家属ICU后综合征症状评估量表的研制及信效度检验:一项横断面研究OA

Objective Post-Intensive Care Syndrome-Family(PICS-F)refers to the new-onset or aggravated multidimensional impairments in physical,psychological,and social functioning that family members may develop during and after the patient's intensive care unit(ICU)stay,which can affect their physical and mental health,decision-making and caregiving capacity,and even patient outcomes.However,the existing tools have limited applicability to family members after ICU discharge.Based on the symptom management theory,this study aims to develop a symptom assessment scale for PICS-F and test its reliability and validity among family members within 1 month after ICU discharge,thereby providing a tool for early clinical assessment.Methods An item pool for the scale was constructed through a scoping review and semi-structured interviews with family members,and a preliminary version of the scale was formed after Delphi expert consultation and revision following a pilot survey.A cross-sectional design was then adopted for scale validation.Two-phase validation study was carried out.Family members of patients transferred out of ICU within 1 month were conveniently sampled from the Second Affiliated Hospital of Army Medical University and the General Hospital of Northern Theater Command.In Phase 1(March – May 2026),190 participants were enrolled,and item analysis and exploratory factor analysis(EFA)were performed to screen items and determine the dimensional structure.In Phase 2(May—June 2026),201 participants were enrolled,and confirmatory factor analysis(CFA)was applied to verify model fit.Convergent validity,discriminant validity,and internal consistency reliability were also examined.Results The final version of the PICS-F symptom assessment scale comprised 20 items across 4 dimensions:emotional symptoms,physiological symptoms,cognitive symptoms,and social functioning distress.EFA extracted 4 common factors with a cumulative variance contribution rate of 70.209%,and the factor loadings of individual items ranged from 0.527 to 0.939,forming 4 first-order dimensions.CFA demonstrated adequate model fit,with χ2/df=2.377,root mean square error of approximation(RMSEA)=0.083,comparative fit index(CFI)=0.916,Tucker-Lewis index(TLI)=0.902,and standardized root mean squared residual(SRMR)=0.063.All dimensions achieved acceptable convergent validity,with average variance extracted(AVE)>0.5 and composite reliability(CR)>0.7,indicating satisfactory discriminant validity.The total scale exhibited excellent internal consistency(Cronbach's α=0.942)and split-half reliability(0.857),indicating good scale reliability.Conclusion The PICS-F symptom assessment scale developed in this study demonstrates satisfactory reliability and validity,and can serve as a comprehensive instrument for evaluating PICS-F-related symptom burden in family members,providing a reference for formulating individualized intervention strategies.