收稿日期: 2024-10-31
网络出版日期: 2025-08-12
基金资助
浙江省教育厅一般科研项目(Y202249636)
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
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。
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 . DOI: 10.3761/j.issn.2096-7446.2025.08.014
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
| [1] | 张佳佳, 陈凤, 宫晓艳, 等. ICU无行为能力患者替代决策的研究进展[J]. 中华急危重症护理杂志, 2022, 3(1):78-82. |
| Zhang JJ, Chen F, Gong XY, et al. Review on surrogate deci-sion-making for incapacitated patients in ICU[J]. Chin J Emerg Crit Care Nurs, 2022, 3(1):78-82. | |
| [2] | Wehking F, Debrouwere M, Danner M, et al. Impact of shared decision making on healthcare in recent literature:a scoping review using a novel taxonomy[J]. J Public Health, 2024, 32(12):2255-2266. |
| [3] | United States Congress. Patient protection and affordable care act[Z]. Washington,DC: U.S. Government Publishing Office, 2010, https://www.congress.gov/bill/111th-congress/house-bill/3590. |
| [4] | Siebinga VY, Driever EM, Stiggelbout AM, et al. Shared decision making,patient-centered communication and patient satisfac-tion-A cross-sectional analysis[J]. Patient Educ Couns, 2022, 105(7):2145-2150. |
| [5] | Agency for Healthcare Research and Quality(AHRQ). The SHARE approach—Achieving patient-centered care with shared decision making: A brief for administrators and practice lead-ers[EB/OL].(2020-05-01) [2024-09-30]. https://www.ahrq.gov/health-literacy/professional-training/shared-decision/index.html. |
| [6] | G?rtner FR, Bomhof-Roordink H, Smith IP, et al. The quality of instruments to assess the process of shared decision making:a systematic review[J]. PLoS One, 2018, 13(2):e0191747. |
| [7] | 程志强, 张宝珍, 夏娇云, 等. ICU患者照顾者代理决策体验质性研究的Meta整合[J]. 中华护理杂志, 2023, 58(16):2027-2033. |
| Cheng ZQ, Zhang BZ, Xia JY, et al. The decision making experience of surrogate decision makers for critically ill patients:a qualitative Meta-synthesis research[J]. Chin J Nurs, 2023, 58(16):2027-2033. | |
| [8] | Naef R, von Felten S, Ernst J. Factors influencing post-ICU psy-chological distress in family members of critically ill patients:a linear mixed-effects model[J]. Biopsychosoc Med, 2021, 15(1):4. |
| [9] | Basile M, Andrews J, Jacome S, et al. A decision aid to support shared decision making about mechanical ventilation in severe chronic obstructive pulmonary disease patients(Informed Toge-ther):feasibility study[J]. J Particip Med, 2018, 10(2):e7. |
| [10] | Locatelli SM, Etingen B, Heinemann A, et al. Perceptions of shared decision making among patients with spinal cord injuries/disorders[J]. Top Spinal Cord Inj Rehabil, 2016, 22(3):192-202. |
| [11] | Edwards A, Elwyn G, Hood K, et al. The development of COMRADE:a patient-based outcome measure to evaluate the effectiveness of risk communication and treatment decision making in consultations[J]. Patient Educ Couns, 2003, 50(3):311-322. |
| [12] | Brislin RW. Comparative research methodology:cross-cultural studies[J]. Int J Psychol, 1976, 11(3):215-229. |
| [13] | Pignatiello GA, Irani E, Tahir S, et al. A psychometric evalua-tion of the Family Decision-Making Self-Efficacy Scale among surrogate decision-makers of the critically ill[J]. Palliat Sup-port Care, 2020, 18(5):537-543. |
| [14] | 李琛, 郑福雪, 陈飞, 等. 护理人际关系量表的汉化及信效度检验[J]. 中华护理杂志, 2023, 58(16):2043-2048. |
| Li C, Zheng FX, Chen F, et al. Sinicization of Nursing Care Interpersonal Relationship Questionnaire and the test of its reliability and validity[J]. Chin J Nurs, 2023, 58(16):2043-2048. | |
| [15] | 李淑花, 商临萍, 袁丽荣, 等. 感染预防控制文化量表的汉化及信效度检验[J]. 中华护理杂志, 2024, 59(6):713-718. |
| Li SH, Shang LP, Yuan LR, et al. The sinicization of the Leading a Culture of Quality for Infection Prevention Scale and the test of its reliability and validity[J]. Chin J Nurs, 2024, 59(6):713-718. | |
| [16] | 汪张毅, 李利平, 邸淑珍, 等. 慢性病患者预期病耻感量表的汉化及信度效度检验[J]. 中国护理管理, 2024, 24(5):681-686. |
| Wang ZY, Li LP, Di SZ, et al. Psychometric properties of the Chinese version of the Chronic Illness Anticipated Stigma Scale[J]. Chin Nurs Manag, 2024, 24(5):681-686. | |
| [17] | 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, 2010:204-208. |
| Wu ML. Practice of questionnaire statistical analysis:SPSS operation and application[M]. Chongqing: Chongqing Universi-ty Press, 2010:204-208. | |
| [18] | 贾雪敬, 史宝欣. 腹膜透析照顾者负担量表的汉化及信效度检验[J]. 中华护理杂志, 2024, 59(21):2633-2639. |
| Jia XJ, Shi BX. Peritoneal dialysis care burden questionnaire:translation and validation[J]. Chin J Nurs, 2024, 59(21):2633-2639. | |
| [19] | Beaton DE, Bombardier C, Guillemin F, et al. Guidelines for the process of cross-cultural adaptation of self-report measu-res[J]. Spine, 2000, 25(24):3186-3191. |
| [20] | Brislin RW. Back-translation for cross-cultural research[J]. J Cross Cult Psychol, 1970, 1(3):185-216. |
| [21] | Hinkle LJ, Bosslet GT, Torke AM. Factors associated with family satisfaction with end-of-life care in the ICU:a systematic review[J]. Chest, 2015, 147(1):82-93. |
| [22] | 安晓, 薛雅婷, 夏雨, 等. ICU患者替代决策者决策疲劳现状及影响因素分析[J]. 中华护理杂志, 2023, 58(8):949-955. |
| An X, Xue YT, Xia Y, et al. Current status of decision fatigue among substitutive decision makers of ICU patients and its influencing factors[J]. Chin J Nurs, 2023, 58(8):949-955. | |
| [23] | Chua CKZ. New strategies to improve communication in the intensive care unit during the COVID-19 pandemic[J]. Crit Care, 2022, 26(1):191. |
| [24] | Briggs D. Improving communication with families in the inten-sive care unit[J]. Nurs Stand, 2017, 32(2):41-48. |
| [25] | 乔晓婷, 隋伟静, 王凯丽, 等. ICU患者家属决策冲突现状及影响因素研究[J]. 中华急危重症护理杂志, 2024, 5(8):677-682. |
| Qiao XT, Sui WJ, Wang KL, et al. Research on the status quo and influencing factors of decision conflict among family members of ICU patients[J]. Chin J Emerg Crit Care Nurs, 2024, 5(8):677-682. |
/
| 〈 |
|
〉 |