冠心病合并糖尿病患者药物素养自评量表的编制及信效度检验

doi:10.3761/j.issn.0254-1769.2024.09.006

摘要/Abstract

摘要：

目的编制冠心病合并糖尿病患者药物素养自评量表并检验其信效度。方法在药物素养概念模型指导下，通过文献分析、质性访谈、专家函询法编制量表初稿。便利选取2022年11月—2023年4月浙江省某三级甲等综合医院421例冠心病合并糖尿病患者进行调查，检验量表信效度。结果冠心病合并糖尿病患者药物素养自评量表包括获取、理解、交流、评价、计算5个维度，共23个条目。量表总的Cronbach’s α系数为0.911，重测信度为0.948，量表水平内容效度指数为0.997，量表各维度及总分与校标量表的相关系数为0.485~0.926。探索性因子分析提取5个公因子，累计方差贡献率为73.753%；验证性因子分析显示量表因子结构稳定。结论该量表具有良好的信效度，可作为冠心病合并糖尿病患者自评药物素养水平的有效评估工具。

关键词: 冠心病, 糖尿病, 药物素养, 量表, 信度, 效度, 护理

Abstract:

Objective To develop a self-assessment scale for medication literacy in patients with coronary heart disease comorbidity diabetes and to test its reliability and validity. Methods According to medication literacy theory model，the initial scale was formed through literature review，the qualitative interview and expert inquiry. Cognitive interview was used to optimize the expression of item text. 421 patients with coronary heart disease comorbidity diabetes in a tertiary hospital in Zhejiang province from November 2022 to April 2023 were selected to investigate the reliability and validity of the scale by convenience sampling. Results The self-assessment scale of drug literacy for coronary heart disease comorbidity diabetes mellitus included 23 items in 5 dimensions including acquisition，understanding，communication，evaluation and calculation. The total Cronbach’s α coefficient of the scale was 0.911；the retest reliability was 0.948；the average content validity index was 0.997；the correlation coefficients between each dimension and total score of the scale and the calibration scale ranged from 0.485 to 0.926. The exploratory factor analysis was employed to extract 5 common factors，and the cumulative variance contribution rate was 73.753%. Confirmatory factor analysis showed that the scale factor structure was stable. Conclusion The scale has good reliability and validity，and it can be used as an effective tool to evaluate the self-rated medication literacy level of patients with coronary heart disease comorbidity diabetes.

Key words: Coronary Heart Disease, Diabetes Mellitus, Medication Literacy, Scale, Reliability, Validity, Nursing Care

刘海婷, 王咏梅, 郑贝贝, 蔡丽丽, 叶林斌, 吴佳芸, 宁丽, 李益民, 陈为霞. 冠心病合并糖尿病患者药物素养自评量表的编制及信效度检验[J]. 中华护理杂志, 2024, 59(9): 1065-1071.

LIU Haiting, WANG Yongmei, ZHENG Beibei, CAI Lili, YE Linbin, WU Jiayun, NING Li, LI Yimin, CHEN Weixia. Development and reliability and validity test of a Self-Assessment Scale for Medication Literacy in Patients with Coronary Heart Disease Comorbidity Diabetes[J]. Chinese Journal of Nursing, 2024, 59(9): 1065-1071.

