肺癌患者运动训练行为感知量表的编制及信效度检验

doi:10.3761/j.issn.0254-1769.2024.01.003

摘要/Abstract

摘要：

目的编制肺癌患者运动训练行为感知量表并检验其信效度。方法依据健康信念模型，通过查阅文献、半结构式访谈、课题组讨论、2轮专家函询和预调查，形成量表初稿。选取2022年10月—2023年4月在郑州市某三级甲等医院就诊且符合条件的842例肺癌患者进行调查，应用项目分析、效度分析及信度分析对条目进行调整，形成正式量表。结果肺癌患者运动训练行为感知量表包含24个条目，探索性因子分析产生身体康复益处、情绪与心态益处、信息障碍、疾病症状障碍、条件障碍、心理障碍等6个公因子，累计方差贡献率为73.916%，验证性因子分析结果显示，卡方/自由度为2.371，近似误差均方根为0.057，规范拟合指数为0.924，比较拟合指数为0.954，模型拟合度较好。量表得分与法兰查活动量表总分呈正相关（r=0.529，P<0.001）；量表总的Cronbach’s α系数、折半信度及重测信度分别为0.884、0.741、0.889。结论构建的肺癌患者运动训练行为感知量表具有良好的信效度，可用于评估肺癌患者运动训练行为的感知状况。

关键词: 肺癌, 运动训练, 行为感知, 信度, 效度, 康复护理

Abstract:

Objective To develop an Exercise Behavior Perception Scale for Lung Cancer Patients in China，and to test its reliability and validity. Methods According to the health belief model，the first draft of the scale was formed through literature review，semi-structured interview，research group discussion，2 rounds of expert correspondence and pre-survey. A total of 842 patients with lung cancer who received treatment in a tertiary A hospital in Zhengzhou City from October 2022 to April 2023 were selected for investigation，and item analysis，validity analysis，and reliability analysis were applied to adjust the items to form a formal scale. Results The Exercise Behavior Perception Scale for Lung Cancer Patients contained 24 items，and exploratory factor analysis generated 6 common factors，including physical rehabilitation benefits，emotional and mental benefits，information disorders，disease symptom disorders，condition disorders，and psychological disorders. The cumulative variance contribution rate reached 73.916%，and the results of confirmatory factor analysis showed that the model fit was good，the χ²/df was 2.371，the root mean square error of approximation was 0.057，the normed fit index was 0.924，and the comparative fit index was 0.954，the scale score was moderately positively correlated with the total score of the Frenchay activities index （r=0.529，P<0.001）. The Cronbach’s α，coefficient，half reliability，and retest reliability of the scale were 0.884，0.741，and 0.889，respectively. Conclusion The Exercise Behavior Perception Scale for Lung Cancer Patients had good reliability and validity，and it can be used to effectively evaluate the exercise behavior perception status of lung cancer patients.

Key words: Lung Cancer, Exercise, Behavior Perception, Reliability, Validity, Rehabilitation Nursing

林琦, 刘玉荣, 杨慧, 杨凤娟, 王丹, 陈瑞云. 肺癌患者运动训练行为感知量表的编制及信效度检验[J]. 中华护理杂志, 2024, 59(1): 22-28.

LIN Qi, LIU Yurong, YANG Hui, YANG Fengjuan, WANG Dan, CHEN Ruiyun. Development and validation of an Exercise Behavior Perception Scale for Lung Cancer Patients[J]. Chinese Journal of Nursing, 2024, 59(1): 22-28.

