孤独症谱系障碍患儿治疗依从性量表（家长版）的研制及信效度检验

doi:10.3761/j.issn.0254-1769.2021.12.009

摘要/Abstract

摘要：

目的研制孤独症谱系障碍患儿治疗依从性量表（家长版）,并进行信效度检验。方法基于药物自我管理概念模型和康复处方依从性评估理论,通过文献回顾法、访谈法和专家函询法形成预测试量表。便利选取2020年8月—2021年1月在广州市2所三级甲等医院门诊和3所儿童康复中心的290名孤独症谱系障碍患儿家长进行调查,对量表进行项目分析和信效度检验。结果孤独症谱系障碍患儿治疗依从性量表（家长版）包括2个分量表,分量表1为药物治疗依从性量表（选填）,共4个条目;分量表2为康复治疗依从性量表,3个维度,共18个条目。分量表1的累计方差贡献率为72.66%;分量表2提取3个公因子,累计方差贡献率为61.71%。分量表1、分量表2的量表平均内容效度指数均为0.930,条目内容效度指数为0.800~1.000;分量表1、分量表2的Cronbach’s α系数分别为0.870、0.902,各维度的Cronbach’s α系数为0.760~0.909。结论孤独症谱系障碍患儿治疗依从性量表（家长版）具有良好的信效度,可用于对孤独症谱系障碍患儿治疗依从性进行评估,为今后进一步优化患儿的治疗和护理提供科学依据,以期改善患儿预后,减轻疾病负担。

关键词: 孤独症谱系障碍, 依从性, 康复治疗, 信度, 效度, 儿科护理学

Abstract:

Objective To develop a treatment compliance scale for children with autism spectrum disorder（ASD）（parental version）,and to evaluate the reliability and validity. Methods Based on the conceptual model of drug self-management and evaluation theory of rehabilitation prescription compliance,we formed a pretest scale by literature review,interview and expert consultation. To analyze items of the scale and test the reliability and validity,we processed a survey among 290 parents of children with ASD in outpatient department of 2 tertiary hospitals and 3 children’s rehabilitation centres in Guangzhou from August 2020 to January 2021. Participants were selected by convenience sampling. Results The treatment compliance scale for children with ASD includes 2 subscales. Subscale 1 is medication compliance scale（optional）,with 4 items in total. Subscale 2 is a rehabilitation treatment compliance scale,consisting of 18 items in 3 dimensions. The cumulative variance contribution rate of subscale 1 was 72.66%. Regarding Subscale 2,there are 3 common factors being extracted,with cumulative variance contribution rate of 61.71%. Subscale 1 and subscale 2 had the same content validity index（CVI） of 0.930,and CVI of each item ranged from 0.800 to 1.000. The Cronbach’s α coefficients of subscales 1 and subscale 2 were 0.870 and 0.902,and the Cronbach’s α coefficients of each dimension were 0.760~0.909. Conclusion The treatment compliance scale for children with ASD（parental version） has good reliability and validity,and it can be used to evaluate the treatment compliance of children with ASD. This scale provides scientific support for further optimization treatment and nursing of ASD children to improve the prognosis of ASD children and reduce the burden of disease.

Key words: Autism Spectrum Disorder, Compliance, Rehabilitation Treatment, Reliability, Validity, Pedi-atric Nursing

王佳乐, 杨巧红, 于小雪, 严嘉健. 孤独症谱系障碍患儿治疗依从性量表（家长版）的研制及信效度检验[J]. 中华护理杂志, 2021, 56(12): 1812-1818.

WANG Jiale, YANG Qiaohong, YU Xiaoxue, YAN Jiajian. Development and reliability and validity test of treatment compliance scale for children with autism spectrum disorder（parental version）[J]. Chinese Journal of Nursing, 2021, 56(12): 1812-1818.

