背景：结直肠癌是全球第三大常见恶性肿瘤，死亡率高，手术是其早期治疗的核心手段。由于结直肠癌患者具有高龄、手术时间较长以及特殊的手术体位等特殊风险因素，深静脉血栓形成（DVT）成为其术后常见并发症，发生率达11.0%，且一旦发生DVT，患者两年死亡率高达52%，因此有效预防DVT于结直肠癌术后患者至关重要。国内外指南及共识均明确指出，基本预防是降低患者发生DVT的关键措施之一。但目前结直肠癌患者DVT基本预防依从性普遍不足，且尚无标准化测量工具来探究患者依从性不佳的原因，增加了落实DVT预防工作的难度。计划行为理论是常用的行为改变理论，理论系统覆盖患者预防行为意向影响因素，可指导提高行为实施依从性，被广泛应用于编制患者行为意向测量工具领域。鉴于此，有必要基于计划行为理论编制结直肠癌术后患者DVT基本预防行为意向问卷，以识别影响依从性的关键因素，为提高患者DVT基本预防依从性提供科学依据，从而达到切实落实DVT预防工作，降低结直肠癌患者术后DVT发生率的目标。

目的：（1）编制结直肠癌术后患者DVT基本预防行为意向问卷；（2）验证结直肠癌术后患者DVT基本预防行为意向问卷的适用性。

方法：本研究以计划行为理论为基础编制问卷，并进行初步验证。（1）于2024年1月至2月，采用目的抽样法，抽取北京协和医院结直肠癌术后患者进行半结构式访谈，采用Colaizzi七步分析法分析访谈结果，基于TPB问卷编制模板初步形成条目池，随后通过两轮专家函询及预调查完善初版问卷。于2024年5月至6月，采用便利抽样法，抽取研究地120名结直肠癌术后患者进行问卷信效度检验。项目分析用于筛选条目，确保条目区分度和代表性，信度分析采用Cronbach's α系数和折半信度评估问卷的内部一致性；效度分析通过专家评定法检验内容效度（I-CVI和S-CVI），并通过探索性因子分析验证结构效度，最终形成正式问卷。（2）于2024年7月至2025年2月，采用便利抽样法，抽取研究地共240名结直肠癌术后患者进行问卷初步应用。通过Spearman相关分析各维度相关性，同时分析各维度得分情况，评估问卷在目标人群中的适用性、可行性及临床价值。

结果：（1）本研究编制的“结直肠癌术后患者DVT基本预防行为意向问卷”共包含13个条目，行为态度、主观规范、知觉行为控制维度各3个条目，行为意向维度4个条目。所编制问卷具有较好信效度。内容效度指数（S-CVI）为0.929，总问卷Cronbach's α系数为0.946，折半信度为0.965。探索性因子分析KMO值为0.916，Bartlett球型检验值3900.644（df-78，P<0.001），最终提取4个公因子，累积方差贡献率为60.855％。（2）问卷初步验证阶段，共收集240例结直肠癌术后患者，问卷各维度得分数据均呈非正态分布，行为意向维度得分为23（20, 25），行为态度维度得分为17（15, 19）、主观规范维度得分为17（15, 18）、知觉行为控制维度得分为17（15, 19）；Spearman相关性分析结果显示，计划行为理论各维度得分之间存在显著的正相关，（r范围为0.488～0.839）。

结论：本研究基于计划行为理论所编制的“结直肠癌术后患者DVT基本预防行为意向问卷”具有较好信效度，患者接受度好，具有一定可行性及应用价值，可作为结直肠癌术后患者DVT基本预防行为意向评估的测量工具。

Background: Colorectal cancer, the third most common malignant tumor globally and a leading cause of cancer-related mortality, is primarily treated with surgery in its early stages. However, postoperative DVT is a common complication, with an incidence rate of 11.0%, largely due to factors such as patient age, prolonged surgical duration, and specific intraoperative positioning. This complication significantly impacts patient survival, with a two-year mortality rate as high as 52%. Effective DVT prevention is crucial. While guidelines highlight basic prevention to reduce DVT incidence, current adherence is suboptimal, and standardized tools to explore poor compliance are lacking. The Theory of Planned Behavior (TPB) offers a systematic approach to understanding preventive behavior intention and has been widely used in developing related measurement tools. Thus, developing a TPB-based questionnaire to assess postoperative colorectal cancer patients' DVT prevention behavioral intention is essential. It can identify key factors affecting adherence, offering a scientific basis to improve adherence and reduce postoperative DVT incidence.

Objective: (1) To develop a DVT basic prevention behavioral intention questionnaire for colorectal cancer patients after surgery; (2) Validate the applicability of the DVT basic prevention behavioral intention questionnaire for colorectal cancer patients after surgery.

Methods: This study developed and preliminarily validated the questionnaire based on TPB. (1) From January to February 2024, a purposive sampling method was used to select postoperative colorectal cancer patients from Peking Union Medical College Hospital for semi-structured interviews. The Colaizzi seven-step analysis method was used to analyze the interview results, and a preliminary item pool was formed based on the TPB questionnaire template. Subsequently, the initial version of the questionnaire was refined through two rounds of expert consultations and a pilot survey. From May to June 2024, convenience sampling was used to select 120 colorectal cancer patients after surgery from the same department for questionnaire reliability and validity testing. Item analysis was performed to select items for their discriminative power and representativeness. Reliability was evaluated using Cronbach's α and split-half reliability for internal consistency. Content validity was assessed via expert review (I-CVI and S-CVI), and exploratory factor analysis was conducted to confirm structural validity, leading to the final version of the questionnaire. (2) From July 2024 to February 2025, convenience sampling was used to select 240 colorectal cancer patients after surgery from the same department for the preliminary application of the questionnaire. Spearman correlation analysis was used to examine the correlations between dimensions, and the scores of each dimension were analyzed to assess the applicability, feasibility, and clinical value of the questionnaire in the target population.

Results: (1) The developed "DVT Basic Prevention Behavioral Intention Questionnaire for Colorectal Cancer Patients After Surgery" consists of 13 items, with three items each for the dimensions of behavioral attitude, subjective norm, and perceived behavioral control, and four items for the behavioral intention dimension. The content validity index (S-CVI) was 0.929, the total Cronbach's α coefficient was 0.946, and the split-half reliability was 0.965. The exploratory factor analysis showed a KMO value of 0.916, a Bartlett's test of sphericity value of 3900.644 (df=78, P<0.001), and four common factors were extracted, with a cumulative variance contribution rate of 60.855%. (2) In the preliminary validation phase, data from 240 colorectal cancer patients after surgery were collected. The scores of each dimension were non-normally distributed. The behavioral intention dimension score was 23 (20, 25), the behavioral attitude dimension score was 17 (15, 19), the subjective norm dimension score was 17 (15, 18), and the perceived behavioral control dimension score was 17 (15, 19). Spearman correlation analysis showed significant positive correlations between the scores of each dimension of TPB (ranging from 0.488 to 0.839).

Conclusion: The developed questionnaire has good reliability and validity, is well-accepted by patients, and has certain feasibility and application value. It can be used as a measurement tool for assessing the behavioral intention of DVT basic prevention in colorectal cancer patients after surgery.