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Article(id=1322168565243953867, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168481081049284, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.09.020, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1747670400000, receivedDateStr=2025-05-20, revisedDate=1768406400000, revisedDateStr=2026-01-15, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159150658, onlineDateStr=2026-10-28, pubDate=1778342400000, pubDateStr=2026-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159150658, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159150658, creator=13701087609, updateTime=1793159150658, updator=13701087609, issue=Issue{id=1322168481081049284, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='9', pageStart='1425', pageEnd='1616', issueExtLink='null', onlineDate='null', pubDate='1778342400000', pubDateStr='2026-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159130592, creator='13701087609', updateTime=1793159130592, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1572, endPage=1578, ext={EN=ArticleExt(id=1322168565483029196, articleId=1322168565243953867, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Research progress on psychosocial adaptation assessment tools for patients with chronic diseases, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This article reviewed the concepts related to psychosocial adaptation,as well as the main content,reliability,validity,characteristics,and application status of psychosocial adaptation assessment tools for patients with chronic diseases.The aim is to provide references and basis for scientifically assessing the psychosocial adaptation level of chronic disease patients and for the development and application of disease-specific psychosocial adaptation assessment tools for different chronic conditions.

, authors=Qi ZHANG1, Yiwen DUAN2, Huijuan QIAN1, Qunfeng LU1, authorsList=Qi ZHANG, Yiwen DUAN, Huijuan QIAN, Qunfeng LU, authorCompany=null, correspAuthors=Qunfeng LU, 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=1322168565982151373, articleId=1322168565243953867, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=慢性病病人心理社会适应评估工具的研究进展, columnId=1220689485482873504, journalTitle=护理研究, columnName=科研综述, runingTitle=null, highlight=null, articleAbstract=

对心理社会适应相关概念及慢性病病人心理社会适应评估工具主要内容、信效度、特点、应用现状进行综述，以期为科学评估慢性病病人心理社会适应水平以及不同慢性病心理社会适应特异评估工具的开发与应用提供借鉴与依据。

, authors=张琪1, 段怡雯2, 钱会娟1, 陆群峰1, *, *, authorsList=张琪, 段怡雯, 钱会娟, 陆群峰, authorCompany=null, correspAuthors=陆群峰, authorNote=

张琪,助理研究员

, correspAuthorsNote=
陆群峰，E-mail：
LU Qunfeng, E-mail:
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张琪,助理研究员

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Comparison of basic information among different psychosocial adaptation assessment tools

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评估工具开发时间国家理论依据内容框架Cronbach's α系数适用人群是否汉化或改编
PAIS-SR1986年美国未提及7个维度、46个条目0.47~0.87患病群体是
AQ2016年伊朗罗伊适应模式4个维度、55个条目0.88慢性病病人否
PAS2013年美国压力应对理论和认知适应理论4个维度、20个条目0.96慢性病病人及其照顾者是
SAS-SR1976年美国未提及6个维度、42个条目未报告患病群体是
OAI-232009年英国未提及4个维度、23个条目0.93造口术后病人是
OAS-341983年美国未提及5个维度、34个条目0.85造口术后病人是
MAC1988年英国未提及5个维度、40个条目0.65~0.84癌症病人是
PAQ2010年英国未提及4个维度、35个条目0.83~0.86乳腺癌病人否
CSAS2004年中国未提及5个维度、33个条目0.63~0.93乳腺癌病人否
帕金森病病人心理社会适应量表2015年中国未提及6个维度、32个条目0.94帕金森病病人否
炎症性肠病心理社会适应问卷2020年中国应激-适应理论6个维度、29个条目0.89炎症性肠病病人否
慢性皮肤病病人心理社会适应问卷2021年中国慢性皮肤病病人心理社会适应模式3个维度、18个条目0.93慢性皮肤病病人否
乳腺癌心理社会适应问卷2012年中国未提及5个维度、44个条目0.95乳腺癌病人否
慢性心力衰竭病人疾病适应量表2023年中国罗伊适应模式3个维度、21个条目0.78慢性心力衰竭病人否
), ArticleFig(id=1322531291526972126, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168565243953867, language=CN, label=表1, caption=

