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

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