2型糖尿病患者慢性肾脏病风险感知量表的编制及信效度检验

doi:10.3761/j.issn.0254-1769.2022.15.004

摘要/Abstract

摘要：

目的编制2型糖尿病患者慢性肾脏病风险感知量表（Perception of Risk of Chronic Kidney Disease Scale,PRCKDS）,并评价其信效度。方法以健康信念模型为理论框架,通过查阅文献、质性访谈和专家函询构建量表条目池,经专家咨询及预调查,形成预试量表,选取526例糖尿病患者对预试量表进行项目分析及因子分析后形成正式量表,并于2020年8月—12月通过网络调查收集420例糖尿病患者的有效问卷,采用Spearman 相关分析、因子分析和Cronbach’s α系数评价量表的内容效度、结构效度和信度。结果正式量表包括易感性、严重性、有益性、阻碍性和促发因素5个维度,共36个条目,Spearman相关系数分析显示,内容效度较好,各维度总分与同维度各条目得分间的相关系数（0.416~0.868）绝对值均大于各维度总分与其他维度各条目得分间的相关系数（-0.126~0.642）,差异具有统计学意义（P<0.05）。验证性因子分析提示,正式量表模型适配度各检验量均在可接受范围内。36个条目在相应因子的载荷均>0.45且都在预设的5个维度之内,表明结构效度较好。量表的Cronbach’s α系数为0.875,分半信度为0.865。结论该研究构建的PRCKDS信效度良好,可作为评估2型糖尿病患者慢性肾脏病风险感知的有效、可靠测量工具。开展慢性肾脏病预防宣教时应区分不同风险感知人群并采取个性化策略。

关键词: 糖尿病, 慢性肾脏病, 风险感知, 量表编制, 信度, 效度, 护理

Abstract:

Objective To develop and evaluate the reliability and validity of Perception of Risk of Chronic Kidney Disease Scale（PRCKDS） for patients with type 2 diabetes mellitus. Methods The item pool was determined by literature review,interview,expert consultation,and pre-investigation,and the formal scale was formed. The newly developed PRCKDS was tested on 420 patients with type 2 diabetes through an online survey. The reliability and validity of the scale were evaluated by Spearman correlation analysis,factor analysis,and Cronbach’s α respectively. Results There were 36 items in the formal scale,with 5 dimensions including susceptibility,severity,beneficence,hindrance and precipitating factors. Spearman correlation analysis indicated that the content validity was good. Confirmatory factor analysis indicated that the model fit was good. The factor loads of 36 items were all greater than 0.45 and within the preset 5 dimensions,indicating that the structure validity was good. The Cronbach’s α of homogeneity is 0.875,and the split reliability is 0.865. Conclusion The PRCKDS established in this study has good reliability and validity,and it can be used as an effective and reliable measurement tool to assess the risk perception of chronic kidney disease in patients with type 2 diabetes mellitus. Different risk perception groups should be differentiated,and individualized strategies should be adopted in the prevention education of chronic kidney disease.

Key words: Diabetes Mellitus, Chronic Kidney Disease, Risk Perception, Scale Development, Reliability, Validity, Nursing Care

曹霞, 杨斌芳, 林艳辉, 陈滋, 周建松. 2型糖尿病患者慢性肾脏病风险感知量表的编制及信效度检验[J]. 中华护理杂志, 2022, 57(15): 1818-1824.

CAO Xia, YANG Binfang, LIN Yanhui, CHEN Zi, ZHOU Jiansong. Development of the Perception of Risk of Chronic Kidney Disease Scale for type 2 diabetic patients and the test of its reliability and validity[J]. Chinese Journal of Nursing, 2022, 57(15): 1818-1824.