不同心理社会适应评估工具基本信息比较

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评估工具开发时间国家理论依据内容框架Cronbach's α系数适用人群是否汉化或改编
PAIS-SR1986年美国未提及7个维度、46个条目0.47~0.87患病群体是
AQ2016年伊朗罗伊适应模式4个维度、55个条目0.88慢性病病人否
PAS2013年美国压力应对理论和认知适应理论4个维度、20个条目0.96慢性病病人及其照顾者是
SAS-SR1976年美国未提及6个维度、42个条目未报告患病群体是
OAI-232009年英国未提及4个维度、23个条目0.93造口术后病人是
OAS-341983年美国未提及5个维度、34个条目0.85造口术后病人是
MAC1988年英国未提及5个维度、40个条目0.65~0.84癌症病人是
PAQ2010年英国未提及4个维度、35个条目0.83~0.86乳腺癌病人否
CSAS2004年中国未提及5个维度、33个条目0.63~0.93乳腺癌病人否
帕金森病病人心理社会适应量表2015年中国未提及6个维度、32个条目0.94帕金森病病人否
炎症性肠病心理社会适应问卷2020年中国应激-适应理论6个维度、29个条目0.89炎症性肠病病人否
慢性皮肤病病人心理社会适应问卷2021年中国慢性皮肤病病人心理社会适应模式3个维度、18个条目0.93慢性皮肤病病人否
乳腺癌心理社会适应问卷2012年中国未提及5个维度、44个条目0.95乳腺癌病人否
慢性心力衰竭病人疾病适应量表2023年中国罗伊适应模式3个维度、21个条目0.78慢性心力衰竭病人否
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慢性病病人心理社会适应评估工具的研究进展
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张琪 1 , 段怡雯 2 , 钱会娟 1 , 陆群峰 1, *, *
护理研究 | 科研综述 2026,40(9): 1572-1578
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护理研究 |科研综述 2026 , 40 (9) : 1572 -1578
慢性病病人心理社会适应评估工具的研究进展
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张琪1, 段怡雯2, 钱会娟1, 陆群峰1, *, *
作者信息
  • 1上海交通大学医学院附属第六人民医院，上海 200233
  • 2复旦大学护理学院
通讯作者:
陆群峰，E-mail：
LU Qunfeng, E-mail:
作者简介:

张琪,助理研究员

Research progress on psychosocial adaptation assessment tools for patients with chronic diseases
Qi ZHANG1, Yiwen DUAN2, Huijuan QIAN1, Qunfeng LU1
Affiliations
  • 1The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233 China
  • 2School of Nursing, Fudan University
出版时间: 2026-05-10 doi: 10.12102/j.issn.1009-6493.2026.09.020
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摘要
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对心理社会适应相关概念及慢性病病人心理社会适应评估工具主要内容、信效度、特点、应用现状进行综述，以期为科学评估慢性病病人心理社会适应水平以及不同慢性病心理社会适应特异评估工具的开发与应用提供借鉴与依据。

慢性病  /  心理社会适应  /  评估工具  /  综述

This article reviewed the concepts related to psychosocial adaptation,as well as the main content,reliability,validity,characteristics,and application status of psychosocial adaptation assessment tools for patients with chronic diseases.The aim is to provide references and basis for scientifically assessing the psychosocial adaptation level of chronic disease patients and for the development and application of disease-specific psychosocial adaptation assessment tools for different chronic conditions.

