癌症患者自杀风险评估量表的编制及信效度检验

doi:10.16460/j.issn1008-9969.2023.13.013

摘要/Abstract

摘要： 目的编制癌症患者自杀风险评估量表,为癌症患者自杀风险评估及构建有效的针对性的干预方案提供依据。方法在自杀三阶段理论框架的基础上,参考贝克绝望量表、人际需求问卷、自杀能力量表条目设置,采用文献回顾、半结构化访谈、小组讨论及德尔菲法确定量表初稿。采用便利抽样法抽取上海市某三级甲等医院的140例癌症患者进行调查,通过项目分析及探索性因子分析形成正式版量表。采用便利抽样法抽取上海市某三级甲等医院的205例癌症患者进行调查,通过验证性因子分析和信度分析进一步检验量表性能。结果形成了包含痛苦、绝望感与联结、自杀能力3个维度及15个条目的癌症患者自杀风险评估量表。验证性因子分析结果显示,量表的模型适配良好。总量表的Cronbach α系数为0.907,折半信度为0.818,内容效度指数为0.920。以自杀行为问卷-修订版为金标准,当量表的截断值为30分时,敏感度和特异度分别为63.60%和78.10%,ROC曲线下面积为0.766。结论该量表具有良好的信效度,可作为癌症患者的自杀风险评估工具。

关键词: 癌症, 自杀, 自杀三阶段理论, 信度, 效度

Abstract: Objective To develop a suicide risk assessment scale for cancer patients and to provide reference for suicide risk assessment and effective targeted intervention program for cancer patients. Methods Based on the Three-Step Theory of Suicide, with reference to the Beck Hopelessness Scale, Interpersonal Needs Questionnaire, and entry settings of Suicidal Ability Scale, the initial scale was constructed after literature review, semi-structured interview, group discussion, and Delphi method. Convenience sampling was used to select 140 patients in a tertiary grade-A hospital in Shanghai for the first investigation, and the final version of the scale was formed through item analysis and exploratory factor analysis. Convenience sampling was used to select 205 patients in a tertiary grade-A hospital in Shanghai for the second investigation, and the scale performance was further examined through confirmatory factor analysis and reliability analysis. Results The suicide risk assessment scale for cancer patients consisted of 3 dimensions of distress, feelings of hopelessness and association, suicidal ability and 15 items. The model fit of the scale was good. The Cronbach's alpha coefficient of internal consistency of the total table was 0.907; half-fold reliability 0.818; and content validity index of the total table 0.920. With the Suicidal Behaviors Questionnaire-Revised (SBQ-R) as the gold standard and a cutoff value of 30 points for the equivalence scale, the sensitivity and specificity were 63.60% and 78.10%, respectively, with an area under the ROC curve of 0.766. Conclusion The scale has good reliability and validity, and it can be used as a suicide risk assessment tool for patients with cancer.

Key words: cancer, suicide, Three-Step Theory of Suicide, reliability, validity

中图分类号:

R473.73

孙梦晨, 冯芳茗, 何佳倩, 范思雨, 杨颖, 季佳妮. 癌症患者自杀风险评估量表的编制及信效度检验[J]. 护理学报, 2023, 30(13): 13-17.

SUN Meng-chen, FENG Fang-ming, HE Jia-qian, FAN Si-yu, YANG Ying, JI Jia-ni. Development of Suicide Risk Assessment Scale for cancer patients and its reliability and validity[J]. Journal of Nursing, 2023, 30(13): 13-17.

