脑卒中患者行为决策评估量表的编制及信效度检验

doi:10.3761/j.issn.0254-1769.2022.13.011

摘要/Abstract

摘要：

目的编制脑卒中患者行为决策评估量表并检验其信效度。方法基于跨理论模型、健康信念模型和行为决策相关理论等界定概念结构,通过文献回顾、半结构式访谈等初步构建量表条目池,经专家函询形成初始量表,采用认知性访谈对条目进行预测试及调整,2020年2月—10月,便利选取327例脑卒中患者进行调查,检验量表信效度。结果脑卒中患者行为决策评估量表包括4个维度、共30个条目,探索性因子分析累计方差贡献率为64.408%,条目采用Likert 5级评分法,4个维度分别命名为“行为改变动机”“行为改变意向”“决策因素”和“决策平衡”。量表内容效度指数为0.800~1.000;Cronbach’s α系数为0.934,折半信度为0.797,2周重测信度为0.833。结论脑卒中患者行为决策评估量表信效度较好,可作为评估脑卒中患者健康行为决策的有效工具。

关键词: 脑卒中, 健康行为, 行为决策, 量表, 信效度

Abstract:

Objective To develop and test the reliability and validity of the Behavioral Decision-making Scale for stroke patients. Methods The conceptual structure was defined based on theory analysis. The literature review and semi-structured interview were conducted to build the items pool. The initial scale was formed after expert consultations;the cognitive interview was conducted to test and adjust the items. Then,327 stroke patients were conveniently investigated from February to October 2020,and the data was used to test the reliability and validity of the scale. Results The scale consisted of 30 items,4 dimensions,with a cumulative variance contribution of 64.408%. The 4 dimensions were named as “behavioral change motivation”,“behavioral change intention”,“decision factors”,and “decision balance”. The content validity index of the total scale was 0.800-1.000;the Cronbach’s alpha coefficient was 0.934,the half reliability was 0.797,and the 2-week retest reliability was 0.833. Conclusion The Behavior Decision-making Scale has good reliability and validity,and it can be used as a valid tool to assess health behavior decision making in stroke patients.

Key words: Stroke, Healthy Behavior, Behavioral Decision Making, Scale, Reliability and Validity

林蓓蕾, 张振香, 梅永霞, 王文娜, 王盼盼, 唐起岚, 郭君, 张伟宏. 脑卒中患者行为决策评估量表的编制及信效度检验[J]. 中华护理杂志, 2022, 57(13): 1605-1610.

LIN Beilei, ZHANG Zhenxiang, MEI Yongxia, WANG Wenna, WANG Panpan, TANG Qilan, GUO Jun, ZHANG Weihong. Development and psychometric test of the Behavioral Decision-making Scale for Stroke Patients[J]. Chinese Journal of Nursing, 2022, 57(13): 1605-1610.