chronic disease  /  psychosocial adaptation  /  assessment tools  /  review
张琪, 段怡雯, 钱会娟, 陆群峰. 慢性病病人心理社会适应评估工具的研究进展. 护理研究, 2026 , 40 (9) : 1572 -1578 . DOI: 10.12102/j.issn.1009-6493.2026.09.020
Qi ZHANG, Yiwen DUAN, Huijuan QIAN, Qunfeng LU. Research progress on psychosocial adaptation assessment tools for patients with chronic diseases[J]. Chinese Nursing Research, 2026 , 40 (9) : 1572 -1578 . DOI: 10.12102/j.issn.1009-6493.2026.09.020
正文
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随着人口老龄化和代谢相关危险因素持续流行的双重压力，慢性病已是我国居民的主要死亡原因，占总死亡人数的88.5%[1-2]。此外，慢性病具有起病隐匿、病程长且病情迁延不愈的特点，病人长期的医疗与护理给社会带来极大的疾病负担，占到了疾病总负担的70%以上[3]。慢性病病人长期带病生存，也承受着巨大的心理社会压力，如情绪失调、病耻感、社会疏离感等，导致病人难以正常回归社会，出现严重的心理社会适应不良[4-7]。研究显示，慢性病病人心理社会适应是其健康行为改善与生活质量提升的重要预测因子，也是卫生保健人员促进慢性病病人疾病康复与预后的重要干预靶点[8-9]。科学、准确地评估慢性病病人的心理社会适应水平是进一步开展护理干预实践的重要前提。虽然当前已经有针对慢性病病人心理社会适应的相关评估工具，但各工具的质量参差不齐，测量内容存在一定差异。因此，现对当前国内外慢性病病人心理社会适应相关评估工具进行全面综述，总结评估工具的内容、信效度、优缺点及应用现状并进行对比，以期为我国开发及规范应用相关评估工具提供借鉴，并为促进慢性病病人的心理社会适应护理实践提供相关依据。
1　心理社会适应的概念
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心理社会适应这一概念已经被广泛用于护理学、社会学以及教育学等领域中。罗伊适应模式在阐述心理社会适应这一概念时虽未对其进行明确界定，但在阐述自我概念与角色功能等具体适应方式和过程时将这一概念与生理适应进行了区分[10]。2001年，Livneh等[11]通过文献研究，提出慢性病和残疾的心理社会适应概念框架，该框架认为慢性病病人的心理社会适应是动态的、发展的和复杂的转变过程，并强调主观能动性和积极品质在个体适应过程中的重要性。2015年，McMillan等[12]进行了文献研究，采用Rodgers演化概念分析法对心理社会适应进行了界定：心理社会适应是一个连续的过程，受个体或环境特征的影响，这一过程中内外部的互动反映了个体在适应环境时的改变；这一过程的主要特征是变化、过程、连续、互动和影响，先决条件指改变的生活环境，其导致的结果可分为积极结局和消极结局。当前，这一界定得到护理学领域相关学者的普遍认可与使用。
在心理学范畴中，适应通常包含3层含义：1）生理适应，即生物学意义上的适应；2）心理适应，指个体在遭受外界应激后利用心理防御机制来重建平衡的自我调节过程；3）社会适应，指个体通过改变自己的行为以符合社会规范，并最终获得更好发展的过程。生理适应是生物体通过遗传和习得方式来保障其最基本生存和需求的现象；心理适应是一种综合的心理功能，是个体借助心理防御机制来减轻应激所致的压力，并逐渐恢复内在平衡的自我调节过程，是社会适应的心理基础[13-14]；社会适应是个体按照社会规范调整自我以实现自身与社会关系的协调[15]。因此，生理适应可以视为内在机制，心理社会方面的适应则是病人在具体患病情境中的外部表现。现有的部分研究中直接使用适应一词来反映心理社会适应，导致这一概念使用的不准确性与不一致性。研究工具的选择需要正确理解与把握心理社会适应的科学内涵，这也导致现有的慢性病心理社会适应评估工具内涵与测量内容的差异。
2　慢性病病人心理社会适应评估工具
