press,2007:1.
[26]	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 operation and application[M]. Chongqing: Chongqing University Press, 2010.
[27]	徐晓锋, 刘勇. 评分者内部一致性的研究和应用[J]. 心理科学, 2007, 30(5):1175-1178.
	Xu XF, Liu Y. The research and application of interrater agreement[J]. Psychol Sci, 2007, 30(5):1175-1178.
[28]	Stanton K, Watson D. An examination of the structure and construct validity of the Wender Utah Rating Scale[J]. J Pers Assess, 2016, 98(5):545-552.

肺移植患者居家肺康复自我管理行为量表的构建与信效度检验

Development，reliability and validity of the Self-Management Behavior Scale for Home-Based Pulmonary Rehabilitation in Lung Transplant Recipients

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

图/表 2

参考文献 28

相关文章 15

编辑推荐

Metrics

[1]	中华护理学会静脉输液治疗专业委员会, 北京护理学会, （执笔：李佳, 李旭英, 覃惠英, 陈利芬, 吴珍明, 胡泽吟, 罗梦娜, 范育英, 吴嘉慧, 林宇萍, 王蕾, 孙文彦, 冯毕龙, 高伟, 李亚南, 侯罗娅, 李春燕. 中心静脉通路装置拔除护理专家共识[J]. 中华护理杂志, 2026, 61(9): 1157-1162.
[2]	周霞, 马艳艳, 师正坤, 于海霞, 周艳, 胡红玲, 李莜, 陈思思, 张京慧. 隧道式经股静脉PICC置入术在困难静脉通路婴幼儿中的应用研究[J]. 中华护理杂志, 2026, 61(9): 1163-1170.
[3]	黄萍, 李黎, 郭骊莉, 徐莹, 叶赟, 江淑芳. 与无针输液接头相关的导管相关性血流感染风险评估工具的构建与初步应用[J]. 中华护理杂志, 2026, 61(9): 1171-1179.
[4]	李佳, 张玉玲, 邢乐, 张利峰, 牛秀峰, 许莉. 早产儿经上肢置入PICC尖端继发性异位风险预测模型的建立与验证[J]. 中华护理杂志, 2026, 61(9): 1180-1186.
[5]	何娟, 赵蕾蕾, 叶冠军, 余艳芬, 傅晓君, 周琴. 1例双侧无名静脉及上腔静脉人工血管置换术后患者经上肢置入PICC的护理[J]. 中华护理杂志, 2026, 61(9): 1187-1191.
[6]	梁江淑渊, 曾妃, 何鹏, 谢梦珊, 江悦, 蒋宗恒, 王建茗. 静脉-静脉体外膜肺氧合患者早期活动风险等级评估系统的构建及应用研究[J]. 中华护理杂志, 2026, 61(9): 1192-1199.
[7]	陈晨, 顾肖, 郭凡, 王敏, 倪兴梅, 黄琴, 程念开. 3种衰弱评估工具对急诊老年创伤患者不良结局的预测价值[J]. 中华护理杂志, 2026, 61(9): 1200-1207.
[8]	郑煜琳, 刘晋宁, 张静, 郭会敏, 谷艳梅, 张莉莉. 酒精性肝病患者肝移植术后再饮酒现状及其影响因素分析[J]. 中华护理杂志, 2026, 61(9): 1208-1214.
[9]	叶俊霜, 沈丽佳, 孟霞靓, 张玉姣, 蔡根莲, 邵碧云, 周亚辉, 张柳倩, 应金萍. 维持性血液透析患者对口腔衰弱认知和体验的质性研究[J]. 中华护理杂志, 2026, 61(9): 1215-1220.
[10]	王芸姣, 杨玉金, 郑春艳, 彭菲津, 王淑贞, 蒋喜露, 周为民, 王薇, 张娜. 糖尿病下肢动脉硬化闭塞症患者介入术后康复护理方案的构建及应用研究[J]. 中华护理杂志, 2026, 61(9): 1221-1229.
[11]	杨明霞, 安冉, 臧金凤, 李春梅. 老年慢性病共病患者及照护者老老照护能力与自我忽视的相关性分析[J]. 中华护理杂志, 2026, 61(9): 1230-1236.
[12]	梁和静, 许鹊, 史云霞, 祖金美, 黄文静, 杨春旭, 郭明华, 王磊. 颈动脉内膜剥脱术围手术期护理质量评价指标的构建[J]. 中华护理杂志, 2026, 61(9): 1237-1244.
[13]	韩媛媛, 石玉竹, 尚文涵, 么莉. 870所三级甲等医院老年住院患者跌倒伤害发生现状与影响因素分析[J]. 中华护理杂志, 2026, 61(9): 1245-1252.
[14]	夏云芳, 王洪, 崔岱, 付真真, 朱敏. 1例弥漫性毒性甲状腺肿合并超敏反应综合征青少年患者的护理[J]. 中华护理杂志, 2026, 61(9): 1253-1256.
[15]	周益飞, 王海苹, 胡益环, 应莉, 罗松娜. 1例氢氟酸中毒并发呼吸心搏骤停患者的急救护理[J]. 中华护理杂志, 2026, 61(9): 1257-1260.