脑卒中恢复期患者主动运动指导满足感评定量表的编制与验证

关键词：脑卒中恢复期  主动运动指导  需求  接受度  满足感

Keywords:stroke recovery phase  active exercise guidance  needs  acceptance  satisfaction

摘要：

      摘要 目的：编制《脑卒中恢复期患者主动运动指导满足感评定量表》并验证其临床信效度，为有效评估脑卒中恢复期患者主动运动指导的需求和接受程度提供适用性测评工具。 方法：以自我决定理论为主框架，整合Brunnstrom分期理论和社会认知理论，结合文献回顾、半结构式访谈、专家函询和预调查的结果，形成初始量表；采用方便抽样法，选取2024年11月—2025年2月在贵州省某三级甲等医院康复科门诊就诊及住院的434例脑卒中恢复期患者，进行信效度检验，形成正式量表。 结果：回收有效问卷422份，有效回收率97.24%；量表包含2个部分，8个维度，18个条目；3轮专家函询积极系数均为100%，肯德尔和谐系数>0.5，权威系数>0.7，变异系数<0.280；量表各部分及总量表的各条目决断值均>8；量表各部分及总量表的条目得分与总分的相关系数均>0.6；量表各部分及总量表的I-CVI>0.8，S-CVI>0.9；探索性因子分析后，累积方差贡献率为77.895%，因子无多重载荷；验证性因子分析结果显示，模型拟合度良好，其中χ2/df=1.250，RMESA=0.034，CFI=0.935，GFI=0.915；量表各部分及总量表的Cronbach's α系数、折半信度、重测信度均>0.8。 结论：量表具有良好的信效度，不仅能够系统评估脑卒中恢复期患者对主动运动指导的需求与接受度，还可通过“需求-接受度”差值量化评估患者对主动运动指导的满足感，识别患者主动运动康复瓶颈。

Abstract:

      Abstract Objective： To develop and validate the stroke recovery phase patient active exercise guidance satisfaction rating scale（SRPPAEGSRS） for stroke recovery patients. Method： Using the self-determination theory as the primary framework， integrated with the Brunnstrom staging and social cognitive theories， an initial scale was developed through literature review， semi-structured interviews， expert consultations， and a preliminary survey. A convenience sampling of 434 stroke patients in the recovery phase who visited or were hospitalized in the rehabilitation department of a tertiary hospital in Guizhou province from November 2024 to February 2025 were recruited. Reliability and validity tests were conducted to finalize the scale. Result： A total of 422 valid questionnaires were collected， with an effective response rate of 97.24%. The scale consisted of 2 parts， 8 dimensions， and 18 items. Three rounds of expert consultations showed a 100% positive coefficient， Kendall's harmony coefficient >0.5， authority coefficient >0.7， and coefficient of variation <0.280. The critical ratio （CR） for all items in each part and the total scale was >8. The correlation coefficients between item scores and total scores for each part and the total scale were >0.6. The item-level content validity index（I-CVI） was >0.8， and the scale-level content validity index （S-CVI） was >0.9. Exploratory factor analysis yielded a cumulative variance contribution rate of 77.895%，with no cross-loadings. Confirmatory factor analysis indicated good model fit（χ2/df=1.250， RMSEA=0.034，CFI=0.935，GFI=0.915）. The Cronbach's α coefficient， split-half reliability， and test-retest reliability for each part and the total scale were all >0.8. Conclusion： The scale demonstrated good reliability and validity，enabling systematic assessment stroke patients' needs and acceptance of active exercise guidance during recovery. Additionally， it quantifies patients' satisfaction with active exercise guidance through the "need-acceptance" discrepancy and identifies bottlenecks in their active rehabilitation.