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分别从普适性和针对特定慢性病的特异性评估工具两个方面进行综述，以期为医疗保健人员选用合适的评估工具，以为进一步开发针对不同慢性病的心理社会适应本土化测评工具提供思路。
2.1　普适性慢性病心理社会适应评估工具
2.1.1　疾病心理社会适应量表（Self-Report Psychosocial Adjustment to Illness Scale，PAIS-SR）
量表由Derogatis[16]于1986年编制而成，用于评估患病群体的心理社会适应水平。该量表共包括7个维度46个条目，分别为卫生保健、职业环境、家庭环境、亲密关系、扩大的家庭关系、社会环境以及心理状况。PAIS-SR采用Likert 4级评分法，各条目评分分别为0~3分，得分越高表示病人的心理社会适应问题越多，根据得分情况分为低度（0~34分）、中度（34~50分）及重度（51~138分）。我国学者姚静静[17]于2013年汉化引进PAIS-SR，经信效度检验以及文化调适后形成包含7个维度、44个条目的中文版量表，7个维度调整为卫生保健、工作能力、家庭关系、性能力、交流情况、娱乐情况、心理状况。中文版PAIS-SR的Cronbach's α系数为0.87，信效度良好。该量表是一个多维结构的量表，能够全面、系统评估患病人群的心理社会适应情况，是当前国内外用于评估心理社会适应应用最广泛的工具。但该工具是一个普适性的疾病心理社会适应评估工具，对测量特定疾病人群的心理社会适应水平仍存在一定的限制[18-20]；此外，该量表编制过程仅基于既往文献与个人经验，缺乏科学理论的指导，量表条目数较多，在临床的推广受限。
2.1.2　适应问卷（Adaptation Questionnaire,AQ）
问卷由Mansouri等[21]于2016年基于罗伊适应模式编制而成，可用于评估慢性病病人的适应水平。该问卷共包括4个维度、55个条目，分别为生理功能、自我概念、角色功能以及相互依赖。量表各条目采用Likert 5级评分法，得分越高表示病人的疾病适应状况越好。经测试，量表Cronbach's α系数为0.88，具有较好的信效度。该问卷是一个普适性的评估工具，难以捕捉某些特异疾病群体的心理社会适应问题；此外，该问卷研制时间较短，当前的实践证据比较有限，今后还需要更多研究应用并验证该问卷的有效性和可靠性。
2.1.3　心理适应量表（Psychological Adaptation Scale,PAS）
量表由Biesecker等[22]于2013年基于压力应对理论和认知适应理论编制而成，可用于评估慢性病病人及其照顾者的心理适应水平。PAS包括4个维度、20个条目，分别为应对效能、自尊、灵性健康以及社会融合，条目采用Likert 5级评分法，得分越高表明其心理适应水平越高。量表的Cronbach's α系数为0.96。王梦佳等[23]于2020年汉化引进该量表，经过文化调适后形成4个维度、20个条目的中文版量表，维度分别为应对能力、自强、社交能力以及心理成长。中文版PAS与源量表的维度保持一致，但部分维度条目数发生改变，量表的Cronbach's α系数为0.90，信效度良好。该量表是针对慢性病病人及其照顾者开发的普适性工具，该量表结构多维、条目简明且信效度良好，已经被不同国家的学者翻译并使用，均显示出较好的临床适用性[24-25]。
2.1.4　社会适应量表（Self-Report Social Adjustment Scale,SAS-SR）
量表由Weissman[26]于1976年借鉴其他量表发展而来，用于评估病人的社会适应水平。SAS-SR共包含6个维度、42个条目，分别为工作角色、社会和休闲活动、扩大的家庭关系、婚姻/伴侣关系、父母关系以及家庭成员关系。条目采用Likert 5级评分法，得分越高表明病人的心理适应问题越严重，作者报告其信效度良好，但未报告具体数值。该量表已被广泛应用于不同疾病群体的社会适应水平评估中，但对于特定疾病的心理社会适应问题难于捕捉[27-28]。此外，该量表内容主要侧重于社会适应的评估，无法全面地评估和反映慢性病病人的心理社会适应情况。
2.2　心理社会适应特异性评估工具
2.2.1　造口适应量表-23条目（Ostomy Adjustment Inventory,OAI-23）