图/表 1

参考文献 17

[1]	Yusuf S, Joseph P, Rangarajan S, et al. Modifiable risk factors,cardiovascular disease,and mortality in 155 722 individuals from 21 high-income,middle-income,and low-income countries(PURE):a prospective cohort study[J]. Lancet, 2020, 395 (10226):795-808. DOI URL
[2]	扈芷晴, 秦邦辉, 孙艳君, 等. 跨期决策在慢性病患者健康行为研究中的应用[J]. 南京医科大学学报(社会科学版), 2021, 21(6):579-583.
	Hu ZQ, Qin BH, Sun YJ, et al. Application of intertemporal decision-making in the study of health behavior of patients with chronic diseases[J]. J Nanjing Med Univ Soc Sci, 2021, 21(6):579-583.
[3]	Hagger MS, Weed M. DEBATE:do interventions based on behavioral theory work in the real world?[J]. Int J Behav Nutr Phys Act, 2019, 16(1):36. DOI URL
[4]	田向阳. 行为决策的评估理论构建研究[J]. 健康教育与健康促进, 2020, 15(2):167-172.
	Tian XY. A study on construction of assessment theory on behavioral decision-making[J]. Heal Educ Heal Promot, 2020, 15(2):167-172.
[5]	Edwards W. Behavioral decision theory[J]. Annu Rev Psychol, 1961, 12:473-498. DOI URL
[6]	徐晨晨, 薛婷. 行为决策理论在健康行为中的应用[C]// 中国心理学会. 第二十三届全国心理学学术会议摘要集(上). 中国心理学会, 2021:915-916.
	Xu CC, Xue T. Application of behavioral decision theory to health behavior[C]// Chinese Psychological Society. Collection of abstracts from the twenty-third national psychology conference(above). Chinese Psychological Society, 2021:915-916.
[7]	彭向东, 褚勇强, 萨支红, 等. 健康行为理论:从健康信念模式到风险认知和健康行为决策[J]. 中国健康教育, 2014, 30(6):547-548,568.
	Peng XD, Chu YQ, Sa ZH, et al. Health behavior theory:from health belief model to risk perception and health behavior decision making[J]. Chin J Heal Educ, 2014, 30(6):547-548,568.
[8]	吴小菊, 陈俊芳, 符佳慧, 等. 健康领域的跨期决策与健康行为[J]. 心理科学进展, 2020, 28(11):1926-1938.
	Wu XJ, Chen JF, Fu JH, et al. Time preferences for public health and health behavior[J]. Adv Psychol Sci, 2020, 28(11):1926-1938. DOI URL
[9]	林蓓蕾, 梅永霞, 张振香, 等. 健康相关行为决策平衡测评工具的研究进展[J]. 中国全科医学, 2020, 23(13):1599-1605. DOI
	Lin BL, Mei YX, Zhang ZX, et al. Research progress on decisional balance tools of health-related behaviors[J]. Chin Gen Pract, 2020, 23(13):1599-1605.
[10]	Glanz K, Rimer BK, Viswanath KV. Health behavior and health education,theory,research and practice(4th ed)[M]. New York: Jossey Bass, 2008.
[11]	Velicer WF, DiClemente CC, Prochaska JO, et al. Decisional ba-lance measure for assessing and predicting smoking status[J]. J Pers Soc Psychol, 1985, 48(5):1279-1289. PMID
[12]	林蓓蕾, 郭云飞, 张振香, 等. 脑卒中患者疾病体验及其复发风险感知的质性研究[J]. 中华护理杂志, 2021, 56(1):80-85. DOI
	Lin BL, Guo YF, Zhang ZX, et al. A qualitative study on disease experience and recurrence risk perception of stroke survivors[J]. Chin J Nurs, 2021, 56(1):80-85.
[13]	德威利斯RF. 量表编制:理论与应用[M]. 席仲恩,杜珏,译. 3版. 重庆: 重庆大学出版社, 2016:61,167.
	Devellis RF. Scale development:theory and applications[M]. Xi ZE,Du Y,translate. 3rd ed. Chongqing: Chongqing University Press, 2016:61,167.
[14]	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国脑血管疾病分类2015[J]. 中华神经科杂志, 2017, 50(3):168-171.
	Chinese Medical Association, Cerebrovascular Disease Group. Classification of Chinese cerebrovascular diseases 2015[J]. Chin J Neurol, 2017, 50(3):168-171.
[15]	曹锦丹, 王崇梁. 健康行为改变不同阶段的信息框架效应概念模型研究[J]. 图书情报工作, 2019, 63(5):23-31. DOI
	Cao JD, Wang CL. Conceptual model of information framing effects in different stages of health behavior change[J]. Libr Inf Serv, 2019, 63(5):23-31.
[16]	Lin BL, Zhang ZX, Thrift AG, et al. Qualitative study of stroke survivors’ perceptions of secondary prevention[J]. J Adv Nurs, 2022, 78(5):1377-1388. DOI URL
[17]	黄玲玲, 郭佳, 丁云, 等. 文化调适在跨文化健康行为干预中的应用进展[J]. 中华护理杂志, 2017, 52(5):613-617.
	Huang LL, Guo J, Ding Y, et al. Cultural adaptation for behavioral health interventions in cross-cultural background[J]. Chin J Nurs, 2017, 52(5):613-617.