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Article(id=1322931567747793725, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.12.025, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1747238400000, receivedDateStr=2025-05-15, revisedDate=1780416000000, revisedDateStr=2026-06-03, acceptedDate=null, acceptedDateStr=null, onlineDate=1793341064630, onlineDateStr=2026-10-30, pubDate=1782316800000, pubDateStr=2026-06-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793341064630, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793341064630, creator=13701087609, updateTime=1793341064630, updator=13701087609, issue=Issue{id=1322931549481599694, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='12', pageStart='2001', pageEnd='2192', issueExtLink='null', onlineDate='null', pubDate='1782316800000', pubDateStr='2026-06-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793341060276, creator='13701087609', updateTime=1793343118019, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940180335829530, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940180335829531, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2180, endPage=2184, ext={EN=ArticleExt(id=1322931567965897534, articleId=1322931567747793725, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Research progress on assessment tools of the social integration for patients with schizophrenia, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This paper systematically reviewed the content,characteristics and application status of social integration assessment tools for patients with schizophrenia,so as to provide a basis for the development of social integration assessment tools for schizophrenia patients in China,and to provide some references for clinical practice and related intervention research.

, authors=Linyi WEI1, Li MA2, Xinglei WANG2, Xinman DOU1, 2, authorsList=Linyi WEI, Li MA, Xinglei WANG, Xinman DOU, authorCompany=null, correspAuthors=Xinman DOU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322931568314024767, articleId=1322931567747793725, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=精神分裂症病人社会融合评估工具研究进展, columnId=1220689485482873504, journalTitle=护理研究, columnName=科研综述, runingTitle=null, highlight=null, articleAbstract=

系统综述了精神分裂症病人社会融合评估工具的内容、特点及应用情况，旨在为我国精神分裂症病人社会融合评估工具的发展提供依据，为开展临床实践及相关干预研究提供参考。

, authors=魏麟懿1, 马丽2, 王兴蕾2, 豆欣蔓1, 2, *, *, authorsList=魏麟懿, 马丽, 王兴蕾, 豆欣蔓, authorCompany=null, correspAuthors=豆欣蔓, authorNote=

魏麟懿,护师,硕士研究生

, correspAuthorsNote=
豆欣蔓，E-mail：
DOU Xinman， E-mail：
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魏麟懿,护师,硕士研究生

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魏麟懿,护师,硕士研究生

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精神分裂症病人社会融合评估工具研究进展
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魏麟懿 1 , 马丽 2 , 王兴蕾 2 , 豆欣蔓 1, 2, *, *
护理研究 | 科研综述 2026,40(12): 2180-2184
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护理研究 |科研综述 2026 , 40 (12) : 2180 -2184
精神分裂症病人社会融合评估工具研究进展
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魏麟懿1, 马丽2, 王兴蕾2, 豆欣蔓1, 2, *, *
作者信息
  • 1兰州大学护理学院，甘肃 730000
  • 2兰州大学第二医院
通讯作者:
豆欣蔓，E-mail：
DOU Xinman， E-mail：
作者简介:

魏麟懿,护师,硕士研究生

Research progress on assessment tools of the social integration for patients with schizophrenia
Linyi WEI1, Li MA2, Xinglei WANG2, Xinman DOU1, 2
Affiliations
  • 1School of Nursing, Lanzhou University, Gansu 730000 China
  • 2Lanzhou University Second Hospital
出版时间: 2026-06-25 doi: 10.12102/j.issn.1009-6493.2026.12.025
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摘要
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系统综述了精神分裂症病人社会融合评估工具的内容、特点及应用情况，旨在为我国精神分裂症病人社会融合评估工具的发展提供依据，为开展临床实践及相关干预研究提供参考。

精神分裂症  /  社会融合  /  评估工具  /  护理  /  综述

This paper systematically reviewed the content,characteristics and application status of social integration assessment tools for patients with schizophrenia,so as to provide a basis for the development of social integration assessment tools for schizophrenia patients in China,and to provide some references for clinical practice and related intervention research.