量表由Simmons等[29]于2009年编制而成，用于评价造口术后病人的适应情况。量表共包含4个维度、23个条目，分别为接纳、焦虑、社会参与以及愤怒。量表采用Likert 5级评分法，条目得分分别为0~4分，总分越高说明病人心理社会适应越好。经检验，量表整体的Cronbach's α系数为0.93，分半信度为0.91，信效度良好。该量表的条目数适量，且已经被翻译成不同语言版本用于评估造口术后病人的社会适应情况，有一定的临床应用价值[30-31]。但量表初始条目池的构建主要来源于文献回顾，缺乏一定的理论依据，是否能全面反映造口术后病人的心理社会适应情况还有待进一步考量。
2.2.2　造口适应量表-34条目（Ostomy Adjustment Scale-34,OAS-34）
量表由美国的Olbrisch[32]于1983年编制，用于评估造口术后病人的适应情况。量表共包含5个维度、34个条目，分别为一般功能、负性情绪、造口护理知识、羞耻以及造口术对外表的积极贡献。量表条目采用Likert 6级评分法，作者报告量表的Cronbach's α系数为0.85，信效度良好。Zhang等[33]于2014年汉化引入该量表，中文版本量表经检验和调适后保留了4个维度、30个条目，分别为负性情绪、一般功能、治疗态度以及生活担忧。中文版量表的整体Cronbach's α系数为0.92，分半信度为0.97。该量表的开发主要基于文献回顾以及具有造口护理经验的医疗保健专家的意见，其内容涵盖造口术后存在的关键心理社会问题，具有疾病特异性。此外，该量表已经被不同国家学者翻译并应用于造口术后病人适应情况的评估中，具有较好的信效度[34]。
2.2.3　癌症病人心理适应量表（Mental Adjustment to Cancer Scale,MAC）
量表由Watson等[35]于1988年构建，用于评估癌症病人的心理社会适应情况。量表共包括5个维度、40个条目，分别为战斗精神、无助、焦虑关注、宿命论以及认知回避。作者报告量表各维度的Cronbach's α系数为0.65~0.84。2008年，源作者进一步修订了此量表，形成更为简明的Mini-MAC，该修订版共5个维度、29个条目[36]。Mini-MAC与源量表的保持维度一致，但在认知回避维度增加了3个条目。2003年，Ho等[37]将Mini-MAC汉化引入我国香港地区，汉化版量表共29个条目、3个维度，分别为负性情绪、积极态度以及认知回避。2008年，官锐园等[38]将其引入我国内地地区，经调适后最终包括3个维度、19个条目，分别为无望、焦虑以及积极态度，并将其命名为简明癌症病人心理适应问卷。经过文化调适和检验后，中文版量表总体Cronbach's α系数为0.86，可用于评估我国癌症病人的心理社会适应情况。该量表编制条目池的构建主要基于文献回顾及其对乳腺癌以及淋巴瘤病人的质性访谈结果，但该量表主要聚焦于癌症病人群体的心理功能适应，无法反映其社会适应情况。该量表得到了广泛的应用，在不同类型癌症病人心理适应的评估中均具有较高的适用性。
2.2.4　积极适应问卷（Positive Adjustment Questionnaire,PAQ）
问卷由Boot等[39]于2010年编制而成，用于评估乳腺癌病人的积极适应水平。PAQ共包括4个维度、35个条目，分别为满足感、再评估、新生活以及有价值的生活。量表采用Likert 7级评分法，经检验量表各维度Cronbach's α系数为0.83~0.86，信效度良好。该量表初始条目池的构建源于其他相关评估工具内容以及对乳腺癌女性的质性访谈结果，关注乳腺癌特定人群的适应问题，特异性较高。但量表涵盖的维度和条目对全面了解和评估乳腺癌病人的心理社会适应水平有一定的局限性，其可靠性和有效性还有待进一步验证和修订。
2.2.5　中文版社会适应量表（Chinses version of Social Adjustment Scale,CSAS）
量表由Fielding等[40]于2004年编制而成，主要评估乳腺癌女性这一群体的社会适应情况。量表共包含5个维度、33个条目，分别为与家庭的关系、自我意象、朋友关系、社交乐趣以及性吸引力。条目采用Likert 5级评分法，得分越高表明其心理适应水平越高。量表各维度Cronbach's α系数为0.63~0.93，信效度良好。研究通过对17例乳腺癌病人的半结构化访谈，归纳乳腺癌病人在回归社会方面的担忧以形成量表的初始条目池，然而，量表主要侧重于病人社会适应的评价，无法反映病人的心理适应情况。此外，该量表当前主要在我国乳腺癌病人中应用，尚未检索到在其他国家背景下的应用证据，后续仍需要不同文化及更多样本的验证。
