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Article(id=1324078283763102449, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202508088, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1754409600000, receivedDateStr=2025-08-06, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614463033, onlineDateStr=2026-11-02, pubDate=1769270400000, pubDateStr=2026-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614463033, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614463033, creator=13701087609, updateTime=1793614463033, updator=13701087609, issue=Issue{id=1324078175000605624, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='1769270400000', pubDateStr='2026-01-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614437103, creator='13701087609', updateTime=1793614526046, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078548130082942, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078548130082943, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=287, endPage=292, ext={EN=ArticleExt(id=1324078284220281586, articleId=1324078283763102449, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Construction of community-based primary prevention behavior compliance scale for elderly patients with stroke based on Delphi method, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To construct the Compliance Scale for primary prevention of stroke among the elderly in the community, to evaluate the compliance level of the elderly in the community as a whole, and to provide reference tools for the investigation of the current situation of primary prevention, influencing factors and health education.

Methods

In accordance with the 2024 Guideline for the Primary Prevention of Stroke from the American Heart Association/American Stroke Association, the theory of self-care for chronic diseases was used as the theoretical framework. Literature review and Delphi method were used to conduct two rounds of consultation with 18 experts. A pilot study was conducted among community-dwelling older adults to validate the applicability of the scale items.

Results

The questionnaire recovery rate for both rounds of inquiry reached 100%, and the expert authority coefficient was 0.89. In the two rounds of correspondence, the average importance of items was >3.5, the full score ratio was >0.2, the CV (coefficient of variation) stood at ≤0.25, and the Kendall W coordination coefficient was 0.305 and 0.265 respectively (all P<0.001). The final form is a community-based primary prevention behavior compliance scale for elderly stroke with 3 dimensions, 10 sub dimensions and 33 items.

Conclusion

Based on the guidelines for primary prevention of stroke (2024) and the theory of self-care for chronic diseases as the theoretical framework, the community elderly stroke primary prevention behavior compliance scale has good reliability and scientificity, and can be used as an evaluation tool to evaluate the community elderly stroke primary prevention behavior compliance.

, authors=Jie DING, Zi-ying LI, Yu-ting YANG, Tong-xia ZHAN, authorsList=Jie DING, Zi-ying LI, Yu-ting YANG, Tong-xia ZHAN, authorCompany=null, correspAuthors=Tong-xia ZHAN, 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=1324078286598451959, articleId=1324078283763102449, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=社区老年人脑卒中一级预防行为依从性量表的构建, columnId=1228016573533847611, journalTitle=现代预防医学, columnName=基层卫生服务, runingTitle=null, highlight=null, articleAbstract=
目的

构建社区老年人脑卒中一级预防行为依从性量表，以整体评估社区老年人群依从行为水平，为一级预防现状调查、影响因素及健康宣教提供参考工具。

方法

基于《2024年美国心脏协会/美国卒中协会脑卒中一级预防指南》，以慢性病自我护理理论为理论框架，采用文献回顾法、德尔菲（Delphi）法，对18名专家进行两轮函询。通过对社区老年人的预调查，验证量表条目的适用性。

结果

两轮函询问卷回收率均为100%，函询专家权威系数为0.89。2轮函询中条目重要性均数均>3.5、满分比均>0.2，变异系数CV均≤0.25，Kendall W协调系数分别为0.305，0.265（均P<0.001）。最终形成3个维度，10个子维度，33个条目的社区老年人脑卒中一级预防行为依从性量表。

结论

基于脑卒中一级预防指南（2024）、以慢性病自护理论为理论框架的社区老年人脑卒中一级预防行为依从性量表具有良好的可靠性和科学性，可作为评估社区老年人脑卒中一级预防行为依从性的评估工具。

, authors=丁洁, 李姿莹, 杨雨婷, 战同霞, authorsList=丁洁, 李姿莹, 杨雨婷, 战同霞, authorCompany=null, correspAuthors=战同霞, authorNote=

丁洁（2001—），女，硕士在读，研究方向：慢病管理

, correspAuthorsNote=
战同霞，E-mail:
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丁洁（2001—），女，硕士在读，研究方向：慢病管理