图/表 3

表1 2型糖尿病患者慢性肾脏病风险感知量表探索性因子分析结果

Table 1 Exploratory factor analysis for Perception of Risk of Chronic Kidney Disease Scale

表2 2型糖尿病患者慢性肾脏病风险感知量表模型修饰前后适配结果与比较

Table 2 Spearman Correlation Coefficient of Perception of Risk of Chronic Kidney Disease Scale

图1 2型糖尿病患者慢性肾脏病风险感知路径图

Figure 1 The Path Analysis of the Perception of Risk of Chronic Kidney Disease Scale for Type 2 Diabetic Patients

参考文献 25

[1]	GBD Chronic Kidney Disease Collaboration. Global,regional,and national burden of chronic kidney disease,1990-2017:a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2020, 395(10225):709-733. DOI URL
[2]	Zhang LX, Long JY, Jiang WS, et al. Trends in chronic kidney disease in China[J]. N Engl J Med, 2016, 375(9):905-906. DOI URL
[3]	中华医学会糖尿病学分会微血管并发症学组. 中国糖尿病肾脏疾病防治临床指南[J]. 中华糖尿病杂志, 2019, 11(1):15-28.
	The Microvascular Complications Group of Chinese Diabetes Association. Chinese clinical practice guideline of diabetic kidney disease[J]. Chin J Diabetes Mellitus, 2019, 11(1):15-28.
[4]	Kanna B, Ukudeyeva A, Faiz M, et al. Qualitative study of knowledge,perception,behavior and barriers associated with cardiovascular disease risk among overweight and obese Hispanic taxi drivers of South Bronx,NYC[J]. BMC Public Health, 2020, 20(1):683. DOI URL
[5]	Martos T, Csabai M, Bagyura Z, et al. Cardiovascular disease risk perception in a Hungarian community sample:psychometric evaluation of the ABCD Risk Perception Questionnaire[J]. BMJ Open, 2020, 10(7):e036028.
[6]	张丽娣, 李乐之. 慢性病感知控制研究现状及展望[J]. 中华护理杂志, 2014, 49(1):91-94.
	Zhang LD, Li LZ. Research status and prospect about perceived control in patients with chronic diseases[J]. Chin J Nurs, 2014, 49(1):91-94.
[7]	Thomson P, Rushworth GF, Andreis F, et al. Longitudinal study of the relationship between patients’ medication adherence and quality of life outcomes and illness perceptions and beliefs about cardiac rehabilitation[J]. BMC Cardiovasc Disord, 2020, 20(1):71. DOI URL
[8]	Chen CC, Fang WJ, An Y, et al. The multiple mediating effects of illness perceptions and coping strategies on the relationship between physical symptoms and depressive symptoms in patients with heart failure[J]. Eur J Cardiovasc Nurs, 2020, 19(2):125-133. DOI URL
[9]	Alzubaidi H, Mc Narmara K, Kilmartin GM, et al. The relationships between illness and treatment perceptions with adherence to diabetes self-care:a comparison between Arabic-speaking migrants and Caucasian English-speaking patients[J]. Diabetes Res Clin Pract, 2015, 110(2):208-217. DOI URL
[10]	Timmermans I, Versteeg H, Meine M, et al. Illness perceptions in patients with heart failure and an implantable cardioverter defibrillator:dimensional structure,validity,and correlates of the brief illness perception questionnaire in Dutch,French and German patients[J]. J Psychosom Res, 2017, 97:1-8. DOI PMID
[11]	林蓓蕾, 张振香, 郭云飞, 等. 脑卒中患者复发风险感知评估量表的编制及信效度检验[J]. 中华护理杂志, 2021, 56(11):1666-1671. DOI
	Lin BL, Zhang ZX, Guo YF, et al. Development and psychometric test of recurrence risk perception scale for patients with stroke[J]. Chin J Nurs, 2021, 56(11):1666-1671.
