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Abstract
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Background Identification of the warning signs of psychological crisis by observing behaviors is favorable for early detection and management of the potential psychological crisis.However,in China,there is still no psychological crisis warning instrument available.
OBJECTIVE To develop an individual psychological crisis warning instrument for dynamic early warning of psychological crisis.
METHODS Items were screened using Delphi expert consultation method to form the Psychological Crisis Signs Checklist (PCSC).By two rounds of survey,the reliability and validity of PCSC were examined,and the PCSC was then modified on the basis of an expert discussion according to item analysis including inter-rater reliability,sensitivity and specificity indicators.The Yoden Index was used to calculate the warning threshold.
RESULTS The items were screened by a two-round Delphi study,resulting in a 35-item PCSC.During a formal survey 〔the number of respondents in the formal survey was 183,consisting of the crisis group (n=82),and non-crisis group (n=101) 〕,the PCSC demonstrated excellent internal consistency (Cronbach's α=0.85) and inter-rater reliability (rs=0.84),scores of PCSC could effectively distinguish between crisis and non-crisis group.The Spearman' rho between PCSC and Triage Assessment Form (TAF) was 0.90,indicating good criterion validity.The PCSC was then modified on the basis of an expert discussion according to item analysis including inter-rater reliability,sensitivity and specificity indicators.The modified PCSC includes 30 items.Based on the threshold corresponding to the maximum Youden index,it was determined that when the total PCSC score is ≥9,yellow crisis alarms;when the total cutoff score is ≥14,red crisis alarms.
CONCLUSION The PCSC could effectively screen individuals at high risk for psychological crisis,which is conducive to early identification of warning signs and dynamic monitoring of psychological crisis. © 2019 by the Chinese General Practice.
Language: zh |