ICU患者家属风险沟通和治疗决策有效性综合评估量表的汉化及信效度检验

doi:10.3761/j.issn.2096-7446.2025.08.014

摘要/Abstract

摘要：

目的对风险沟通和治疗决策有效性综合评估量表（Combined Outcome Measure for Risk Communication and Treatment Decision-Making Effectiveness，COMRADE）进行汉化，并检验中文版量表在ICU患者家属中的信效度。方法按照Brislin翻译模式，将英文版COMRADE量表翻译成中文并进行文化调试，确保其语义和文化的适用性。采用方便抽样法，选取2024年4月—8月在浙江省3所三级甲等综合医院ICU的450名患者家属进行问卷调查，评估量表的信效度。结果中文版COMRADE量表包含风险沟通和决策有效性2个维度，共20个条目，量表的内容效度为0.96；因子分析提取2个公因子，累积方差贡献率为60.67%；量表总的Cronbach’s α系数为0.842，折半信度为0.701~0.749。验证性因子分析显示模型拟合良好（χ²/df=2.143，近似误差均方根为=0.068，比较拟合指数为=0.920，增量拟合指数为=0.910）。结论中文版COMRADE量表具有良好的信度和效度，可用于评估ICU患者家属在替代医疗决策过程中的风险沟通与决策有效性。

关键词: 风险沟通, 治疗决策, 信度, 效度, 量表

Abstract:

Objective To translate the Combined Outcome Measure for Risk Communication and Treatment Decision-Making Effectiveness（COMRADE） to Chinese，and test the reliability and validity of the Chinese version of the scale in the families of critically ill patients. Methods The English version of COMRADE was translated into Chinese according to the Brislin translation model and culturally adjusted to ensure its semantic and cultural applicability. A convenience sampling method was employed to select 450 family members of patients in the ICUs of a tertiary class A general hospital in Zhejiang Province between April and August 2024 for the purpose of assessing the reliability and validity of the scale. Results The Chinese version of the COMRADE contained 2 dimensions of risk communication and decision effectiveness，with a total of 20 items，and the content validity of the scale was 0.96. The factor analysis extracted 2 common factors，and the cumulative variance contribution rate was 63.67%. The total Cronbach’s alpha coefficient of the scale was 0.842，with folded reliabilities ranging from 0.701 to 0.749. Validation factor analysis showed a good model fit（χ²/df=2.143，RMSEA=0.068，CFI=0.920，TLI=0.910）. Conclusion The Chinese version of the COMRADE scale has been demonstrated to possess both reliability and validity，and thus represents a valuable tool for the assessment of the effectiveness of risk communication and decision-making processes among ICU family members in the context of alternative medicine.

Key words: Risk Communication, Treatment Decision-Making, Reliability, Validity, Scale

陈盈, 唐佳迎, 郭芝廷, 封秀琴. ICU患者家属风险沟通和治疗决策有效性综合评估量表的汉化及信效度检验[J]. 中华急危重症护理杂志, 2025, 6(8): 975-981.

CHEN Ying, TANG Jiaying, GUO Zhiting, FENG Xiuqin. Reliability and validity testing of the Chinese version of Combined Outcome Measure for Risk Communication and Treatment Decision-Making Effectiveness in family members of ICU patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 975-981.

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