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(In Chinese), articleTitle=Application and prospect of digital technology in nutrition and health management of the elderly in community, refAbstract=null)], funds=[Fund(id=1324078291036025629, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078283763102449, awardId=x2025183, language=CN, fundingSource=山东第二医科大学校级大学生创新创业训练计划(x2025183), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324078286900441848, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078283763102449, xref=null, ext=[AuthorCompanyExt(id=1324078286921413369, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078283763102449, companyId=1324078286900441848, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Nursing, Shandong Second Medical University, Weifang, Shandong 261053, China), AuthorCompanyExt(id=1324078286933996282, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078283763102449, companyId=1324078286900441848, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=山东第二医科大学护理学院，山东 潍坊 261053)])], figs=[ArticleFig(id=1324078290683704089, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078283763102449, language=EN, label=Table 1, caption=

Concentration and coordination of expert opinions

, figureFileSmall=null, figureFileBig=null, tableContent=
专家函询轮数重要性
（分）		变异系数协调程度
Kendall W值χ2值P
第一轮3.83~5.00~0.220.305170.068<0.001
第二轮4.28~5.00~0.150.265152.452<0.001
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专家意见集中程度及协调程度

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专家函询轮数重要性
（分）		变异系数协调程度
Kendall W值χ2值P
第一轮3.83~5.00~0.220.305170.068<0.001
第二轮4.28~5.00~0.150.265152.452<0.001
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Scale for compliance with stroke primary prevention and its items in community-dwelling older adults

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一级指标二级指标问卷条目重要性赋值（）分变异系数满分比
（%）
健康生活方式依从性合理膳食依从性我会每天摄入新鲜蔬菜/水果（>400克/天）4.560.1156
会减少饱和脂肪（黄油、奶油）和反式脂肪酸（烘焙点心、油炸食品）的摄入4.890.0789
我会减少红肉(猪肉、牛、羊肉)的摄入量，以鱼类和蛋类作为蛋白质的主要来源4.280.1128
我会控制每天摄入食盐的量≤5 g（约一平茶匙）4.780.0978
规律运动依从性我会避免一直坐着，每连续坐1小时后，站起来活动（如站立伸展、慢走等）2-3分钟4.610.1367
我每天保持轻度运动（如散步、家务劳动）4.500.1150
我每周至少3次、每次至少持续30分钟中等或以上强度的有氧运动（如快走、慢跑、广场舞、游泳等）4.560.1461
体重管理依从性我会每周监测一次体重变化4.330.1439
我会使体重指数（BMI=体重/身高2）保持在正常范围（18.5-23.9）4.610.1367
戒烟限酒依从性我不吸烟/已戒烟4.780.0978
我不饮酒或者已戒酒/尽可能减少酒精（男性<25克/天；女性<12.5克/天）摄入量4.890.0789
其他健康生活方式依从性（充足睡眠、情绪管理、预防便秘等我会保持规律作息,每晚睡眠时长在7到9小时之间4.560.1461
我会用健康方式缓解压力（如倾诉、听音乐、冥想等）,避免情绪激动4.890.0789
我会通过调整饮食（如增加膳食纤维）、饮水、运动等方式积极预防便秘4.780.0978
健康监测依从性生理生化指标监测依从性我会根据医生建议定期测量血压4.890.0789
我会根据医生建议定期测量血糖4.890.0789
我会根据医生建议定期测量血脂4.890.0789
我会根据医生建议通过控制饮食、增加运动、服用药物等来使血压/血糖/血脂控制达标4.830.0883
心血管专项检查依从性我每年定期去医院脉诊/进行心电图检查筛查房颤4.560.1567
我每年定期去医院进行颈动脉狭窄检查4.610.1161
慢病管理依从性主动寻求外部支持行为依从性我会通过网络、书籍等途径主动学习脑卒中相关的知识（危险因素、发病先兆、发病急救4.670.1067
我会主动咨询专业人员脑卒中预防的知识4.670.1067
我会积极参加预防脑卒中的健康宣教活动4.440.1244
我会主动寻求家人/朋友的帮助来监督自身预防脑卒中的行为4.670.1067
遵医嘱服药依从性我会遵医嘱服药治疗高血压/高血糖/高血脂/心脏病等5.000.00100
服药过程中我不擅自停药、增加和减少药物剂量等5.000.00100
我能及时发现服用治疗药物的不良反应4.610.1161
脑卒中预警症状识别及应对管理依从性若出现口角歪斜症状，应主动及时就医5.000.00100
若出现一侧肢体无力或无力症状，应主动及时就医5.000.00100
若出现眩晕或行走不稳症状，应主动及时就医5.000.00100
若出现口齿不清语言交流困难症状，应主动及时就医5.000.00100
若出现视物模糊、双眼向一次凝视或者失明症状，应主动及时就医5.000.00100
若出现剧烈头痛、恶心症状，应主动及时就医5.000.00100
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社区老年人脑卒中一级预防行为依从性量表及条目

