中晚期帕金森病患者社区护理需求量表的制订及信效度检验

doi:10.3761/j.issn.0254-1769.2022.11.011

摘要/Abstract

摘要：

目的制订中晚期帕金森病患者社区护理需求量表,并检验其信效度。方法在马斯洛需求层次理论和约翰逊行为系统模式的指导下,参考相关文献,结合半结构式访谈和德尔菲法,初步形成中晚期帕金森病患者社区护理需求量表;采用预调查和项目分析法对量表进行修订。2021年5月—10月,选取400例中晚期帕金森病患者,采用面对面调查的形式进行问卷调查,进一步检验量表信效度。结果中晚期帕金森病患者社区护理需求量表包含日常照顾需求、跌倒预防需求、自主功能障碍需求、情感支持需求、疾病治疗需求和延续护理需求6个维度,39个条目。量表的Cronbach’s α系数为0.922,折半信度为0.702,各条目的内容效度指数为0.78~1.00,平均量表水平的内容效度指数为0.907。探索性因子分析提取出6个主要因子,累计方差贡献率为68.952%,验证性因子分析结果显示,模型适配理想,因子结构稳定。结论中晚期帕金森病患者社区护理需求量表能较全面地反映患者对社区护理支持的需求,具有良好的信效度,可用于动态评估疾病症状,指导护理人员开展健康评估、疾病管理和教育。

关键词: 帕金森病, 社区护理, 需求, 信度, 效度

Abstract:

Objective To develop the questionnaire of community nursing needs assessment tool for middle and advanced Parkinson’s disease and to test its reliability and validity. Methods Based on Maslow theory of hierarchical needs and Johnson behavior theory,using literature review,semi-structured interviews and Delphi,the primary questionnaire was initially formulated on community nursing needs for middle and advanced Parkinson’s disease,and the questionnaire was adjusted and revised through pre-survey. 400 patients with middle and advanced Parkinson’s disease in Chongqing from March to October 2021 were investigated in the form of face-to-face survey,and the reliability,validity and needs were further analyzed. Results The community nursing needs questionnaire for middle and advanced Parkinson’s disease contains 39 items in 6 dimensions,including daily life care needs,fall prevention needs,autonomic dysfunction needs,emotional support needs,disease treatment needs and continuing care needs. The Cronbach’s α coefficients of the questionnaire was 0.922,and the split-half reliability of the questionnaire was 0.702. The total content validity index of the questionnaire was 0.907 and each item ranged from 0.78 to 1.00 Exploratory factor analysis extracted 6 main factors and the cumulative variance contribution rate was 68.952%. Confirmatory factor analysis showed that the model fit well and the factor structure was stable. Conclusion The questionnaire has good reliability and validity,which can be used as a specific tool to comprehensively reflect the needs of patients for community nursing support,and it can also be used as an auxiliary tool for dynamic evaluation of disease symptom control to guide nurses to carry out health assessment,management and education.

Key words: Parkinson’s Disease, Community Nursing, Needs, Reliability, Validity

李琴, 宋彩萍, 陈雨露, 江玲, 万雪莉, 冯金华. 中晚期帕金森病患者社区护理需求量表的制订及信效度检验[J]. 中华护理杂志, 2022, 57(11): 1351-1358.

LI Qin, SONG Caiping, CHEN Yulu, JIANG Ling, WAN Xueli, FENG Jinhua. Development and reliability and validity tests of the tool of community nursing needs scale for patients with middle and advanced Parkinson’s disease[J]. Chinese Journal of Nursing, 2022, 57(11): 1351-1358.

图/表 4

表1 中晚期帕金森病患者社区护理需求量表信度分析结果

Table 1 Reliability analysis results of the tool of community nursing needs scale for patients with middle and advanced Parkinson’s disease

表2 中晚期帕金森病患者社区护理需求量表探索性因子分析结果（n=370）

Table 2 Results of exploratory factor analysis of the tool of community nursing needs scale for patients with middle and advanced Parkinson’s disease（n=370）

表3 6个备选模型整体拟合度比较

Table 3 Comparison of overall goodness of fit of six alternative models

表4 中晚期帕金森病患者社区护理需求量表区分效度检验结果（n=370）

Table 4 Discriminant validity results of the tool of community nursing needs scale for patients with middle and advanced Parkinson’s disease（n=370）

