心脏病儿童运动恐惧量表的研制及信效度检验

doi:10.12372/jcp.2025.24e1359

摘要/Abstract

摘要：

目的研制心脏病儿童运动恐惧量表并开展信效度检验，为评估心脏病儿童的运动恐惧水平提供切实可用的工具。方法通过心脏病儿童人群调研、专家咨询及预调查，对心脏病患者运动恐惧量表进行修订，以编制适合7~18岁年龄人群使用的儿童版本量表。并于2024年1月至7月在294名适用人群中完成量表填写，完善量表条目，进行信效度分析。结果本次研制的心脏病儿童运动恐惧量表共包含11个条目，探索性因子分析共提取出2个因子，累计方差贡献率为51.241%，因子命名为“运动恐惧”“回避倾向”。总体Cronbach's α系数为0.820，折半信度为0.782，分维度Cronbach's α系数分别为0.811和0.820，折半信度为0.772、0.830。结论心脏病儿童运动恐惧量表易于填写且具有良好的信效度，儿童可独立阅读并填写，适宜作为7~18岁心脏病儿童运动恐惧水平的评价工具。

关键词: 运动恐惧量表, 心脏病, 信度, 效度, 儿童

Abstract:

Objective To adapt the Tampa Scale for Kinesiophobia for use in pediatric populations with heart disease and evaluate its reliability and validity as a tool for assessing fear of exercise in this population. Methods The scale was revised based on surveys of children with heart disease, expert consultations, and preliminary surveys. From January to July 2024, the revised scale was administered to 294 children aged 7-18 years with heart disease using a convenience sampling method. Results The final scale comprised 11 items. Exploratory factor analysis extracted two factors, labeled " fear of exercise " and " avoidance tendency," which accounted for a cumulative variance of 51.241%. The overall Cronbach’s α coefficient was 0.820, and the split-half reliability was 0.782. For the subdimensions, Cronbach’s α coefficients were 0.811 and 0.820, with split-half reliabilities of 0.772 and 0.830. Conclusion The Kinesiophobia scale for children with heart disease demonstrates strong psychometric properties and is a reliable and valid tool for evaluating exercise-related fear in children aged 7-18 years with heart disease.

Key words: Kinesiophobia scale, heart disease, reliability, validity, child

李儇儇, 杨朕, 陈琳, 蔡小满, 罗雯懿. 心脏病儿童运动恐惧量表的研制及信效度检验[J]. 临床儿科杂志, 2025, 43(5): 356-362.

LI Xuanxuan, YANG Zhen, CHEN Lin, CAI Xiaoman, LUO Wenyi. Revision and reliability and validity testing of the Tampa Scale for Kinesiophobia for children with heart disease[J]. Journal of Clinical Pediatrics, 2025, 43(5): 356-362.

图/表 6

表1

心脏病儿童运动恐惧量表条目内容及专家咨询各条目CV值"

条目内容	第一轮专家咨询		第二轮专家咨询
条目内容	均数±标准差	CV/%	均数±标准差	CV/%
1.我害怕在身体活动/体育锻炼中会伤到自己	4.70±0.68	14.36	4.78±0.44	9.23
2.如果我试着进行身体活动/体育锻炼，心脏问题就会加重	4.50±0.85	18.89	4.67±0.71	15.14
3.我感觉我的身体有严重的问题	4.60±0.70	15.20	4.60±0.70	15.20
4.如果我进行身体活动/体育锻炼，心脏问题可能会减轻	4.60±0.70	15.20	4.89±0.33	6.81
5.大家（家人/朋友等）对我的身体状况不够重视	4.60±0.70	15.20	4.78±0.67	13.95
6.我的心脏问题会让我的身体变得越来越差	4.90±0.32	6.45	54.90±0.32	6.45
7.一般情况下，出现心脏问题通常是因为身心受到了伤害或刺激	4.50±0.71	15.71	4.78±0.44	9.23
8.只引起胸部不舒服的事情不一定是危险的	4.60±0.70	15.20	4.67±0.50	10.71
9.我怕不小心在活动/锻炼中受伤	4.60±0.52	11.22	4.89±0.33	6.81
10.减少不必要的运动，心脏问题就不会越来越差	4.60±0.70	15.20	4.78±0.44	9.23
11.如果我的身体不受伤，我的心脏就不会出问题	4.30±0.95	22.07	4.78±0.44	9.23
12.我可以通过参加活动锻炼，来更好地保护心脏	4.50±1.97	21.60	4.56±0.53	11.56
13.当心脏不舒服或胸闷时，就提示我要不要停止活动或锻炼，这样就不会伤到我自己	4.20±1.03	24.60	4.67±0.71	15.14
14.对于像我这样身体状况的人来说，身体活动/体育锻炼真的不安全	4.70±0.68	14.36	4.89±0.33	6.81
15.我的心脏太容易出问题了，所以我无法和别人做同样的事情	4.70±0.68	14.36	4.70±0.68	14.36
16.尽管有些事会让我出现心脏问题，但我不觉得它们都是真正危险的	4.50±0.71	15.71	4.89±0.33	6.81
17.当一个人心脏有问题时，他/她应该不进行身体活动/体育锻炼	4.70±0.68	14.36	4.78±0.44	9.23

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项目	例数（%）
性别
男	149（50.70）
女	145（49.30）
文化程度
小学	202（68.70）
初中	67(22.80)
高中/中专	25(8.50)
疾病诊断
左向右分流型先天性心脏病	164（55.80）
梗阻型先天性心脏病	32（10.90）
发绀型先天性心脏病	32（10.90）
瓣膜性心脏病	31（10.50）
充血性心力衰竭	15（5.10）
肺动脉高压	15（5.10）
房室传导阻滞	3（1.00）
心脏移植术后	2（0.70）

条目	临界比（t）	P	相关系数（r）	P
1	13.00	<0.001	0.66	<0.001
2	12.65	<0.001	0.64	<0.001
3	14.19	<0.001	0.65	<0.001
4	4.32	0.039	0.25	<0.001
5	2.04	0.044	0.07	0.227
6	9.31	<0.001	0.53	<0.001
7	7.36	<0.001	0.47	<0.001
8	3.58	0.204	0.27	<0.001
9	10.94	<0.001	0.58	<0.001
10	9.32	<0.001	0.55	<0.001
11	6.34	<0.001	0.44	<0.001
12	7.59	0.613	0.43	<0.001
13	1.77	0.079	0.13	0.026
14	10.95	<0.001	0.65	<0.001
15	8.84	<0.001	0.50	<0.001
16	3.69	0.192	0.29	<0.001
17	10.74	<0.001	0.60	<0.001

项目	因子1（运动恐惧）	因子2（回避倾向）	共同度
条目1	0.661	0.252	0.500
条目2	0.689	0.206	0.517
条目3	0.715	0.169	0.540
条目6	0.579	0.138	0.354
条目9	0.573	0.296	0.416
条目14	0.751	0.039	0.566
条目15	0.639	-0.088	0.416
条目7	0.051	0.813	0.664
条目10	0.168	0.780	0.637
条目11	0.001	0.806	0.650
条目17	0.220	0.773	0.646
条目12	-0.366	0.322	0.242
特征值	4.095	2.054
累计贡献率/%	28.159	51.241