[12]	Janz NK, Becker MH. The Health Belief Model:a decade later[J]. Health Educ Q, 1984, 11(1):1-47. DOI PMID
[13]	Park KO, Park SH, Yu M. Physicians’ experience of communication with nurses related to patient safety:a phenomenological study using the colaizzi method[J]. Asian Nurs Res, 2018, 12(3):166-174. DOI URL
[14]	浦亚楼, 孟爱凤, 智晓旭, 等. 基于德尔菲法的南京市肿瘤患者居家护理服务需求问卷编制及信效度检验[J]. 中国全科医学, 2019, 22(35):4375-4380. DOI
	Pu YL, Meng AF, Zhi XX, et al. Development,reliability and validity of the Questionnaire of Home Care Service Needs in Cancer Patients in Nanjing using the Delphi method[J]. Chin Gen Pract, 2019, 22(35):4375-4380.
[15]	马婉贞, 顾平, 张晶晶, 等. 医护人员医学叙事能力量表的编制及信效度检验[J]. 中华护理杂志, 2020, 55(4):578-583. DOI
	Ma WZ, Gu P, Zhang JJ, et al. Development of the Narrative Competence Scale and its test of reliability and validity[J]. Chin J Nurs, 2020, 55(4):578-583.
[16]	张晓鹏, 王驭良, 胡浩, 等. 简体中文版King健康问卷在膀胱过度活动症患者中应用的信度和效度分析[J]. 中华泌尿外科杂志, 2010(11):735-740.
	Zhang XP, Wang YL, Hu H, et al. Reliability and validity of the Chinese version of the King Health Questionnaire in patients with overactive bladder[J]. Chin J Urol, 2010(11):735-740.
[17]	Reise SP, Widaman KF, Pugh RH. Confirmatory factor analysis and item response theory:two approaches for exploring measurement invariance[J]. Psychol Bull, 1993, 114(3):552-566. DOI URL
[18]	王庆妍, 康虹, 唐四元. 护士标准预防依从信念量表的编制与信效度检测[J]. 中华护理杂志, 2015, 50(8):906-911.
	Wang QY, Kang H, Tang SY. Development and psychometric testing of Nurses’ Compliance Belief with Standard Precautions Scale[J]. Chin J Nurs, 2015, 50(8):906-911.
[19]	Bentler PM. Comparative fit indexes in structural models[J]. Psychol Bull, 1990, 107(2):238-246. DOI PMID
[20]	Aycock DM, Clark PC, Araya S. Measurement and outcomes of the perceived risk of stroke:a review[J]. West J Nurs Res, 2019, 41(1):134-154. DOI PMID
[21]	林蓓蕾, 张振香, 梅永霞, 等. 国内外健康相关领域风险感知测评工具的研究进展[J]. 中国慢性病预防与控制, 2020, 28(5):386-391.
	Lin BL, Zhang ZX, Mei YX, et al. Research progress of risk perception assessment tools in health-related fields at home and abroad[J]. Chin J Prev Control Chronic Dis, 2020, 28(5):386-391.
[22]	Murillo R, Katic BJ, Gonzalez T, et al. The association of prediabetes and diabetes risk perception with leisure-time physical activity and weight loss[J]. Am J Health Promot, 2019, 33(4):534-540. DOI URL
[23]	方蕾. 慢性病病人风险感知问卷的编制及其影响因素研究[D]. 西安: 第四军医大学,2015.
	Fang L. The study of Questionnaire Construction of Risk Perception and its influence factors for common chronic inpatients[D]. Xi’an: The Fourth Military Medical University,2015.
[24]	Jones CJ, Smith H, Llewellyn C. Evaluating the effectiveness of health belief model interventions in improving adherence:a systematic review[J]. Health Psychol Rev, 2014, 8(3):253-269. DOI URL
[25]	李灿, 辛玲. 调查问卷的信度与效度的评价方法研究[J]. 中国卫生统计, 2008, 25(5):541-544.
	Li C, Xin L. Research on evaluation method of reliability and validity of questionnaire[J]. Chin J Heal Stat, 2008, 25(5):541-544.