目的 构建居家慢性心力衰竭患者容量超负荷早期预警自我评分表并进行验证，为居家慢性心力衰竭患者的容量超负荷早期预警提供依据。 方法 基于文献研究及质性研究,制订专家函询问卷，采用德尔菲法对20名专家进行两轮函询，运用层次分析法确定各项指标权重并赋分，进行信效度检验和受试者工作特征曲线（receiver operating characteristic curve，ROC）分析。 结果 两轮专家函询的有效回收率分别为91%、100%，专家权威系数0.88。构建的评分表包含4项一级指标、10项二级指标以及36项三级指标，三级指标分值范围为1~7分；评分表内部一致性信度为0.767，内容效度为0.921；ROC分析最佳界点值为28分。 结论 基于德尔菲法构建的居家慢性心力衰竭患者容量超负荷早期预警自我评分表可靠性较高、科学性较强，可作为简易评分工具，为居家慢性心力衰竭患者快速自我评估容量负荷水平并给出早期预警提供依据。

Objective To construct a self-rating scale for early warning of volume overload in home-based patients with CHF ,so as to provide evidence for early warning of volume overload in home-based patients with CHF. Methods Based on literature research and qualitative research,an expert questionnaire was formulated,and 20 experts were surveyed through of expert mail survey using Delphi method.The weight of each indicator was analyzed by the analytic hierarchy process,and the scoring was assigned.The reliability and validity were tested,and the receiver operating characteristic curve(ROC) analysis was conducted. Results The effective return rate of the first and second rounds of expert mail survey was 91% and 100% respectively,with the coefficient of authority of experts being 0.88.A self-rating scale with 4 primary indicators,10 secondary indicators,and 36 tertiary indicators was constructed.After the analytic hierarchy process was used to assign scores,the tertiary indicators had scores ranging from 1 to 7.The internal consistency reliability coefficient of the scale was 0.767,and the content validity coefficient was 0.921.After the ROC analysis,the optimal cut-off value was 28.Conclusions The self-rating scale for early warning of volume overload in home-based patients with CHF constructed by Delphi method has high reliability and strong scientific validity,and can be used as a simple scoring tool to provide evidence for home-based CHF patients to quickly self-assess their volume load levels and give early warning.

R473.54

江苏省干部保健科研课题（BJ20004）；南京鼓楼医院护理科研项目（2023-B216）