Abstract:

Objective To develop a Community Self-Management Scale for Patients with Chronic Obstructive Pulmonary Disease（COPD） in stable stage,to determine the critical value of its grade and to test its reliability and validity. Methods According to the content of self-management theory,the pre-scale was compiled by the methods of literature research and Delphi. A questionnaire survey was conducted among 554 COPD outpatients in the respiratory department of 5 tertiary general hospitals in Fujian Province from April 15 to October 31,2021. The items of the scale were analyzed to test the reliability and validity,grade classification,and critical value determination of the scale. Results The scale included 39 items in 3 dimensions,and its cumulative variance contribution rate was 71.534%. The content validity index of each item of the scale（I-CVI） ranges from 0.941 to 1.000,and the overall content validity was 0.985. Confirmatory factor analysis showed that the model fits well. The correlation coefficient between each item and dimension of the scale was 0.678 to 0.840;the correlation coefficient between dimensions was 0.622 to 0.764;the correlation coefficient between dimensions and the total score of the scale ranged from 0.849 and 0.914. The Cronbach’s α coefficients of dimensions ranged from 0.963 to 0.971,and the total Cronbach’s α was 0.979. The dimension of split-half reliability ranges from 0.963 to 0.966,and the semi-reliability of the total score was 0.985. The total score ranged from 39 to 195,among which the score of 39 to 84 recommended as low level,85 to 139 as medium level,and 140 to 195 as high level. Conclusion The scale developed in this study has good reliability and validity,which can be used to evaluate the self-management level of community COPD stable patients.

Key words: Pulmonary Disease,Chronic Obstructive, Self-Management, Scale, Reliability, Validity, Community Health Nursing

摘要：

目的 编制社区慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）稳定期患者自我管理量表,并检验其信效度。 方法 以自我管理理论为指导,通过文献分析、专家函询形成初始版量表。便利选取2021年4月15日—10月31日在福建省5所三级甲等医院呼吸科门诊复查的554例COPD稳定期患者作为调查对象,进行问卷调查、信效度检验,并划分等级、确定临界值。 结果 该量表包括3个维度、39个条目,累计方差贡献率为71.534%。条目水平的内容效度指数为0.941~1.000,量表水平的内容效度指数为0.985。验证性因子分析结果提示,模型的拟合程度良好。量表各条目与所属维度的相关系数为0.678~0.840,维度间的相关系数为0.622~0.764,各维度与总量表的相关系数为0.849~0.914。量表各维度的Cronbach’s α系数为0.963~0.971,量表总的Cronbach’s α系数为0.979;各维度的分半信度为0.963~0.966,量表总的分半信度为0.985。量表总分为39~195分,其中39~84分为低水平、85~139分为中等水平、140~195分为高水平。 结论 该研究编制的量表信、效度较好,可用于评价社区COPD稳定期患者的自我管理水平。

关键词: 肺疾病,慢性阻塞性, 自我管理, 量表, 信度, 效度, 社区保健护理