Abstract:

Objective To develop a knowledge-attitude-practice assessment scale for home prevention and management of parastostomy hernia in ostomy patients，and to test its reliability and validity，to provide a reliable tool for evaluating the knowledge and practice level of home prevention and management of parastostomy hernia in patients with ostomy. Methods Based on the theory of knowledge，attitude and practice，the initial scale was generated through literature review，semi-structured interviews，expert correspondence，research group discussion and pre-survey. From May to December 2023，685 patients with ostomy from the ostomy clinic of a tertiary hospital in Tianjin were investigated by purpose sampling method，and the reliability and validity were tested. Results A total of 673 valid questionnaires were collected，the results showed that the knowledge-attitude-practice assessment scale for preventing and managing parastomal hernia of ostomy patients at home included 3 dimensions of knowledge，attitude and practice，with a total of 27 items. The response rates of 2 rounds of the questionnaire were both 100%；the authority coefficients were all 0.915；the Kendall’s coefficients of concordance were 0.279 and 0.301，respectively. The content validity index of each item was 0.875~1.000；the content validity index of the average scale level was 0.988；after 2 exploratory factor analysis，the cumulative variance contribution rate was 65.920%. The results of confirmatory factor analysis showed that the model had a good fit，with a chi-square degree of freedom ratio（/df） of 1.945，the fitting goodness index（GFI） of 0.851，the comparative goodness of fit index（CFI） of 0.919，the root means square error of approximation（RMSEA） of 0.060. The Cronbach’s alpha coefficient result of the scale is 0.957，with a test-retest reliability of 0.826 and a half reliability of 0.934. Conclusion The knowledge-attitude-practice assessment scale has good reliability and validity，and can be used as an assessment tool for home prevention and management of parastostomy hernia in ostomy patients.

Key words: Parastostomy Hernia, In-Home Nursing, Management, Scale Development, Reliability, Validity

摘要：

目的 编制造口患者居家预防及管理造口旁疝知信行量表并检验其信效度，旨在为评估造口患者居家预防及管理造口旁疝知信行水平提供可靠的评估工具。 方法 依据知信行理论，结合文献回顾、半结构式访谈、专家函询和预调查的结果，形成初始量表。于2023年5月—12月，采用目的抽样法，选取在天津市某三级甲等医院造口门诊就诊的685例造口患者作为调查对象，进行信度和效度检验。 结果 回收有效问卷673份，造口患者居家预防及管理造口旁疝知信行量表包含知识、态度、行为3个维度，共27个条目。2轮专家函询积极系数均为100%，权威系数均为0.915，肯德尔和谐系数分别为0.279、0.301。量表各条目的内容效度为0.875~1.000，平均内容效度为0.988；经2次探索性因子分析后显示，累计方差贡献率为65.920%。验证性因子分析结果显示，模型拟合度较好，其中卡方自由度比值为1.945，拟合优度指数为0.851，适配度指数为0.919，近似误差平方根为0.060。量表的Cronbach’s α系数为0.957，重测信度为0.826，折半信度为0.934。 结论 该研究编制的造口患者居家预防及管理造口旁疝知信行量表具有良好的信度和效度，可作为评估造口患者居家预防及管理造口旁疝现状的评估工具。

关键词: 造口旁疝, 居家护理, 管理, 量表编制, 信度, 效度