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一级指标二级指标问卷条目重要性赋值（）分变异系数满分比
（%）
健康生活方式依从性合理膳食依从性我会每天摄入新鲜蔬菜/水果（>400克/天）4.560.1156
会减少饱和脂肪（黄油、奶油）和反式脂肪酸（烘焙点心、油炸食品）的摄入4.890.0789
我会减少红肉(猪肉、牛、羊肉)的摄入量，以鱼类和蛋类作为蛋白质的主要来源4.280.1128
我会控制每天摄入食盐的量≤5 g（约一平茶匙）4.780.0978
规律运动依从性我会避免一直坐着，每连续坐1小时后，站起来活动（如站立伸展、慢走等）2-3分钟4.610.1367
我每天保持轻度运动（如散步、家务劳动）4.500.1150
我每周至少3次、每次至少持续30分钟中等或以上强度的有氧运动（如快走、慢跑、广场舞、游泳等）4.560.1461
体重管理依从性我会每周监测一次体重变化4.330.1439
我会使体重指数（BMI=体重/身高2）保持在正常范围（18.5-23.9）4.610.1367
戒烟限酒依从性我不吸烟/已戒烟4.780.0978
我不饮酒或者已戒酒/尽可能减少酒精（男性<25克/天；女性<12.5克/天）摄入量4.890.0789
其他健康生活方式依从性（充足睡眠、情绪管理、预防便秘等我会保持规律作息,每晚睡眠时长在7到9小时之间4.560.1461
我会用健康方式缓解压力（如倾诉、听音乐、冥想等）,避免情绪激动4.890.0789
我会通过调整饮食（如增加膳食纤维）、饮水、运动等方式积极预防便秘4.780.0978
健康监测依从性生理生化指标监测依从性我会根据医生建议定期测量血压4.890.0789
我会根据医生建议定期测量血糖4.890.0789
我会根据医生建议定期测量血脂4.890.0789
我会根据医生建议通过控制饮食、增加运动、服用药物等来使血压/血糖/血脂控制达标4.830.0883
心血管专项检查依从性我每年定期去医院脉诊/进行心电图检查筛查房颤4.560.1567
我每年定期去医院进行颈动脉狭窄检查4.610.1161
慢病管理依从性主动寻求外部支持行为依从性我会通过网络、书籍等途径主动学习脑卒中相关的知识（危险因素、发病先兆、发病急救4.670.1067
我会主动咨询专业人员脑卒中预防的知识4.670.1067
我会积极参加预防脑卒中的健康宣教活动4.440.1244
我会主动寻求家人/朋友的帮助来监督自身预防脑卒中的行为4.670.1067
遵医嘱服药依从性我会遵医嘱服药治疗高血压/高血糖/高血脂/心脏病等5.000.00100
服药过程中我不擅自停药、增加和减少药物剂量等5.000.00100
我能及时发现服用治疗药物的不良反应4.610.1161
脑卒中预警症状识别及应对管理依从性若出现口角歪斜症状，应主动及时就医5.000.00100
若出现一侧肢体无力或无力症状，应主动及时就医5.000.00100
若出现眩晕或行走不稳症状，应主动及时就医5.000.00100
若出现口齿不清语言交流困难症状，应主动及时就医5.000.00100
若出现视物模糊、双眼向一次凝视或者失明症状，应主动及时就医5.000.00100
若出现剧烈头痛、恶心症状，应主动及时就医5.000.00100
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社区老年人脑卒中一级预防行为依从性量表的构建
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丁洁 , 李姿莹 , 杨雨婷 , 战同霞
现代预防医学 | 基层卫生服务 2026,53(2): 287-292
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现代预防医学 |基层卫生服务 2026 , 53 (2) : 287 -292
社区老年人脑卒中一级预防行为依从性量表的构建
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丁洁, 李姿莹, 杨雨婷, 战同霞
作者信息
  • 山东第二医科大学护理学院，山东 潍坊 261053
通讯作者:
战同霞，E-mail:
作者简介:

丁洁（2001—），女，硕士在读，研究方向：慢病管理

Construction of community-based primary prevention behavior compliance scale for elderly patients with stroke based on Delphi method
Jie DING, Zi-ying LI, Yu-ting YANG, Tong-xia ZHAN
Affiliations
  • School of Nursing, Shandong Second Medical University, Weifang, Shandong 261053, China
出版时间: 2026-01-25 doi: 10.20043/j.cnki.MPM.202508088
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摘要
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目的

构建社区老年人脑卒中一级预防行为依从性量表，以整体评估社区老年人群依从行为水平，为一级预防现状调查、影响因素及健康宣教提供参考工具。

方法

基于《2024年美国心脏协会/美国卒中协会脑卒中一级预防指南》，以慢性病自我护理理论为理论框架，采用文献回顾法、德尔菲（Delphi）法，对18名专家进行两轮函询。通过对社区老年人的预调查，验证量表条目的适用性。

结果

两轮函询问卷回收率均为100%，函询专家权威系数为0.89。2轮函询中条目重要性均数均>3.5、满分比均>0.2，变异系数CV均≤0.25，Kendall W协调系数分别为0.305，0.265（均P<0.001）。最终形成3个维度，10个子维度，33个条目的社区老年人脑卒中一级预防行为依从性量表。

结论

基于脑卒中一级预防指南（2024）、以慢性病自护理论为理论框架的社区老年人脑卒中一级预防行为依从性量表具有良好的可靠性和科学性，可作为评估社区老年人脑卒中一级预防行为依从性的评估工具。

脑卒中  /  社区老年人群  /  一级预防行为  /  依从性  /  德尔菲法
Objective

To construct the Compliance Scale for primary prevention of stroke among the elderly in the community, to evaluate the compliance level of the elderly in the community as a whole, and to provide reference tools for the investigation of the current situation of primary prevention, influencing factors and health education.

Methods

In accordance with the 2024 Guideline for the Primary Prevention of Stroke from the American Heart Association/American Stroke Association, the theory of self-care for chronic diseases was used as the theoretical framework. Literature review and Delphi method were used to conduct two rounds of consultation with 18 experts. A pilot study was conducted among community-dwelling older adults to validate the applicability of the scale items.

Results

The questionnaire recovery rate for both rounds of inquiry reached 100%, and the expert authority coefficient was 0.89. In the two rounds of correspondence, the average importance of items was >3.5, the full score ratio was >0.2, the CV (coefficient of variation) stood at ≤0.25, and the Kendall W coordination coefficient was 0.305 and 0.265 respectively (all P<0.001). The final form is a community-based primary prevention behavior compliance scale for elderly stroke with 3 dimensions, 10 sub dimensions and 33 items.

Conclusion

Based on the guidelines for primary prevention of stroke (2024) and the theory of self-care for chronic diseases as the theoretical framework, the community elderly stroke primary prevention behavior compliance scale has good reliability and scientificity, and can be used as an evaluation tool to evaluate the community elderly stroke primary prevention behavior compliance.