schizophrenia  /  social integration  /  assessment tool  /  nursing  /  review
魏麟懿, 马丽, 王兴蕾, 豆欣蔓. 精神分裂症病人社会融合评估工具研究进展. 护理研究, 2026 , 40 (12) : 2180 -2184 . DOI: 10.12102/j.issn.1009-6493.2026.12.025
Linyi WEI, Li MA, Xinglei WANG, Xinman DOU. Research progress on assessment tools of the social integration for patients with schizophrenia[J]. Chinese Nursing Research, 2026 , 40 (12) : 2180 -2184 . DOI: 10.12102/j.issn.1009-6493.2026.12.025
正文
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精神分裂症（schizophrenia,SZ）是一种慢性、复发性、高致残性的精神病性障碍，常起病于青壮年时期，呈反复波动的病程[1]。其主要特征为精神错乱、冷漠、社交退缩及认知障碍，这些症状严重影响了病人的日常生活、人际交往和职业功能[2]。一项为期10年的研究发现，精神分裂症病人首次住院后10年内再入院率达70.5%，其中22.4%的病人复发次数≥5次[3]。尽管规范化的抗精神病药物治疗为主要预防复发手段[4]，但一项随机对照试验发现，单一药物治疗18个月内复发率为42.9%，而药物联合心理治疗复发率为18.6%[5]。因此，临床治疗需结合药物干预和社会心理干预[6]。同时，随着医疗技术的发展和康复理念的不断革新，使精神分裂症病人恢复社会职业功能、回归社会已成为最终治疗目标[7]。在此背景下，系统评估精神分裂症病人社会融合水平具有重要临床价值。社会融合(social integration,SI)指个体通过生产性活动、社会关系、社区参与和休闲活动融入社会的过程[8]。当前，国内外学者对精神分裂症病人的社会融合关注度较高，国际上已有许多评估工具，其中部分为普适性工具，还有一些专门为精神分裂症病人开发的特异性工具。本研究对国内外精神分裂症病人社会融合的评估工具进行综述，旨在为我国对精神分裂症病人社会融合的研究和干预提供参考依据。
1　普适性评估工具
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1.1　社区融合量表（the Community Integration Measure,CIM）
CIM是由McColl等[9]于2001年编制，最初用于评估获得性脑损伤病人的社会融合。该量表只有一个核心维度，即病人的整体社区融合水平，共10个条目。CIM采用Likert 5级评分法，“完全同意”计5分，“完全不同意”计1分，总分为10~50分，得分越高，代表病人社区融合水平越好。该量表的Cronbach's α系数为0.87，信效度良好。目前已被用于脑卒中、脊髓损伤等其他疾病病人的社区融合度测量，且被翻译成土耳其语、日语、汉语等不同语言[10-12]。2014年，Liu等[12]对CIM进行汉化，并在慢性脑卒中病人中验证显示，中文版CIM的Cronbach′s α系数为0.84。CIM条目简明，具有较高的可操作性和可理解性；但CIM现有评估维度局限于症状严重程度，缺乏对认知功能、社会适应能力等多维度的综合评估；同时，由于尚未在我国精神分裂症病人群体中进行信效度验证研究，其适用性和可靠性尚未得到充分验证，未来还需进一步验证。
1.2　社区融入问卷（Community Integration Questionnaire,CIQ）
CIQ是由Willer等[13]于1993年编制，最初用于测量创伤性脑损伤病人的社区融入状况。CIQ包括家庭融合、社交融合和生产活动3个维度，共15个条目。其中14个条目采用0~2分计分，其余1个条目回答“有”计1分，“没有”计0分），总分为0~29分，得分越高表明病人社区融合程度越高。CIQ的重测信度为0.91，信效度良好。目前已被用于脊髓损伤、多发性硬化、脑卒中、精神疾病等病人的社会融合测量，且被翻译成韩语、波斯语、葡萄牙语等不同语言[14-18]。2016年，杨玉慧等[19]对CIQ进行汉化，并在脊髓损伤病人中验证显示，中文版CIQ的Cronbach′s α系数为 0.80，其中生产活动维度的Cronbach′s α系数相对较低（0.45）。2016年，Callaway等[20]将CIQ修订为CIQ-R，此次修订新增了3个电子网络使用条目，以适应现代社交环境，并修改了条目10的选项，以扩大适用人群。修订后的量表包括家庭融合、社交融合、生产活动和电子社交网络4个维度，共18个条目，总分为0~35分，得分越高表明病人社区融合越好。CIQ-R的Cronbach′s α系数为0.80，信效度良好。目前已被翻译成意大利语[21]、克罗地亚语[22]、马来语[23]等不同语言并进行了信效度检验。2024年，Xie等[24]对CIQ-R进行汉化与修订，形成中文版CIQ-R-C。此次修订新增一项电子购物条目（每个月使用电子设备购物的频率）。该量表在脊髓损伤病人中展示出良好的信效度，但条目10的效度较低，未来需进一步优化。CIQ是当前应用较为广泛的评估工具，可快速、全面评估病人社会融合；但其仅关注了病人的行为频率，未从主观层面评估病人的行为质量及对社交满意度等。CIQ-R通过纳入电子社交条目更契合现代需求，但仍需结合主观指标（如满意度量表）以提升生态效度。未来研究可通过条目优化或多工具联合使用来完善评估维度。