参考文献

[1] Chung TH, Hanley K, Le YC, et al.A validation study of PHQ-9 suicide item with the Columbia Suicide Severity Rating Scale in outpatients with mood disorders at National Network of Depression Centers[J]. J Affect Disord,2023,320:590-594.DOI:10.1016/j.jad.2022.09.131.
[2] Nelson C, Johnston M, Shrivastava A.Improving risk assessment with suicidal patients a preliminary evaluation of the clinical utility of the Scale for Impact of Suicidality-Management, Assessment and Planning of Care (SIS-MAP)[J].Crisis,2010,31(5):231-237.DOI:10.1027/0227-5910/a000034.
[3] Nimeus A, Stahlfors FH, Sunnqvist C, et al.Evaluation of a modified interview version and of a self-rating version of the Suicide Assessment Scale[J]. Eur Psychiatry, 2006,21(7):471-477. DOI:10.1016/j.eurpsy.2006.01.011.
[4] 陆双鹤,张又文,隋晓爽,等.青少年自杀倾向量表测评大学生样本的效度和信度[J].中国心理卫生杂志, 2020, 34(1): 66-73.DOI:10.3969/j.issn.1000-6729.2020.1.013.
[5] 杨明丽,杨婷.住院精神病人自杀风险评估量表的初步编制[J].临床心身疾病杂志,2015(5):62-66. DOI:10.3969/j.issn.1672-187X.2015.05.022-0062-05.
[6] 高帆,李静雅,张康莉,等.军人自杀风险评估量表的编制[J].实用医药杂志, 2016, 33(7):636-637,645.DOI:10.14172/j.issn1671-4008.2016.07.025.
[7] 周霜,张京,叶盈,等.恶性肿瘤患者自杀风险评估量表的初步编制[J].中国全科医学,2019,22(9):1062-1067.DOI:10.12114/j.issn.1007-9572.2018.00.229.
[8] Klonsky ED, May AM.The Three-Step Theory (3ST): a new theory of suicide rooted in the "ideation-to-action" framework[J].Int J Cogn Ther,2015, 8(2):114-129.DOI:10.1521/ijct.2015.8.2.114.
[9] Anderson AM, Happ MB.The Three-Step Theory of suicide analysis and evaluation[J]. ANS Adv Nurs Sci,2021,44(1):89-100.DOI:10.1097/ANS.0000000000000337.
[10] 陈伟. 自杀三阶段理论在中国大学生样本中的初步验证-基于自杀“意念-行为”框架[D].天津:天津大学,2016.
[11] 孔媛媛,张杰,贾树华,等. Beck绝望量表中文版在青少年中使用的信度和效度[J].中国心理卫生杂志, 2007, 21(10):686-689.DOI:10.3321/j.issn:1000-6729.2007.10.008.
[12] 李晓敏,辛铁钢,袁靖,等.人际需求问卷中文版测评大学生样本的效度与信度[J].中国临床心理学杂志,2015,23(4):590-593.DOI:10.16128/j.cnki.1005-3611.2015.04.005.
[13] 张先庚,刘珊,刘林峰,等.基于德尔菲法构建初级医养结合老年护理人才岗位胜任力评价指标体系[J].解放军护理杂志,2022,39(3):24-27.DOI:10.3969/j.issn.1008-9993.2022.03.006.
[14] 郑卫军,何凡.现况调查的样本量计算方法[J].预防医学,2020, 32(6):647-648. DOI:10.19485/j.cnki.issn2096-5087.2020.06.028.
[15] 张莹,杨睿哲,彭晓霞,等.验证性因子分析原理、模型及其在量表结构效度评价中的应用[J].中华健康管理学杂志,2022,16(6):428-432.DOI:10.3760/cma.j.cn115624-20210928-00569.
[16] 石绪亮,朱亚,董江雪等.自杀行为问卷-修订版(SBQ-R)在中国大学生群体中的信效度检验[J].中国健康心理学杂志,2021,29(4):593-597.DOI:10.13342/j.cnki.cjhp.2021.04.025.
[17] 何红艳,周体,曾登芬,等.临床护理教师胜任力评价量表的研制及信效度检验[J].护理学报,2020, 27(24):11-14.DOI: 10.16460/j.issn1008-9969.2020.24.011.
[18] 徐立敏,钱志刚.临床带教教师隐性知识共享量表的编制及信效度检验[J].护理学报,2022,29(15):24-27.DOI:10.16460/j.issn1008-9969.2022.15.024.
[19] 吴明隆. 结构方程模型AMOS的操作与应用[M].重庆:重庆大学出版社,2010:37-62.
[20] 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,2010:243-244.
[21] 张帅,许国栋,陈红霞,等.晚期癌症患者居家安宁疗护需求评估量表的编制及信效度检验[J]. 护理学杂志,2023,38(2):96-99.DOI:10.3870/j.issn.1001-4152.2023.02.096.