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参考文献 18

[1]	Xia CF, Dong XS, Li H, et al. Cancer statistics in China and United States,2022:profiles,trends,and determinants[J]. Chin Med J (Engl), 2022, 135(5):584-590.
[2]	中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2023版)[J]. 中华医学杂志, 2023, 103(27):2037-2074.
	Chinese Society of Oncology,Journal of the Chinese Medical Association. Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer(2023 edition)[J]. Natl Med J China, 2023, 103(27):2037-2074.
[3]	中国老年保健协会肺癌专业委员会, 天津市医疗健康学会加速外科康复专业委员会. 老年肺癌外科治疗中国专家共识(2022版)[J]. 中国肺癌杂志, 2023, 26(2):83-92.
	Chinese Geriatric Health Care Association Lung Cancer Committee, Tianjin Medical Health Association Accelerated Surgical Rehabilitation Committee. Consensus of Chinese experts on surgical treatment of lung cancer in the elderly(2022 edition)[J]. Chin J Lung Cancer, 2023, 26(2):83-92.
[4]	Edbrooke L, Bowman A, Granger CL, et al. Exercise across the lung cancer care continuum:an overview of systematic reviews[J]. J Clin Med, 2023, 12(5):1871. DOI URL
[5]	Edbrooke L, Granger CL, Denehy L. Physical activity for people with lung cancer[J]. Aust J Gen Pract, 2020, 49(4):175-181. DOI PMID
[6]	Mikhail B. The health belief model:a review and critical evaluation of the model,research,and practice[J]. Adv Nurs Sci, 1981, 4(1):65-82.
[7]	Lightfoot CJ, Wilkinson TJ, Song Y, et al. Perceptions of exercise benefits and barriers:the influence on physical activity behaviour in individuals undergoing haemodialysis and peritoneal dialysis[J]. J Nephrol, 2021, 34(6):1961-1971. DOI PMID
[8]	方方, 刘双霞, 孟保玲, 等. 运动自我效能在终末期肾脏病患者运动益处及障碍感知与锻炼意向间的中介效应[J]. 护理学杂志, 2023, 38(1):26-30.
	Fang F, Liu SX, Meng BL, et al. Mediating effect of exercise self-efficacy on the relationship between perceived exercise benefits,perceived exercise barriers and exercise intention in patients with end-stage renal disease[J]. J Nurs Sci, 2023, 38(1):26-30.
[9]	Elshahat S, Treanor C, Donnelly M. Factors influencing physical activity participation among people living with or beyond cancer:a systematic scoping review[J]. Int J Behav Nutr Phys Act, 2021, 18(1):50. DOI PMID
[10]	王晶晶, 白晨晓, 张泽懿, 等. 老年慢性阻塞性肺疾病患者锻炼行为感知现状及影响因素分析[J]. 中华护理杂志, 2022, 57(1):36-42. DOI URL
	Wang JJ, Bai CX, Zhang ZY, et al. The current status of ex-ercise perception and its influencing factors in elderly pa-tients with chronic obstructive pulmonary disease[J]. Chin J Nurs, 2022, 57(1):36-42.
[11]	Koehn S, Amirabdollahian F. Reliability,validity,and gender invariance of the exercise benefits/barriers scale:an emerging evidence for a more concise research tool[J]. Int J Environ Res Public Health, 2021, 18(7):3516. DOI URL
[12]	Hu YC, Chen XX, Fan JX, et al. The subjective will and psychological experience of home-based exercise in lung cancer patients during interval of chemotherapy:a qualitative study[J]. J Multidiscip Healthc, 2023, 16:663-674. DOI URL
[13]	Rami-Porta R, Bolejack V, Crowley J, et al. The IASLC lung cancer staging project:proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer[J]. J Thorac Oncol, 2015, 10(7):990-1003. DOI PMID
[14]	罗伯特·F,. 德威利斯. 量表编制:理论与应用[M]. 3版. 重庆: 重庆大学出版社, 2016:61,167.
	DeWillis FR. Scale preparation:theory and application[M]. 3rd ed. Chongqing: Chongqing University Press, 2016:61,167.
[15]	佟利, 陈善佳, 谢官莉, 等. Frenchay活动量表的预测效度和信度研究[J]. 康复学报, 2019, 29(2):20-26.
	Tong L, Chen SJ, Xie GL, et al. Prediction validity and reliability of Frenchay Activity Scale[J]. Rehabil Med, 2019, 29(2):20-26.
[16]	李琴, 刘婷, 张珊, 等. 痛风患者疾病感知评估量表的编制及信效度检验[J]. 中华护理杂志, 2023, 58(7):836-842. DOI URL
	Li Q, Liu T, Zhang S, et al. Development and psychometric validation of the Illness Perception Assessment Scale for Gout Patients[J]. Chin J Nurs, 2023, 58(7):836-842. DOI URL
[17]	Zheng J, You LM, Lou TQ, et al. Development and psychometric evaluation of the Dialysis patient-perceived Exercise Benefits and Barriers Scale[J]. Int J Nurs Stud, 2010, 47(2):166-180. DOI PMID
[18]	张雨欣, 张开利. 老年人恐惧跌倒相关性活动限制的研究进展[J]. 中华护理杂志, 2023, 58(1):112-116. DOI URL
	Zhang YX, Zhang KL. Research progress on activity restriction related to fear of falling in the elderly[J]. Chin J Nurs, 2023, 58(1):112-116.