1.3　社会和社区机会概况量表（Social and Community Opportunities Profile，SCOPE）
SCOPE是由Huxley 等[25]于2006年开发，用于评估精神疾病病人和其他一般人群的社会融入程度。2012年，Huxley等[26]为提高SCOPE的适应性，将长版121个条目简化为短版48个条目。短版由主观指标和客观指标构成，涵盖休闲与社会参与、住房与居住环境、社会安全感、工作机会、经济状况、教育机会、自我健康评估、家庭和社会关系8个核心维度，每个量表包括对机会的满意度和感知机会部分；其中对机会的满意度部分采用Likert 7级评分法，1分为“非常不满意”，7分为“非常满意”；感知机会部分采用Likert 5级评分法，1分为“机会极少”，5分为“机会充足”。客观量表项目回答“否”计0分，“是”计1分。总分越高，代表社会融合度越高。目前，SCOPE已被翻译成波兰语[27]、汉语[28]等不同语言并进行信效度检验。中文版SCOPE由Chan等[28]于2016年完成，共52个条目。针对中国精神分裂症病人的验证研究显示，该量表具有良好的心理测量学特性，对机会的满意度维度的Cronbach's α系数为0.80，感知机会维度的Cronbach's α系数为0.62，均优于原量表。SCOPE可从主观及客观维度全面评估社会融合，但由于开发较晚，尚未在其他人群中进行验证，未来有待进一步验证。
2　特异性量表
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2.1　成人精神障碍社区融合量表（Community Integration Scale for Adults with Psychiatric Disorder,CIS-APP-34）
CIS-APP-34是由Cabral等[29]于2014年基于Wong社区融合的多维模型和文献回顾构建的，用于评估精神障碍病人的社区融合程度。该量表为自评量表，包括独立使用社区资源、社区支持、社交网络特征、社区活动参与、社区情感联系5个维度，共34个条目，采用Likert 5级（0~4分）评分法，得分越高表示社区融合程度越高。量表的Cronbach's α系数为0.902[30]。我国学者将CIS-APP-34汉化，并在稳定期精神分裂症病人中验证，结果显示，中文版CIS-APP 的Cronbach's α系数为0.917，可作为研究我国精神障碍群体社区融合的评估工具[31-32]。CIS-APP-34是一个多维度、易于理解的评估工具，但多数条目偏向主观感知，缺乏客观行为指标，可能会影响量表的生态效度。
2.2　社会融合调查量表（the Social Integration Survey,SIS）
SIS是由Kawata等[33]于2008年开发，旨在从病人及照顾者角度衡量精神分裂症病人过去4周内的社会功能。SIS分为病人版本和照顾者版本，各版本均包括社会感知、工作互动、社交技能、社会活动参与和日常生活自理5个维度，共62个条目。部分条目采用Likert 4级（0~3分）评分法，部分条目采用Likert 6级（0~5分）评分法，维度计分标准化为0~100分后汇总为总分，得分越高代表病人社会融合程度越高。该量表在8例精神分裂症病人和129名照顾者中的验证结果显示，除工作互动分量表外，其余分量表Cronbach's α系数为0.68~0.84，可用于精神分裂症病人社会融合的测量。SIS可从病人及照顾者不同的角度评估病人的社会融合程度，但病人版本和照顾者版本间的结果一致性较低，同时该量表更关注病人的社会功能情况，缺乏对认知及心理层面的评估。目前，尚未检索到有研究使用该量表，在文化适应性等方面有待进一步验证。
2.3　社会融入量表（Social Inclusion Scale，SIS）
SIS是由Secker等[34]于2009年编制，用于评估心理健康服务使用者的社会融入情况。SIS为自评量表，最初包括22个条目，经修订后包括社会孤立、社会关系、社会接纳3个维度，共16个条目。SIS采用Likert 4级评分法，“非常不符合”计1分，“非常符合”计4分，总分越高，代表社会融合度越高，其Cronbach's α系数为0.85。2024年，吉彬彬等[35]对SIS进行汉化修订，并在孤独症儿童父母中进行验证。中文版SIS包括社会接纳、社会接触、活动参与和主观感受4个维度，共19个条目，量表的Cronbach's α系数为0.817。为提升中文版SIS对孤独症儿童父母群体的适用性，吉彬彬等[35]对条目7、条目10、条目12的表达进行了修订。然而，修订后的条目不再适用于原量表的目标人群，未来需针对不同疾病群体对量表条目进行修订。同时社会接纳子量表的内部一致性（Cronbach's α系数为0.54）较低，未来还需进一步优化条目以提升信度。
2.4　Filia社会融入量表（Filia Social Inclusion Measure,F-SIM16）