相关文章 15

[1]	候莹鸽, 李好正, 侯云霞, 汪子寒, 李静, 王松梅, 赵亚杰, 阎玲. 食管癌术后患者胃食管反流自我管理测评量表的编制及信效度检验[J]. 护理学报, 2023, 30(5): 12-17.
[2]	马珠月, 姚珊珊, 史妍妍, 陆宁宁, 邾萍, 程芳. 女性乳腺癌患者淋巴水肿风险感知评估问卷的编制及信效度检验[J]. 护理学报, 2023, 30(4): 1-5.
[3]	钱湛, 杨晓婷, 林觐民. 癌症患者生育忧虑体验的Meta整合[J]. 护理学报, 2023, 30(4): 55-60.
[4]	董世攀, 梁小英, 黄兰怡, 梁善英, 梁锦波, 代炜, 赵玉玲, 黄沂. 功能性腹胀患者健康促进行为量表的汉化及信效度检验[J]. 护理学报, 2023, 30(3): 11-15.
[5]	苗康康, 陈勤. 儿童环境健康知识和技能问卷的汉化及信效度分析[J]. 护理学报, 2023, 30(2): 17-22.
[6]	相军爱, 闫荣, 丁敏, 孟祥敏, 林雨婷, 柳文慧, 姜凯. 癌症患者临终关怀偏好的研究进展[J]. 护理学报, 2023, 30(14): 37-41.
[7]	周贵玲, 徐蓉, 边旭娜, 郑维. 中青年2型糖尿病患者健康素养量表的研制及信效度检验[J]. 护理学报, 2023, 30(14): 73-78.
[8]	乔悦, 段培蓓, 王晓庆, 杨丽华, 邹炎铃, 费超男. 173例晚期癌症患者家庭回避癌症沟通现状及影响因素分析[J]. 护理学报, 2023, 30(13): 18-23.
[9]	牟静静, 任吉, 张彬彬, 门肖霞, 朱亚飞, 王亚男, 张鑫, 胡海燕, 赵晓甦. 直肠癌保肛术后患者盆底康复训练知信行问卷的编制及信效度检验[J]. 护理学报, 2023, 30(13): 65-68.
[10]	谭兰惠, 房培, 喻惠丹, 冯翎, 余立平. 231例女性癌症患者自我倡权现状及影响因素分析[J]. 护理学报, 2023, 30(12): 62-66.
[11]	张佳惠, 庞书勤, 洪雪珮, 郑智慧, 李绵利, 黄钰峰, 王炜骏. 老年前期人群退休规划过程量表的汉化及信效度检验[J]. 护理学报, 2023, 30(10): 1-6.
[12]	唐涵, 尚磊. 青少年癌症患者家庭照护者健康素养的研究进展[J]. 护理学报, 2023, 30(10): 31-34.
[13]	卢宇彤, 蒋运兰, 刘露, 刘明婷, 谢红梅, 陈曾丽. 青少年自杀真实体验质性研究的Meta整合[J]. 护理学报, 2023, 30(10): 40-45.
[14]	张慧鑫, 蔡卫新, 邢娅娜, 王翠雪, 尹志科, 张俊丽, 典慧娟, 林笑女. 护士心理韧性相关执业环境因素评估量表的构建及信效度检验[J]. 护理学报, 2023, 30(1): 53-59.
[15]	李慧, 潘玲, 李博, 刘晓辉. 患者安全胜任力自评量表的汉化及其在实习护生中的信效度评价[J]. 护理学报, 2022, 29(9): 47-51.

Metrics

Viewed

Full text

Abstract

Cited

Shared