脑卒中自我管理效能量表的编制及信效度检验

Development and Validation of the Stroke Self-Management Efficacy Scale

摘要: 目的：编制适用于我国文化背景的脑卒中患者自我管理效能量表，并检验其信度和效度。方法：基于自我效能理论框架，通过文献分析、半结构式访谈、德尔菲专家函询及预调查形成量表初稿。于2025年3月至2025年12月，采用便利抽样法，对云南省曲靖市3所三级甲等医院的450例脑卒中居家康复患者进行调查，对量表进行项目分析、内部一致性信度、重测信度、内容效度、结构效度及校标关联效度检验。结果：最终形成的脑卒中自我管理效能量表包含疾病管理、康复训练、日常生活、情绪与社交4个维度，共16个条目。探索性因子分析显示，4个公因子的累计方差贡献率为72.815%。验证性因子分析表明模型拟合良好(χ²/df = 2.241, RMSEA = 0.063, CFI = 0.953, TLI = 0.945)。量表中的Cronbach’s α系数为0.945，折半信度为0.876，重测信度(间隔2周)为0.901。量表总分与中文版一般自我效能量表(GSES)的相关系数为0.762，与脑卒中自我管理行为量表的相关系数为0.718。结论：本量表具有良好的信度和效度，可作为评估我国脑卒中患者自我管理效能感的可靠工具，为识别康复心理动力薄弱环节、制定个性化心理行为干预方案提供依据。

Abstract: Objective: To develop a Stroke Self-Management Efficacy Scale (SSMES) suitable for the Chinese cultural context and to test its reliability and validity. Methods: Based on the self-efficacy theory framework, the initial scale was developed through literature analysis, semi-structured interviews, Delphi expert consultation, and a pre-survey. From March to December 2025, 450 stroke patients undergoing home-based rehabilitation from three tertiary hospitals in Qujing City, Yunnan Province, were surveyed using convenience sampling. Item analysis, internal consistency reliability, test-retest reliability, content validity, construct validity, and criterion-related validity were assessed. Results: The final SSMES consisted of 4 dimensions (disease management, rehabilitation training, daily life, emotion and social interaction) and 16 items. Exploratory factor analysis showed that the cumulative variance contribution rate of the 4 common factors was 72.815%. Confirmatory factor analysis indicated a good model fit (χ²/df = 2.241, RMSEA = 0.063, CFI = 0.953, TLI = 0.945). The total Cronbach’s α coefficient of the scale was 0.945, the split-half reliability was 0.876, and the test-retest reliability (2-week interval) was 0.901. The correlation coefficient between the total score of the SSMES and the Chinese version of the General Self-Efficacy Scale (GSES) was 0.762, and with the Stroke Self-Management Behavior Scale was 0.718. Conclusion: The SSMES demonstrates good reliability and validity, and can serve as a reliable tool for assessing the self-management efficacy of stroke patients in China. It provides a basis for identifying weaknesses in rehabilitation motivation and developing individualized psychological and behavioral intervention plans.