Development and reliability and validity test of the Post-Intensive Care Syndrome Scale for Children

doi:10.3761/j.issn.0254-1769.2025.12.008

Abstract

Abstract:

Objective To develop an assessment scale for post-intensive care syndrome in pediatrics （PICS-p） and evaluate its reliability and validity，aiming to provide a scientifically sound and feasible tool for clinical assessment. Methods Based on the PICS-p conceptual framework，combined with literature review，semi-structured interviews，and Delphi expert consultation，a preliminary scale was developed. From June to December 2023，a survey was conducted among 330 pediatric patients who were discharged from a tertiary children's hospital in Hangzhou，followed by a two-week retest with 30 children to assess the reliability and validity of the scale. Results Finally 304 children completed the survey. The Post-Intensive Care Syndrome Scale for Children consists of 4 dimensions of physical dysfunction，cognitive dysfunction，psychological dysfunction and social dysfunction，with a total of 29 entries，with a cumulative variance contribution of 61.705%. The content validity index for individual items ranged from 0.800 to 1.000，and the content validity index for the scale as a whole was 0.98. The dimensions of the scale showed positive correlations with the Functional Status Scale（r=0.438-0.581，P<0.001）. The overall Cronbach's α coefficient of the scale was 0.847；the split-half reliability was 0.868；the test-retest reliability was 0.832. Conclusion The scale demonstrates good reliability and validity，and it is suitable for assessing the severity of PICS-p in pediatric patients discharged from the PICU.

Key words: Children, Post-Intensive Care Syndrome, Scale, Reliability, Validity, Pediatric Nursing

摘要： 目的编制儿童重症监护后综合征（post intensive care syndrome in pediatrics，PICS-p）评估量表，并检验其信效度，旨在为临床评估提供科学可行的工具。方法以PICS-p概念框架为理论基础，结合文献回顾、半结构式访谈及德尔菲专家函询，形成初始量表。采用便利抽样法，于2023年6月—12月，选取曾在杭州市某三级甲等儿童医院儿科重症监护病房住院治疗的330例患儿进行调查，并于2周后对30例再次调查，检验量表的信效度。结果最终304例患儿完成调查。PICS-p评估量表包括身体功能障碍、认知功能障碍、心理功能障碍及社会功能障碍4个维度，共29个条目，累计方差贡献率为61.705%。量表条目水平的内容效度指数为0.800~1.000，量表水平的内容效度指数为0.980。量表总分及各维度与功能状态量表得分呈正相关（r=0.438~0.581，P<0.001）。量表总的Cronbach's α系数为0.847，折半信度为0.868，重测信度为0.832。结论该量表具有良好的信效度，适用于儿科重症监护病房转出患儿PICS-p严重程度的评估。

关键词: 儿童, 重症监护后综合征, 量表, 信度, 效度, 儿科护理学

ZHU Jiajia, CHUI Linbo, WANG Peiying, ZHOU Jun, TANG Xiaomin, JIN Hongcheng, CHEN Mengyi, LI Jiajia, ZHU Jihua. Development and reliability and validity test of the Post-Intensive Care Syndrome Scale for Children[J]. Chinese Journal of Nursing, 2025, 60(12): 1461-1467.

朱佳佳, 炊琳博, 王培影, 周军, 唐晓敏, 金泓丞, 陈梦怡, 李佳佳, 诸纪华. 儿童重症监护后综合征评估量表的编制及信效度检验[J]. 中华护理杂志, 2025, 60(12): 1461-1467.