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参考文献 24

[1]	黎艳娜, 王艺桥. 我国老年人慢性病共病现状及模式研究[J]. 中国全科医学, 2021, 24(31):3955-3962,3978. DOI
	Li YN, Wang YQ. Prevalence and patterns of multimorbidity among Chinese elderly people[J]. Chin Gen Pract, 2021, 24(31):3955-3962,3978.
[2]	Gan W, Bragg F, Walters RG, et al. Genetic predisposition to type 2 diabetes and risk of subclinical atherosclerosis and cardiovascular diseases among 160,000 Chinese adults[J]. Dia-betes, 2019, 68(11):2155-2164.
[3]	Kazda CM, Chien J, Zhang QY, et al. 192-OR:glycemic control with once-weekly basal insulin fc(BIF) in persons with type 2 diabetes mellitus(T2DM) using continuous glucose monitoring (CGM) in a phase 2 study[J]. Diabetes, 2021, 70(Suppl 1):192.
[4]	李敏, 贾银虎. 2型糖尿病合并冠心病病人的临床特征及危险因素分析[J]. 中西医结合心脑血管病杂志, 2021, 19(23):4135-4138.
	Li M, Jia YH. Clinical characteristics and risk factors of patients with type 2 diabetes mellitus complicated with coronary heart disease[J]. Chin J Integr Med Cardio Cerebrovasc Dis, 2021, 19(23):4135-4138.
[5]	Nguyen MT, Fernando S, Schwarz N, et al. Inflammation as a therapeutic target in atherosclerosis[J]. J Clin Med, 2019, 8(8):1109. DOI URL
[6]	Gentizon J, Hirt J, Jaques C, et al. Instruments assessing medication literacy in adult recipients of care:a systematic review of measurement properties[J]. Int J Nurs Stud, 2021, 113:103785. DOI URL
[7]	Sauceda JA, Loya AM, Sias JJ, et al. Medication literacy in Spanish and English:psychometric evaluation of a new assessment tool[J]. J Am Pharm Assoc, 2012, 52(6):e231-e240. DOI URL
[8]	赖粼, 丁四清, 钟竹青, 等. 冠心病患者药物素养的研究进展[J]. 中华护理杂志, 2020, 55(8):1276-1280. DOI
	Lai L, Ding SQ, Zhong ZQ, et al. Research progress of medication literacy in patients with coronary heart disease[J]. Chin J Nurs, 2020, 55(8):1276-1280.
[9]	沈志莹, 丁四清, 郑凤, 等. 高血压患者药物素养促进计划的制订与实施[J]. 护理学杂志, 2019, 34(10):87-91.
	Shen ZY, Ding SQ, Zheng F, et al. Development and implementation of a medication literacy promotion program for patients with hypertension[J]. J Nurs Sci, 2019, 34(10):87-91.
[10]	Crengle S, Luke JN, Lambert M, et al. Effect of a health literacy intervention trial on knowledge about cardiovascular dis-ease medications among Indigenous peoples in Australia,Canada and New Zealand[J]. BMJ Open, 2018, 8(1):e018569. DOI URL
[11]	Neiva Pantuzza LL, Nascimento ED, Crepalde-Ribeiro K, et al. Medication literacy:a conceptual model[J]. Res Social Adm Pharm, 2022, 18(4):2675-2682. DOI URL
[12]	Pouliot A, Vaillancourt R, Stacey D, et al. Defining and identifying concepts of medication literacy:an international perspective[J]. Res Social Adm Pharm, 2018, 14(9):797-804. DOI PMID
[13]	Zhong ZQ, Shi SJ, Duan YL, et al. The development and psychometric assessment of Chinese Medication Literacy Scale for Hypertensive Patients(C-MLSHP)[J]. Front Pharmacol, 2020, 11:490. DOI URL
[14]	Vervloet M, van Dijk L, Rademakers JJDJM, et al. Recognizing and addressing limited pharmaceutical literacy:development of the RALPH interview guide[J]. Res Social Adm Pharm, 2018, 14(9):805-811. DOI PMID
[15]	中华医学会心血管病学分会介入心脏病学组, 中华医学会心血管病学分会动脉粥样硬化与冠心病学组, 中国医师协会心血管内科医师分会血栓防治专业委员会, 等. 稳定性冠心病诊断与治疗指南[J]. 中华心血管病杂志, 2018, 46(9):680-694.
	Interventional Cardiology Group of Cardiovascular Credit As-sociation of Chinese Medical Association,Atherosclerosis and Coronary Heart Disease Group and Cardiovascular Society of Chinese Medical Association, Thrombus Prevention and Treat-ment Committee of Cardiovascular Physicians Branch of Chi-nese Medical Doctor Association. Guideline for diagnosis and treatment of stable coronary heart disease[J]. Chin J Cardiol, 2018, 46(9):680-694.
[16]	汪寅章. 2型糖尿病临床诊断标准及口服降血糖药现状[J]. 解放军保健医学杂志, 1999, 1(2):1-3.
	Wang YZ. Clinical diagnostic criteria of type 2 diabetes mellitus and current situation of oral hypoglycemic drugs[J]. J Health Care Med Chin PLA, 1999, 1(2):1-3.
[17]	冯翔, 田俊, 王斌全, 等. 护士主导的喉癌术后患者随访清单的制订[J]. 中华护理杂志, 2018, 53(8):956-961.
	Feng X, Tian J, Wang BQ, et al. Development of follow-up checklist for postoperative patients with laryngeal cancer[J]. Chin J Nurs, 2018, 53(8):956-961.
[18]	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.
	Devellis RF. Scale development:theory and applications[M]. 3rd ed. Chongqing: Chongqing University Press, 2016:61,167.
[19]	Streiner DL, Kottner J. Recommendations for reporting the results of studies of instrument and scale development and testing[J]. J Adv Nurs, 2014, 70(9):1970-1979. DOI PMID
[20]	郑凤, 钟竹青, 丁四清, 等. 药物素养评估量表的编译与评价[J]. 中南大学学报(医学版), 2016, 41(11):1226-1231.
	Zheng F, Zhong ZQ, Ding SQ, et al. Modification and evaluation of assessment of medication literacy[J]. J Cent South Univ Med Sci, 2016, 41(11):1226-1231.
[21]	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, 2010:158-224.
	Wu ML. Practice of questionnaire statistical analysis:SPSS operation and application[M]. Chongqing: Chongqing Univ Press, 2010:158-224.
[22]	谭蓉, 胡德英, 刘义兰, 等. 住院患者自杀风险评估量表的编制及信效度检验[J]. 中华护理杂志, 2018, 53(9):1096-1099.
	Tan R, Hu DY, Liu YL, et al. Development of an indicator system for evaluating mental health in inpatients[J]. Chin J Nurs, 2018, 53(9):1096-1099.
[23]	Malhotra NK, Lopes EL, Veiga RT. Structural equation modeling with use of lisrel:an initial vision[J]. Revista Brasileira de Marketing, 2014, 13(2):28-43.
[24]	秦宁, 段应龙, 石双姣, 等. 心血管疾病患者药物素养评估工具的研究进展[J]. 中华护理杂志, 2023, 58(2):186-191. DOI
	Qin N, Duan YL, Shi SJ, et al. Research progress of assessment tools for medication literacy in patients with cardiovascular disease[J]. Chin J Nurs, 2023, 58(2):186-191. DOI