Stroke  /  Community elderly population  /  Primary prevention behavior  /  Compliance  /  Delphi method
丁洁, 李姿莹, 杨雨婷, 战同霞. 社区老年人脑卒中一级预防行为依从性量表的构建. 现代预防医学, 2026 , 53 (2) : 287 -292 . DOI: 10.20043/j.cnki.MPM.202508088
Jie DING, Zi-ying LI, Yu-ting YANG, Tong-xia ZHAN. Construction of community-based primary prevention behavior compliance scale for elderly patients with stroke based on Delphi method[J]. Modern Preventive Medicine, 2026 , 53 (2) : 287 -292 . DOI: 10.20043/j.cnki.MPM.202508088
正文
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脑卒中（Stroke）是一种急性心脑血管疾病，具有高发病率、高致残率、高复发率、高死亡率的显著特点[1-2]。脑卒中已成为全球第二大死因并构成伤残调整寿命年（DALYs）第三大贡献因素[3]，其中65岁以上脑卒中病人占比超过85%，75岁以上的脑卒中病人占比超过72%，老年人是主要的发病人群[4]。我国老龄化进程加速，老年人口比例不断提高[5]，致使脑卒中患病群体日趋扩大[6]，给家庭和社会带来沉重的负担。研究显示，约80%的脑卒中病人存在不同程度的功能障碍[7]，因此将防控关口前移至一级预防阶段，成为最具成本效益的疾病负担控制策略[8]。《2024年美国心脏协会/美国卒中协会脑卒中一级预防指南》[9]提出需通过整合宏观社会因素与多维度危险因素管理（如高血压、高血糖、高血脂等）实现对发病率的有效控制。尽管近年来脑卒中一级预防已成为国内外学者关注的重点，但目前对脑卒中一级预防行为现状的测量多从单一危险行为角度或采用普适的健康促进行为量表[10]测量，缺乏针对所有危险行为水平的测量工具。因此，本研究基于《2024年美国心脏协会/美国卒中协会脑卒中一级预防指南》[11]，以慢性病自我护理理论[12]为框架，包含健康生活方式、健康监测、慢病管理三个方面，采用德尔菲（Delphi）法构建适用于社区场景的老年人脑卒中一级预防行为依从性量表，旨在为评估社区老年人群依从行为水平，提供参考工具。
1　对象与方法
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1.1　函询专家确定
根据研究所需，共遴选出临床医疗、临床护理、临床教育等研究领域的18名专家。年龄：45岁以下8人，45岁~56岁10人；工作年限：5年~15年4人，16年~25年8人，26年~38年6人；职称：中级1人，副高级11人，正高级6人；学历：本科5人，硕士研究生9人，博士研究生4人；研究领域：临床医疗4人，临床护理10人，公共卫生2人，临床教育1人，老年护理1人。根据问卷需求，确定专家纳入标准：①熟悉该领域并在临床医疗、护理教育、临床护理、公共卫生、临床教育、老年护理等领域工作5年及以上；②学历为本科及以上；③中级及以上的职称；④自愿参与本研究并持续参与直至函询结束。
1.2　方法
1.2.1　理论依据
本研究以Riegel提出的慢性病自我护理理论[12]为总体框架，强调个体在慢性病预防、管理与康复过程中的主体性，适用于长期坚持预防行为的老年群体。该理论包含三大核心维度：该理论包含三大核心维度：（1）自护维持：指个体为促进健康福祉而采取的膳食管理、烟草戒断等健康促进行为；（2）自护监测：指通过系统性观察（如监测体重变化和运动效果等）实现对身体参数的动态感知；（3）自护管理：强调对疾病相关症状、身心变化等实施症状缓解策略或专业医疗咨询等应对措施。
1.2.2　文献阅读
采用文献阅读法，检索中国知网、维普数据库、万方数据库、Web of science、Pubmed、Embase等中、英文数据库，限定中文检索词包括“脑卒中”、“脑卒中”、“一级预防”、“社区老年人群”、“依从性”、“慢性病自我护理理论”、“脑卒中一级预防指南（2024）”，英文检索词以“Stroke”AND“Primary Prevention” AND “Community-dwelling Older Adults” OR “Elderly Population”、“Adherence” OR “Compliance”、“Chronic Disease Self-Management Theory”、“2024 Guidelines for Primary Prevention of Stroke”等进行检索。
