躯体疾病住院患者自杀意念预警量表初步编制

Preliminary development of warning scale of suicide ideation of inpatients with somatic disease

目的 编制简洁、实用的躯体疾病患者自杀意念的预警工具.方法 采用5∶1完全随机抽样方法,共抽取了2010年11月至2013年2月期间某三甲综合医院年龄＞15岁的2 677名躯体疾病住院患者.采用自编患者一般资料调查表、躯体健康调查表、最近一周健康调查表、抑郁自评量表、焦虑自评量表等进行调查.采用卡方检验、偏相关分析、t检验、相关分析以及ROC曲线分析等方法进行统计分析.结果 1.形成了有18个条目的自杀意念预警量表.2.编制的自杀预警量表的内部一致性Cronbach＇s α系数为0.84,分半信度为0.60,与抑郁自评量表（r=0.50）、焦虑自评量表得分（r=0.54）呈正相关（P＜0.01）.量表有较好的结构效度.3.经ROC曲线分析得出,曲线下面积为0.83,灵敏度为68.40％,特异度为79.20％.阳性预测值为21.22％,阴性预测值为96.83％.结论 自杀意念预警工具条目区分度、信效度符合测量学要求,有较好的特异度和阴性预测值,可在临床中试用.

Objective To form a concise and useful warning scale of suicide ideation of inpatients with somatic disease.Methods 2 677 inpatients who were more than 15 years old were randomly selected in a comprehensive hospital during the period of 2010.11-2013.02.Self-rating Depression Scale （SDS）,Self-rating Anxiety Scale（SAS） and self-designed questionnaires which included general information,suicide risk factors and somatic disease were applied.Chi square test,partial correlation analysis,t test,correlation analysis and ROC curve analysis were used for statistical analysis.Results 1.The warning scale of suicide ideation which contained 18 items was formed.2.The Cronbach＇s Alpha reliability of the warning scale was 0.84 and its split-half reliability was 0.60.Criterion-related validity studies showed that the scores of the 18 items were positive correlated with SDS and SAS（r SDS =0.50,r SAS =0.54,P＜0.01）.This scale also had good structure validity.3.The ROC curve concluded that the area under curve was 0.83,the sensitivity was 68.40％ and the specificity was 79.20％.Positive and negative predictive values were 21.22％ and 96.83％ respectively.Conclusion The reliability and validity of the warning scale entirely accorded with psychometric demands.It also has good specificity and negative predictive value,so it is suitable for clinical promotion.