2.2.6　帕金森病病人心理社会适应量表
量表由Zhang等[41]于2015年编制而成，用于评估帕金森病人的心理社会适应情况。量表共包含6个维度、32个条目，分别为焦虑/抑郁、自尊、自我生活态度、自我接纳、自我效能感以及社会支持。量表采用Likert 4级评分法，量表整体Cronbach's α系数为0.94，信效度良好。该量表的编制基于我国文化背景，通过文献回顾及临床经验开发，尚未在其他国家或地区进行验证。
2.2.7　炎症性肠病心理社会适应问卷
问卷由齐妍妍等[42]于2020年编制而成，问卷包括6个维度、29个条目，分别为焦虑/抑郁、睡眠障碍、自我效能、身体意象、社会支持以及态度。量表条目采用Likert 5级评分法，总分越高说明病人心理社会适应情况越好。经检验，问卷整体的Cronbach's α系数为0.89，信效度良好。量表在应激-适应理论指导下编制而成，认为适应是生物体采用多种策略调节自我，最终达到内外环境平衡的能力以及过程，包括生理、心理、社会文化以及技术性的适应。该量表基于科学理论编制而成，量表的条目数量适中，内容简单易懂，在临床有一定的推广价值与意义，但个别维度的可靠性还需要更大样本数据的验证。
2.2.8　慢性皮肤病病人心理社会适应问卷
问卷由Zhang等[43]于2021年编制而成，用于评估慢性皮肤病病人的心理社会适应水平。问卷包括3个维度、18个条目，分别为情感维度，包括焦虑/抑郁、身体形象、病耻感3个方面；自我认知维度，包括自尊和自我形象2个方面；社会维度，包括社会交往、社会支持、病耻感3个方面。问卷采用Likert 5级评分法，总分越高代表病人的心理社会适应状况越好。经检验，问卷整体Cronbach's α系数为0.93，信效度良好。问卷由研究者团队基于积极心理学视角构建的慢性皮肤病病人心理社会适应模式，该模式认为慢性皮肤病病人的心理社会适应过程是以自我认知为核心的，并会受到一系列心理社会复杂情景因素‒体验交互的作用与影响。量表条目数适中，是评估我国慢性皮肤病病人心理社会适应水平的可靠工具。但是该量表的编制时间较短，尚未在其他国家人群中进行应用和验证。
2.2.9　乳腺癌心理社会适应问卷
问卷由程然等[44]于2012年编制，是用于评估乳腺癌病人心理社会适应水平的特异性评估工具。问卷共包括5个维度、44个条目，分别为焦虑/抑郁、自尊/自我接纳、态度、归属感以及自我控制/自我效能。量表采用Likert 5级评分法，总的Cronbach's α系数为0.95，信效度良好。该量表的编制基于文献回顾以及半结构化访谈，通过对核心概念进行界定后形成量表条目池，在我国乳腺癌病人中呈现出较好的适用性。但量表条目繁冗，会限制其在临床中的应用；此外，当前缺乏量表的应用报告，其有效性还有待更大样本的验证。
2.2.10　慢性心力衰竭病人疾病适应量表
量表由赵秋阁[45]于2023年编制而成，用于评估慢性心力衰竭病人的心理社会适应水平。该量表共包含3个维度、21个条目，各维度分别为生理适应、心理适应与社会适应。量表采用Likert 5级评分，得分越高表明病人的心理社会适应水平越高。量表总Cronbach's α系数为0.78，信效度良好。量表的构建是在罗伊适应模式的指导下，通过质性访谈归纳病人疾病适应内容形成初始条目池，并且该量表条目简明，在评估我国慢性心力衰竭病人这一特定疾病人群的心理社会适应方面有一定的临床应用和推广价值。
3　慢性病病人心理社会适应评估工具的比较
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3.1　基本情况比较
慢性病心理社会适应评估工具的内容结构、测评方式、适用人群等一般情况的比较见表1。现有的慢性病心理社会适应评估工具在研究人群及研究背景等方面存在差异，有各自的优势和局限性。在适用人群方面，普适性量表PAIS-SR与SAS-SR是普遍适用的自评量表，AQ则主要是针对慢性病病人开发，而PAS则同时用于评估慢性病病人及其照顾者的心理适应水平。其他特异性心理社会适应评估则适用于特定慢性病病人群体，如慢性皮肤病、帕金森病、炎症性肠病、造口术后病人以及癌症等病人群体中，可用于捕捉特异疾病群体的心理社会适应情况。在评估内容方面，PAS、MAC主要侧重于评估慢性病病人的心理适应情况，而SAS-SR、CSAS则主要评估慢性病病人的社会适应水平，无法全面反映慢性病病人的心理社会适应情况。其他量表则对慢性病病人的心理社会适应进行了全面和多维的评估。
