Abstract:

Objective To develop and validate a safety assessment scale for early mobilization in lung transplant patients after surgery. Methods From September 2022 to April 2023，a preliminary scale was constructed using literature analysis，expert meetings，and the Delphi method. From June 2023 to May 2024，a convenience sampling was used to select 135 patients admitted to the lung transplant center of a tertiary general hospital in Jiangsu Province. Item analysis，reliability analysis，and validity analysis were applied to adjust the items，forming the final scale. Results The post-operative early mobilization safety assessment scale for lung transplant patients includes 5 dimensions（consciousness level，vital signs，disease-related factors，mobility，and nutritional status） and 18 items. The inter-rater reliability of the scale is 0.985；the overall content validity index is 0.853；the split-half reliability is 0.716. The area under the receiver operating characteristic curve for predicting adverse events within 72 hours of mobilization is 0.845，with a 95% confidence interval of 0.767 to 0.917（P<0.001）. The optimal cutoff value is 18.5，with a sensitivity of 0.735 and a specificity of 0.782. Conclusion The developed safety assessment scale for early mobilization in lung transplant patients after surgery demonstrates good reliability and validity，and it can serve as a clinical tool to assess the safety of early mobilization activities in these patients.

Key words: Lung Transplantation, Early Mobilization, Safety Assessment, Scale Development, Nursing Care

摘要：

目的 研制肺移植患者术后早期离床安全评估量表并检验其信效度。方法 于2022年9月—2023年4月，采用文献分析法、专家会议法、德尔菲函询法构建量表初稿。于2023年6月—2024年5月，采用方便抽样法，选取江苏省某三级甲等综合医院肺移植中心收治的135例患者进行调查，应用项目分析、信度分析及效度分析对条目进行调整，形成最终版量表。结果 肺移植患者术后早期离床安全评估量表共包括意识水平、生命体征、疾病相关、活动能力和营养状态5个维度、18个条目。量表的评定者间信度为0.985；量表水平的内容效度为0.853；总的分半信度为0.716；预测患者72 h内发生离床不良事件的受试者操作特征曲线下面积为0.845，95%CI为0.767~0.917（P<0.001），最佳临界值为18.5，对应的灵敏度为0.735，特异度为0.782。结论 构建的肺移植患者术后早期离床安全评估量表信效度良好，可作为临床评估肺移植患者术后早期离床活动安全性的测量工具。

关键词: 肺移植, 早期离床, 安全评估, 量表构建, 护理