Figures/Tables 1

References 21

[1]	Manning JC, Pinto NP, Rennick JE, et al. Conceptualizing post intensive care syndrome in children-the PICS-p framework[J]. Pediatr Crit Care Med, 2018, 19(4):298-300.
[2]	Ko MSM, Poh PF, Heng KYC, et al. Assessment of long-term psychological outcomes after pediatric intensive care unit admission:a systematic review and meta-analysis[J]. JAMA Pediatr, 2022, 176(3):e215767.
[3]	Scott Watson R, Choong K, Colville G, et al. Life after critical illness in children-toward an understanding of pediatric post-intensive care syndrome[J]. J Pediatr, 2018,198:16-24.
[4]	Woodruff AG, Choong K. Long-term outcomes and the post-intensive care syndrome in critically ill children:a North American perspective[J]. Children, 2021, 8(4):254.
[5]	Herrup EA, Wieczorek B, Kudchadkar SR. Characteristics of postintensive care syndrome in survivors of pediatric critical illness:a systematic review[J]. World J Crit Care Med, 2017, 6(2):124-134.
[6]	刘明. Colaizzi七个步骤在现象学研究资料分析中的应用[J]. 护理学杂志, 2019,34(11):90-92.
	Liu M. Using an example to illustrate Colaizzi’s phenomenological data analysis method[J]. J Nurs Sci, 2019,34(11):90-92.
[7]	Schofield R, Chircop A, Baker C, et al. Entry-to-practice public health nursing competencies:a Delphi method and knowledge translation strategy[J]. Nurse Educ Today, 2018,65:102-107.
[8]	罗伯特·F. 德威利斯. 量表编制:理论与应用[M]. 席仲恩,杜珏译. 3版. 重庆: 重庆大学出版社,2016:61-167.
	Robert F. DeVellis. Scale development[M]. Xi ZE,Du J Translated. 3rd ed. Chongqing: Chongqing University Press,2016:61-167.
[9]	Pollack MM, Holubkov R, Glass P, et al. Functional Status Scale:new pediatric outcome measure[J]. Pediatrics, 2009, 124(1):e18-28.
[10]	杨洋, 王晶, 童梅玲, 等. 功能状态评估量表的汉化、改良及在极低出生体重婴儿信效度检验[J]. 浙江大学学报(医学版), 2022, 51(5):603-612.
	Yang Y, Wang J, Tong ML, et al. The localization and improvement of the Functional Status Scale and the reliability and validity in very low birth weight infants[J]. J Zhejiang Univ Med Sci, 2022, 51(5):603-612.
[11]	DeVellis RF, Thorpe CT. Scale development:theory and applications[M]. Thousand Oaks,CA: Sage publications, 2021.
[12]	Holding EZ, Turner EM, Hall TA, et al. The association between functional status and health-related quality of life following discharge from the pediatric intensive care unit[J]. Neurocrit Care, 2021, 35(2):347-357. DOI PMID
[13]	Weatherly AJ, Wang L, Lindsell CJ, et al. The physical abilities and mobility scale as a new measure of functional progress in the PICU[J]. J Pediatr Intensive Care, 2021, 13(1):100-107.
[14]	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,2010:158-224.
	Wu ML. Practice of questionnaire statistical analysis:SPSS operation and application[M]. Chongqing: Chongqing University Press,2010:158-224.
[15]	易丹辉, 李静萍. 结构方程模型及其应用[M]. 北京: 北京大学出版社,2019:31-34.
	Yi DH, Li JP. Structural equation model and its application[M]. Beijing: Peking University Press,2019:31-34.
[16]	侯蕾, 章萍, 李静蕊, 等. 糖尿病足患者出院准备度量表的编制及信效度检验[J]. 中华护理杂志, 2024, 59(19):2333-2339. DOI URL
	Hou L, Zhang P, Li JR, et al. Development and reliability and validity of a Discharge Preparation Scale for Diabetic Foot Patients[J]. Chin J Nurs, 2024, 59(19):2333-2339. DOI URL
[17]	史静琤, 莫显昆, 孙振球. 量表编制中内容效度指数的应用[J]. 中南大学学报(医学版), 2012, 37(2):49-52.
	Shi JC, Mo XK, Sun ZQ. Content validity index in scale development[J]. J Cent South Univ Med Sci, 2012, 37(2):49-52.
[18]	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 URL
	Chen YM, Zhao HF, Zhao XS, et al. Development and reliability and validity test of a Risk Perception Scale for Pregnant Women with Gestational Diabetes Mellitus[J]. Chin J Nurs, 2024, 59(6):677-684. DOI URL
[19]	Tang MT, Xu M, Su SY, et al. Post-intensive care syndrome in children:a concept analysis[J]. J Pediatr Nurs, 2021,61:417-423.
[20]	Maddux AB, Pinto N, Fink EL, et al. Postdischarge outcome domains in pediatric critical care and the instruments used to evaluate them:a scoping review[J]. Crit Care Med, 2020, 48(12):e1313-e1321.
[21]	Dow BL, Kenardy JA, Long DA, et al. Cognitive/affective fac-tors are associated with children's acute posttraumatic stress following pediatric intensive care[J]. Psychol Trauma, 2019, 11(1):55.