F-SIM16是由Filia等[36]于2022年在F-SMI基础上修订形成的，用于测量精神疾病病人的社会融入程度。F-SIM16包括住房和社区（条目1~4）、社会关系参与和限制（条目5~8）、就业和教育（条目9~12）和财务（条目13~16）4个维度，共16个条目。量表中还有6项不计入总分的补充条目（2项与健康和福祉相关问题，4项与满意度相关条目），仅用于辅助分析社会融入的影响因素，为临床干预提供依据。F-SIM16采用二分类计分法，部分条目需反向计分，维度计分标准化为0~100分后计为总分，得分越高，表示社会融入越好。量表的Cronbach's α系数为0.92，信效度良好，但因开发较晚，尚未检索到有研究使用，因此，其文化适应性、信效度方面有待进一步验证。
2.5　社会融入用户体验问卷（the Social Inclusion Questionnaire User Experience,SInQUE）
SInQUE由Mezey 等[37]于2013年开发，该量表基于结构化访谈设计，通过量化病人的社会参与情况及主观愿望评估精神疾病病人的社会融入情况。量表包括社会融合、生产力、消费、获得服务与政治参与5个领域，评估分为两个时间点T1（32个条目，首次精神科住院前1年）、T2（58个条目，当前情况，即访谈前1年）。采用二分类计分法，得分越高，代表病人社会融合程度越高。2020年，Mezey 等[38]在192例精神疾病病人中探究了SInQUE的有效性、可靠性、可接受性及实用性，结果表明，SInQUE中T1部分的重测信度为0.85，T2部分的重测信度为0.92。SInQUE可用于长期监测病人的社会融入变化，但基于T1时间点的访谈结果易受回忆偏差的影响；同时该量表需由专业人员访谈完成，可能限制临床大规模应用；此外，量表尚未进行因子分析，有待进一步验证。
2.6　社区联系和参与量表（Community Connections and Engagement Scale,CCES）
CCES是由Petros等[39]于2021年编制，用于测量有严重精神疾病成年人的社区融合。量表包括社区参与、社会支持、社交互动和心理感知4个维度，共33个条目，采用5级评分法。CCES的Cronbach's α系数为0.89，信效度良好。该量表可全面测量社区融合程度，同时提供的数据可支持临床医生进行决策，但因其开发较晚，尚未检索到有研究使用；未来还需在可靠性与文化适应性等方面进一步探究。
3　存在问题和启示
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现有工具可分为普适性与特异性两类。大多数普适性工具评估维度单一或缺乏主观体验评估；特异性工具虽针对精神分裂症病人设计，但多数仍存在主观性偏差、文化适应性不足或操作复杂等问题。因此，未来研究应基于我国社会文化背景，开发本土化评估工具，整合主观体验（如社会归属感、心理满意度）与客观行为指标（如社区参与频率、就业稳定性），并纳入认知功能、社会支持网络等关键维度，形成多维度动态评估工具。同时可结合智能穿戴设备、移动应用程序等数字化技术实现数据实时采集并进行智能分析，提升评估效率与精准度。在此基础上，建议发展精神医学、护理学与数据科学的多学科融合，建立跨学科研究平台，开发基于循证医学的个性化干预方案，最终实现评估工具的科学性、实用性与可推广性的统一，为精神分裂症病人的社会融合与全面康复提供系统性支持。
4　小结
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我国在精神分裂症病人的社会融合研究方面仍处于初期阶段。尽管有学者引入了相关评估工具，但尚未检索到有针对精神分裂症病人社会融合的本土化工具。未来研究应结合我国文化背景，融合技术创新与文化敏感性，开发出多维度、客观性强、适应性广的评估工具。此外，临床工作者需基于病人群体特征和个体差异，选取合适的评估工具，以更准确地评估病人社会融合状况；同时，可建立护士主导的“评估-干预-随访”闭环管理体系，将量表评估纳入社区护理常规流程，为制订个性化康复方案提供依据，从而促进病人社会融合和康复。

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2026年第40卷第12期
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doi: 10.12102/j.issn.1009-6493.2026.12.025
  • 接收时间：2025-05-15
  • 首发时间：2026-10-30
  • 出版时间：2026-06-25
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  • 收稿日期：2025-05-15
  • 修回日期：2026-06-03
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    1兰州大学护理学院，甘肃 730000
    2兰州大学第二医院

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豆欣蔓，E-mail：
DOU Xinman， E-mail：
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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