3.2　应用情况比较
PAIS-SR适用于不同疾病群体，且其评估内容全面，是患病群体心理社会适应评估中应用广泛的工具。然而，鉴于不同患病群体存在的心理社会问题有所不同，该量表对疾病特异相关内容缺乏针对性，无法捕捉特异人群的心理社会适应问题；同时，该量表包含的条目较多，在临床应用和推广方面有一定的局限性。此外，PAS、MAC以及SAS-SR等仅侧重于评估慢性病病人心理或社会某一方面的问题，无法全面反映病人的心理社会适应整体状况，但其内容也可为理解慢性病病人的心理社会适应问题提供线索与借鉴。在特异性评估工具中，MAC主要针对癌症病人群体开发，经过修订简化，被广泛用于癌症病人心理社会适应情况的评估中，呈现出良好的临床适用性。我国学者也分别根据慢性皮肤病、帕金森病、炎症性肠病、乳腺癌以及慢性心力衰竭疾病的特征开发了特异性评估工具，条目的设置基于我国文化背景、符合疾病特点，在相应人群中呈现出较好的心理测量学属性，但在我国背景下开发的相关工具未得到大范围的应用和验证。医疗卫生保健人员可根据不同评估工具的特征，结合临床实际需求选择相应的工具，以便快速、精准地评估不同慢性病病人群体的心理社会适应情况，并做出针对性的护理实践，以促进病人的积极心理社会适应。
4　不足与启示
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当前阶段应用比较广泛的多为国外学者开发的评估工具，由于中西方文化差异，国外引入的评估工具还有待在我国情境下进一步使用和验证。此外，尽管我国学者也逐渐关注到心理社会适应在改善慢性病病人健康相关结局中的重要作用，但仍存在一定的局限性：1）与西方国家相比，我国关于慢性病心理社会适应相关评估工具的研究起步较晚，基于我国文化情境下开发的工具仍有待在大样本的人群中进行验证和完善；2）目前国内的评估工具尚未对病人的心理社会适应水平进行等级划分，后续应通过大范围的调研建立常模，以便在临床中应用和比较；3）由于慢性病心理社会适应的概念尚未统一，后续应进一步明确不同慢性病病人的心理社会问题特征，开发更为简明、精准的心理社会适应工具，以便更好地评价我国不同慢性病病人的心理社会适应情况。
5　小结
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目前，慢性病心理社会适应相关评估工具侧重内容各异，我国相关研究起步较晚，相关评估工具以国外报告为主，我国学者虽对慢性病心理社会适应评估工具进行了探索，并结合我国文化及医疗情境编制了相关的评估工具，但其被接受度和推广度仍有待提高。未来研究中，应进一步对不同类型慢性病的心理社会适应概念内涵进行明确界定，从研究者以及病人多角度编制适合我国情境的评估量表，以了解不同类型慢性病病人的心理社会适应水平，并为后续相应的有效干预策略提供科学、可靠的依据。

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doi: 10.12102/j.issn.1009-6493.2026.09.020
  • 接收时间：2025-05-20
  • 首发时间：2026-10-28
  • 出版时间：2026-05-10
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  • 收稿日期：2025-05-20
  • 修回日期：2026-01-15
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    1上海交通大学医学院附属第六人民医院，上海 200233
    2复旦大学护理学院

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陆群峰，E-mail：
LU Qunfeng, E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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