图/表 2

参考文献 21

[1]	Lai MC, Lombardo MV, Baron-Cohen S. Autism[J]. Lancet, 2014, 383(9920):896-910. DOI URL
[2]	Lyall K, Croen L, Daniels J, et al. The changing epidemiology of autism spectrum disorders[J]. Annu Rev Public Health, 2017, 38:81-102. DOI URL
[3]	Zhou H, Xu X, Yan W, et al. Prevalence of autism spectrum disorder in China:a nationwide multi-center population-based study among children aged 6 to 12 years[J]. Neurosci Bull, 2020, 36(9):961-971. DOI PMID
[4]	陈艳妮, 肖农, 张一然. 科学关注孤独症谱系障碍儿童的干预及全方位发展[J]. 中国实用儿科杂志, 2019, 34(8):617-621.
	Chen YN, Xiao N, Zhang YR. Scientific attention to intervention and all-round development of children with autism spectrum disorders[J]. Chin J Pract Pediatr, 2019, 34(8):617-621.
[5]	Lord C, Elsabbagh M, Baird G, et al. Autism spectrum disorder[J]. Lancet, 2018, 392(10146):508-520. DOI URL
[6]	Hyman SL, Levy SE, Myers SM, et al. Identification,evaluation,and management of children with autism spectrum disorder[J]. Pediatrics, 2020, 145(1):e20193447. DOI URL
[7]	中华医学会儿科学分会发育行为学组, 中国医师协会儿科分会儿童保健专业委员会, 儿童孤独症诊断与防治技术和标准研究项目专家组. 孤独症谱系障碍儿童早期识别筛查和早期干预专家共识[J]. 中华儿科杂志, 2017, 55(12):890-897.
	Developmental Behavioral Group of Pediatrics Branch of Chinese Medical Association, Child Health Care Professional Committee of Pediatrics Branch of Chinese Medical Doctor Association, Expert Group on Diagnosis,Prevention and Treatment Technology and Standards of Children Autism. Expert consensus on early identification,screening and early intervention of children with autism spectrum disorders[J]. Chin J Pediatr, 2017, 55(12):890-897.
[8]	卫生部. 儿童孤独症诊疗康复指南(卫办医政发〔2010〕123号)[J]. 中国儿童保健杂志, 2011, 19(3):289-294.
	Ministry of Health,People’s Republic of China. Guidelines for diagnosis and rehabilitation of children with autism(2010)[J]. Chin J Child Heal Care, 2011, 19(3):289-294.
[9]	Bailey SC, Oramasionwu CU, Wolf MS. Rethinking adherence:a health literacy-informed model of medication self-management[J]. J Health Commun, 2013, 18(Suppl 1):20-30.
[10]	Frost R, Levati S, McClurg D, et al. What adherence measures should be used in trials of home-based rehabilitation interventions? A systematic review of the validity,reliability,and acceptability of measures[J]. Arch Phys Med Rehabil, 2017, 98(6):1241-1256. DOI URL
[11]	张霞, 张鑫, 万晶晶. 妊娠期糖尿病孕妇自我管理评价量表的研制及信效度检验[J]. 中华护理杂志, 2020, 55(10):1509-1513.
	Zhang X, Zhang X, Wan JJ. Development and psychometric test of self-management scale for patients with gestational diabetes mellitus[J]. Chin J Nurs, 2020, 55(10):1509-1513.
[12]	美国精神医学会. 《精神疾病诊断与统计手册》[M]. 5版. 张道龙等译. 北京: 北京大学出版社, 2015.
	American Psychiatric Associatio. Diagnostic and Statistical Ma-nual of Mental Disorders[M]. 5th ed. Zhang DL et al transla-ted. Beijing: Peking University Press, 2015.
[13]	吴明隆. 问卷统计分析实务:SPSS操作与应用[M]. 重庆: 重庆大学出版社, 2010.
	Wu ML. Practice of questionnaire statistical analysis[M]. Chong qing: Chongqing University Press, 2010.
[14]	汪晖, 张梦霞, 尹世玉, 等. 护士长变革型领导力自评量表的研制及信效度检验[J]. 中华护理杂志, 2020, 55(2):209-214.
	Wang H, Zhang MX, Yin SY, et al. The development of Head Nurse’s Transformational Leadership Self-rating Scale and the test of its reliability and validity[J]. Chin J Nurs, 2020, 55(2):209-214.
[15]	周俊. 问卷数据分析破解SPSS的六类分析思路[M]. 北京: 电子工业出版社, 2017.
	Zhou J. Questionnaire data analysis-six types of analysis ideas for solving SPSS[M]. Beijing: Publishing House of Electronics Industry, 2017.
[16]	赵晓燕, 李彦儒, 曾咏梅, 等. 糖尿病健康素养量表的汉化和信效度评价[J]. 中华护理教育, 2021, 18(3):266-269.
	Zhao XY, Li YR, Zeng YM, et al. Evaluation of the reliability and validity of health literacy scale-Chinese[J]. Chin J Nurs Educ, 2021, 18(3):266-269.
[17]	苏中华, 李四劝, 成义仁. 量表评估的内部一致性与克朗巴赫α系数的应用评价[J]. 临床心身疾病杂志, 2009, 15(1):85-86.
	Su ZH, Li SQ, Cheng YR. Internal consistency of scale evaluation and application evaluation of Cronbach α coefficient[J]. J Clin Psychosom Dis, 2009, 15(1):85-86.
[18]	Quittner AL, Modi AC, Lemanek KL, et al. Evidence-based assessment of adherence to medical treatments in pediatric psychology[J]. J Pediatr Psychol, 2008, 33(9):916,936-938. DOI URL
[19]	de Meyer D, Kottner J, Beele H, et al. Delphi procedure in core outcome set development:rating scale and consensus criteria determined outcome selection[J]. J Clin Epidemiol, 2019, 111:23-31. DOI URL
[20]	马晨欢, 王瑜. 孤独症谱系障碍儿童的早期干预方法研究进展[J]. 中国儿童保健杂志, 2020, 28(1):57-60.
	Ma CH, Wang Y. Research advances on early interventional programs for children with autism spectrum disorders[J]. Chin J Child Heal Care, 2020, 28(1):57-60.
[21]	Nguyen TM, La Caze A, Cottrell N. What are validated self-report adherence scales really measuring:a systematic review[J]. Br J Clin Pharmacol, 2014, 77(3):427-445. DOI URL