1.2.3　初始量表条目池的形成
基于《2024年美国心脏协会/美国卒中协会脑卒中一级预防指南》，以慢性病自我护理理论为理论框架，初步构建社区老年人脑卒中一级预防行为依从性量表条目池。设计初始量表3个1级条目：健康生活方式依从性、健康监测依从性、慢病规范管理依从性；10个2级条目；36个3级条目。
1.2.4　专家函询
根据量表调研需求，开展两轮专家函询工作。2025年7月通过微信、电子邮件等形式向遴选确定的专家进行首轮函询，同时要求专家2周内完成反馈。第1轮函询完成后整理专家评分情况，进行条目的筛选、修改，完成后进行第2轮函询。专家函询问卷包括：①问卷指导语：包括研究的目的及必要性、德尔菲专家函询的要求、联系方式等；②问卷主体：专家使用Likert 5级评分法[13]对量表各维度和条目进行重要性评分，程度分为：非常重要=5分，比较重要=4分，一般重要=3分，不太重要=2分，不重要=1分。各条目后均设有专家修改意见及指标增、删意见栏。③专家一般情况调查表：包括专家的姓名、性别、年龄、工作单位、职称、工作年限以及研究方向等信息。④专家判断依据调查表：包括专家的判断依据（Ca）和熟悉程度(Cs)。
1.2.5　条目筛选标准
通过计算维度及各条目重要性评分和变异系数（CV），筛选标准为：保留重要性评分均数>3.5分、变异系数（CV）≤0.25、满分率>20%[14]的条目。参照专家反馈的意见和建议，通过查阅文献及小组研讨后决定该条目的删减与修改。
1.2.6　预调查
便利选取本市某社区8位老年人进行质性访谈。纳入标准：①年龄在60岁以上；②既往有高血压/糖尿病/高血脂等慢性疾病病史；③自愿参与研究。排除标准：①阅读理解和沟通能力差，不能独立或需要在他人帮助下协助完成。②发生过脑卒中。询问量表条目的可理解性、表述清晰度及内容的完整性。结果显示，访谈的老年人均反馈量表语言通俗易懂，内容具有实用性、作答时长合适。
1.2.7　统计学方法
数据分析借助SPSS 29.0和Excel 2019完成。专家一般资料采用一般性统计描述方法分析；问卷回收率反映专家积极程度；权威系数（Cr）代表专家权威程度，Cr=(Ca＋Cs)/2[15]；专家熟悉程度以熟悉程度系数(Cs)来表示；熟悉程度赋值为：1.0表示很熟悉、0.8表示熟悉、0.6表示一般熟悉、0.4表示不熟悉、0.2表示非常不熟悉。专家意见集中程度的评价指标为重要性评分的均数（）、标准差（s）及变异系数（CV）。专家意见协调系数的衡量指标为Kendall协调系数（W）。检验水准α=0.05。
2　结果
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2.1　专家积极程度及权威系数
专家函询问卷的回收率两轮均为100%，Ca、Cs、Cr分别为0.93、0.86、0.89，权威系数（Cr）≥0.7。
2.2　专家意见集中程度和协调程度
两轮专家函询结果显示，变异系数CV均≤0.25、条目重要性均数均>3.5、满分比均>0.2。具体见表1。
2.3　专家函询结果
第1轮专家函询结果：根据筛选标准：满分比均>0.2、条目重要性均数均>3.5，变异系数CV均≤0.25无删减条目。根据函询专家的意见以及小组讨论后，将“其他检查依从性”修改为“心血管专项检查依从性”；将“主动获取脑卒中预防知识依从性”修改为“寻求外部支持行为依从性”；“我会以香草和香料调味，减少食盐的摄入”条目重复，删除；增加条目“我会根据医生建议通过控制饮食、增加运动、服用药物等来使血压/血糖/血脂控制达标”和“若出现眩晕或行走不稳症状，应主动及时就医”；将条目“出现一侧肢体无力或麻木、口角歪斜症状，我会及时拨打120主动就医”拆分为“若出现一侧肢体无力或无力症状，应主动及时就医”和“若出现口角歪斜症状，应主动就医”2个条目。共修改6个条目，删除2个条目，增加4个条目，拆分1个条目。
第2轮函询后，无删减条目，共修改2个条目。将“脑卒中预警症状应对管理依从性”修改为“脑卒中预警症状识别及应对管理依从性”；将“我会控制每天摄入食盐的量≤5g”修改为“我会控制每天摄入食盐的量≤5g（约一平茶匙）”。最终形成3个维度，10个子维度，33个条目。具体见表2。
3　讨论
