Abstract:

Objective To develop a Symptom Perception Distress Scale for patients with cardiovascular diseases and validate its reliability and validity，in order to provide a reliable tool for accurate assessment of symptom perception distress in this population. Methods Using the grounded theory approach，in-depth interviews were conducted with patients with cardiovascular disease. Open coding，axial coding，and selective coding were applied to extract core and main categories of symptom perception distress and construct a conceptual framework. The initial scale was developed through literature analysis，qualitative interviews，and expert consultation. A convenience sample of 600 patients with cardiovascular diseases from a tertiary hospital in Zhejiang Province was surveyed between November 2024 and February 2025 to test the reliability and validity of the preliminary scale. Results The Symptom Perception Distress Scale for cardiovascular diseases comprises 4 dimensions，including identification difficulty，attribution conflict，meaning confusion，and perception distress with a total of 45 items. Exploratory factor analysis extracted 4 common factors，accounting for a cumulative variance contribution rate of 56.38%. Confirmatory factor analysis indicated good model fit. The scale demonstrated a Cronbach’s α coefficient of 0.948，test-retest reliability of 0.881，and split-half reliability of 0.934. Conclusion The developed Symptom Perception Distress Scale for cardiovascular diseases had good reliability and validity. It effectively differentiated symptom perception levels among patients with varying genders，ages，disease durations，and cardiac function classifications，and it can be used as a tool for the degree of symptom perception distress in patients with chronic cardiovascular disease.

Key words: Cardiovascular Diseases, Symptom Perception, Distress, Scale, Reliability, Validity, Nursing Care

摘要：

目的 编制心血管疾病患者症状感知困境量表并验证其信效度，为准确评估心血管疾病患者的症状感知困境水平提供评估工具。方法 采用扎根理论方法，通过深度访谈心血管疾病患者，运用开放性编码、主轴编码和选择性编码，提炼症状感知困境的核心范畴和主范畴构建概念框架。通过文献分析、质性访谈、专家函询法编制量表初稿。便利选取2024年11月至2025年2月浙江省某三级甲等医院600例心血管疾病患者进行调查，对量表初稿进行信效度检验。结果 心血管疾病患者症状感知困境量表包含辨识困难、归因矛盾、意义困惑、感知困扰4个维度，45个条目。探索性因子分析共提取4个公因子，累计方差贡献率为56.380%。验证性因子分析显示模型拟合良好。量表总的Cronbach’s α系数为0.948，重测信度为0.881，分半信度为0.934。结论 编制的心血管疾病患者症状感知困境量表具有良好的信效度，能有效区分不同性别、年龄、病程和心功能分级患者的症状感知水平，可作为心血管疾病患者症状感知困境水平的有效评估工具。

关键词: 心血管疾病, 症状感知, 困境, 量表, 信度, 效度, 护理