中老年2型糖尿病夫妻协同管理量表信效度验证

The reliability and validity of the Couple Collaborative Management Scale for middle-aged and older adults with type 2 diabetes mellitus

目的对美国Helgeson等人设计的糖尿病夫妻协同管理量表进行患者版汉化、开发配偶版;验证两个版本的信效度,并检验两个版本测量结果的一致性。方法使用经汉化及专家法构建的中文版夫妻协同量表在广州3个社区卫生服务中心共62对中老年糖尿病夫妻开展调查,运用R语言3.62对调查数据进行量表信效度和一致性分析。结果中文版夫妻协同管理量表各条目的内容效度比为0.714~1,条目水平内容效度指数为0.857~1,调整后Kappa统计量为0.849~1,专家达成共识的量表水平内容效度指数和平均水平的量表水平内容效度指数分别为0.992、0.946。患者版和配偶版内部一致性信度Cronbach′sα分别为0.94、0.91;重测信度分别为0.69(0.52,0.81)、0.63(0.42,0.77)。患者与配偶的协同评价差异有统计学意义(P=0.002),61.30%的患者对糖尿病的协同评价为“独立解决”,45.20%的配偶对糖尿病的协同评价为“共同协助”。但各行为维度得分在患者和配偶间差异均无统计学意义(P>0.05)。结论研究所开发的中文版中老年2型糖尿病夫妻协同管理量表具有良好的信效度,且患者版与配偶版测量一致性较好,可用于定量测量我国中老年糖尿病患者夫妻在糖尿病管理中的协同程度。

Objective To translate the couple collaborative management scale synthesized by Helgeson et al.in the USA into Chinese patient version and develop spouse version,and to test the reliability,validity and consistency of the patient version and the spouse version.Methods The Chinese version of the Couple Collaborative Management Scale which was adjusted by an expert panel of 7 specialists was used to investigate 62 middle-aged and older couples with diabetes mellitus in 3 community health care centers in Guangzhou,then its reliability,validity and consistency were analyzed by R language 3.62.Results The content validity ratio of each item of the scale was from 0.714 to 1.The item-level content validity index was from 0.857 to 1,adjusted kappa values were from 0.849 to 1,the scale-level content validity index/universal agreement was 0.946,the scale-level content validity index/average was 0.992.Cronbach′s alpha of the internal consistency reliability for the scale was 0.94 and 0.91,respectively.The overall test-retest reliability was 0.69(0.52,0.81)and 0.63(0.42,0.77),respectively.There was difference in the dyadic appraisal of patients and their spouses(P=0.002),with 61.30%of the patients′dyadic appraisal focusing on"individual problem"and 45.20%of the spouses′dyadic appraisal focusing on"shared problem".However,there was no statistical significance of the difference in the scores of each collaborative behavior dimension between patients and their spouses(P>0.05).Conclusion The Chinese version of the couple collaborative management scale for middle-aged and older adults with type 2 diabetes mellitus has good reliability and validity,and the consistency of measurement between the patient version and the spouse version is good,which can be used to quantitatively measure the extent of dyadic between middle-aged and older patients with diabetes and their spouses in diabetes management in China.