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3.1　量表编制的科学性
本量表的编制基于《2024年美国心脏协会/美国卒中协会脑卒中一级预防指南》，以慢性病自我护理理论为理论框架，严格按照量表编制的原则，使用公认度较高的德尔菲法，进行2轮专家函询，最终形成3个维度，10个子维度，33个条目。
本次研究共选取了18名专家，其研究方向涉及临床医疗、临床护理、临床教育等领域。工作年龄在5年及以上，其中硕士研究生及副高级职称占大多数，专家的实践经验与学术素养较高。2轮专家函询过程中，回收率均为100%，专家权威系数均为0.89，Cr均≥0.7，表明参与专家均具备较高的积极性、参与度及较高权威程度，结果可信性良好。2轮函询条目重要性均数均>3.5、满分比均>0.2，变异系数CV均≤0.25，Kendall W协调系数分别为0.305，0.265（均P<0.001)，说明专家对各条目的评价结果具有较高一致性，研究结果科学、可靠。
3.2　研制本量表的意义
随着人口预期寿命显著延长，人口老龄化成为现代社会年龄结构变迁的显著特征，而我国已在2000年就迈入了老龄化社会行列。据2000年及2020年的人口统计数据显示，这二十年间我国老年人口占比显著提升了6.5个百分点，老龄化程度持续加深[16-17]。中国人口规模占全球总人口的20%，伴随老龄人口的增加，我国卒中的患病率居世界首位[18]，因此关注并降低老年人群脑卒中发病的风险成为公共卫生领域的迫切需要。但目前我国关于脑卒中一级预防现状的研究多从单角度进行调查分析，多维度整体角度的脑卒中可控社会因素和危险因素预防依从性现状研究尚存在空白。因此本研究编制的量表具有以下学术价值和实践意义：首先，实现理论框架与实践需求的创新型融合。量表的编制基于《2024年美国心脏协会/美国卒中协会脑卒中一级预防指南》，以慢性病自我护理理论为支撑，将可控社会因素和危险因素转化为可量化的评估维度，突破单一角度研究局限。采用多维度评估，不仅全面评估老年人群基础预防行为的依从性，还纳入了社会支持等深层影响因素，为整体评估老年人群依从性行为提供全新研究视角和标准化工具。第二，为社区精准防控提供科学工具。目前，社区多采用统一化的宣教模式，虽能提升老年人群健康知识知晓率[19]，但缺乏个体差异的精准把握。本量表可以精准识别老年个体在预防行为上的薄弱环节，助力社区卫生服务中心制定“靶向性”健康预防策略。第三，推动脑卒中与预防研究向“机制干预”深化。量表数据可为识别高风险人群、提前实施干预提供预警依据，使脑卒中一级预防由被动应对转向主动防控，为降低社区老年人群脑卒中发病率提供了可操作的研究模式。
4　小结
收起
本研究参照相关指南，通过文献回顾法，经多轮小组研讨，确定了合适理论框架并进行2轮Delphi专家函询，最终形成了3个维度，10个子维度，33个条目的社区老年人脑卒中一级预防行为依从性量表。编制量表过程中，函询专家的积极性、参与度及权威性均达到较高程度。但本研究还存在一定的局限性，如量表编制条目未经实证研究，故在后续研究中，增加量表的信度、效度的检验，对社区老人人群进行大样本试验，以增加该评估工具的科学性和可靠性。
基金
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  • 山东第二医科大学校级大学生创新创业训练计划(x2025183)
文献
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2026年第53卷第2期
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doi: 10.20043/j.cnki.MPM.202508088
  • 接收时间：2025-08-06
  • 首发时间：2026-11-02
  • 出版时间：2026-01-25
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  • 收稿日期：2025-08-06
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山东第二医科大学校级大学生创新创业训练计划(x2025183)
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    山东第二医科大学护理学院，山东 潍坊 261053

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