关键词: 成人患者；出院计划；风险；筛查；量表；信度；效度

Abstract: Objective: To develop a scale to screen discharge planning risk for adult patients and to test its reliability and validity, aiming to provide a scientific and efficient assessment tool that can quickly identify high-risk groups for nurses to ensure appropriate discharge plans for patients. Methods: Based on Neuman Systems Model and Triangle Stratified Hierarchical Classification Model, the item pool of the scale was constructed through literature research, semi-structured interviews and group discussions. After 2 rounds of Delphi expert consultation and pre-survey, the initial scale was formed. Then from May to July 2024, 581 adult patients in a tertiary grade A hospital in Wuhan were selected as research subjects whose data were collected for item analysis, reliability test, reliability test and classification of risk levels. Results: The scale's CVI was 0.930. Exploratory Factor Analysis (EFA) was adopted to extract 4 common factors whose cumulative variance contribution rate was 78.504%. Confirmatory Factor Analysis (CFA) indicated good model fit. The scale consists of 4 dimensions with a total of 12 items and 46 options, including physical and psychological function status, disease diagnosis and treatment, existing nursing needs, and care and support. The scale score ranged from 0 to 36. Using K-means clustering algorithm, patients' risk were divided into three levels: low-risk, medium-risk, and high-risk. The scale's Cronbach's α coefficient was 0.915 with the split-half reliability and the test-retest reliability being 0.909 and 0.912, respectively. Conclusion: The screening scale of discharge planning risk for adult patients not only has good reliability and validity, but also is a simple and widely applicable tool. Medical staff should provide corresponding levels of intervention based on the results of risk assessment, to ensure the implementation of high-quality discharge plans.

Key words: adult patients; discharge planning; risk; screening; scale; reliability; validity