参考文献 23

[1]	Zhang ZX, Roman GC, Hong Z, et al. Parkinson’s disease in China:prevalence in Beijing,Xian,and Shanghai[J]. Lancet, 2005, 365(9459):595-597. DOI URL
[2]	Schrag A, Hommel ALAJ, Lorenzl S, et al. The late stage of Parkinson’s-results of a large multinational study on motor and non-motor complications[J]. Park Relat Disord, 2020, 75:91-96. DOI URL
[3]	何月月, 刘思雨, 尹安春, 等. 帕金森病患者姑息照护的研究进展[J]. 中华护理杂志, 2020, 55(5):786-790.
	He YY, Liu SY, Yin AC, et al. Research progress on palliative care in patients with Parkinson’s disease[J]. Chin J Nurs, 2020, 55(5):786-790.
[4]	陆宇晗. 我国安宁疗护的现状及发展方向[J]. 中华护理杂志, 2017, 52(6):659-664.
	Lu YH. The status quo and development direction of hospice care in China[J]. Chin J Nurs, 2017, 52(6):659-664.
[5]	Katz M, Goto Y, Kluger BM, et al. Top ten tips palliative care clinicians should know about Parkinson’s disease and related disorders[J]. J Palliat Med, 2018, 21(10):1507-1517. DOI URL
[6]	Lee J, Kim Y, Kim S, et al. Unmet needs of people with Parkinson’s disease:a cross-sectional study[J]. J Adv Nurs, 2019, 75(12):3504-3514. DOI URL
[7]	Kwok JYY, Huang TW, Tretriluxana J, et al. Symptom burden and unmet support needs of patients with Parkinson’s disease:a cross-sectional study in Asia-Pacific regions[J]. J Am Med Dir Assoc, 2021, 22(6):1255-1264. DOI URL
[8]	刘娜, 郭玉莲, 赵新利, 等. 帕金森患者希望在自我管理效能与生命质量间的中介效应研究[J]. 中国实用护理杂志, 2020, 36(13):973-978.
	Liu N, Guo YL, Zhao XL, et al. The mediating effects of hope between disease self-management and quality of life[J]. Chin J Pract Nurs, 2020, 36(13):973-978.
[9]	秦文玉, 王爱平. 帕金森病病人自我管理效能问卷的编制及信效度检验[J]. 护理研究, 2021, 35(2):240-245.
	Qin WY, Wang AP. Development of self-management efficacy questionnaire for patients with Parkinson’s disease and its reliability and validity test[J]. Nurs Res China, 2021, 35(2):240-245.
[10]	袁长蓉, 蒋晓莲. 护理理论[M]. 2版. 北京: 人民卫生出版社, 2018.
	Yuan CR, Jiang XL. Nursing theory[M]. 2nd ed. Beijing: People’s Medical Publishing House, 2018.
[11]	中华医学会神经病学分会帕金森病及运动障碍学组. 中国帕金森病治疗指南(第四版)[J]. 中华神经科杂志, 2014, 47(6):428-433.
	Parkinson’s disease & dyskinesia group of Neurology branch of Chinese Medical Association. Guidelines for the treatment of Parkinson’s disease in China(the fourth Edition)[J]. Chin J Neurol, 2014, 47(6):428-433.
[12]	蒲丛珊, 程洋, 董建俐, 等. 居家失能老年人健康管理需求评估指标体系的构建[J]. 中华护理杂志, 2020, 55(2):232-237.
	Pu CS, Cheng Y, Dong JL, et al. Construction of evaluation index system of health management needs for home-based care of the disabled elderly[J]. Chin J Nurs, 2020, 55(2):232-237.
[13]	曹培叶, 赵庆华, 肖明朝, 等. 护理院失能老年人长期照护需求评估指标的研究[J]. 中华护理杂志, 2017, 52(8):980-985.
	Cao PY, Zhao QH, Xiao MZ, et al. A study on long-term care demand assessment indicators for the disabled elderly in nursing home[J]. Chin J Nurs, 2017, 52(8):980-985.
[14]	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. Questionnaire statistical analysis practice:operation and application of SPSS[M]. Chongqing: Chongqing University Press, 2010.
[15]	李峥, 刘宇. 护理学研究方法[M]. 2版. 北京: 人民卫生出版社, 2018.
	Li Z, Liu Y. Nursing research methods[M]. 2nd ed. Beijing: People’s Medical Publishing House, 2018.
[16]	刘军. 中国帕金森病的诊断标准(2016版)[J]. 中华神经科杂志, 2016, 49(4):268-271.
	Liu J. Diagnostic criteria for Parkinson’s disease in China (2016)[J]. Chin J Neurol, 2016, 49(4):268-271.
[17]	Leung K, Trevena L, Waters D. Content validation of the evidence-based nursing practice assessment tool[J]. Nurse Res, 2018, 26(1):33-40. DOI PMID
[18]	王济川, 王小倩, 姜宝法. 结构方程模型:方法与应用[M]. 北京: 高等教育出版社, 2011.
	Wang JC, Wang XQ, Jiang BF. Structural equation models:methods and applications[M]. Beijing: Higher Education Press, 2011.
[19]	张文彤, 董伟. SPSS统计分析高级教程[M]. 3版. 北京: 高等教育出版社, 2018.
	Zhang WT, Dong W. Advanced course of SPSS statistical analysis[M]. 3rd ed. Beijing: Higher Education Press, 2018.
[20]	钟凯颖, 孙龙凤. 基于Kano模型的失能老年人长期照护需求研究进展[J]. 中华护理杂志, 2022, 57(3):368-373.
	Zhong KY, Sun LF. Research progress on long-term care needs of disabled elderly based on Kano model[J]. Chin J Nurs, 2022, 57(3):368-373.
[21]	胡慧秀, 孙超, 张洁, 等. 老年患者出院准备服务需求程度评估表的构建及信效度检验[J]. 中华护理杂志, 2022, 57(2):188-192.
	Hu HX, Sun C, Zhang J, et al. Development and validation of an assessment scale of discharge planning demand for hospitalized elderly patients[J]. Chin J Nurs, 2022, 57(2):188-192.
[22]	Wu PL, Lee MG, Huang TT. Effectiveness of physical activity on patients with depression and Parkinson’s disease:a systematic review[J]. PLoS One, 2017, 12(7):e0181515. DOI URL
[23]	李琴, 陈妙虹, 沈曼璇, 等. 水中运动对帕金森病患者下肢肢体功能影响的Meta分析[J]. 中华护理杂志, 2021, 56(2):276-282.
	Li Q, Chen MH, Shen MX, et al. Effects of water-based exercise on lower limb function in patients with Parkinson’s disease:a Meta-analysis[J]. Chin J Nurs, 2021, 56(2):276-282.