《慢性病病人健康素养调查量表》的维度结构分析

Dimensional Structure of Health Literacy Scale for Patients with Chronic Disease

[目的]通过对《慢性病病人健康素养调查量表》的因子分析,探索其维度结构。[方法]按照多阶段分层随机抽样的原则在上海市抽取4个区共计1013人,将所有的研究对象随机分为两组:516人组的数据用于探索量表的结构,497人组的数据用于验证所得的结果。采用EpiData 3.1建立数据库,采用SPSS 18.0和LISERAL 8.7对所得数据进行探索性因子分析和验证性因子分析。[结果]探索性因子分析最终提取4个公因子,解释了66.274%的方差变异。根据探索性因子分析的结果分别构建三因子模型、四因子模型和五因子模型并进行验证性因子分析,其中四因子模型的误差均方根(RMSEA)=0.080、拟合优度指数(GFI)=0.85、本特勒-波内特规范指数(NFI)=0.94、增量拟合指数(IFI)=0.95、比较拟合指数(CFI)=0.95、χ2/v=3.93,最符合推荐值,因此接受四因子模型。[结论]《慢性病病人健康素养调查量表》应包括24个条目,这24个条目分别归属于信息获取能力、交流互动能力、改善健康意愿、经济支持意愿4个维度。

The authors declare they have no actual or potential competing financial interests. Abstract： [ Objective ] To explore the dimensional structure of Health Literacy Scale for Patients with Chronic Disease through factor analysis. [ Methods ] A total of 1013 patients were selected from 4 districts in Shanghai by multistage stratified random sampIing method and interviewed using the Health Literacy Scale for Patients with Chronic Disease. After a database established using Epidata 3.1, the data of 516 participants randomly selected were retrieved for exploratory factor analysis by SPSS 18.0 and the data of the other 497 participants were for confirmatory factor an^dysis by LISERAL 8.7. [ Results ] The results of exploratory factor analysis showed 4 common factors were extracted from the 28 items of the scale, which explained 66.274% of the total variance. Among the 3 common factors model, the 4 common factors model, and the 5 common factors model which were derived from the exploratory factor analysis, the 4 common factors model showed the best fit to our data. Its root mean square error of approximation （RMSEA） was 0.080; goodness-of-fit index （GFI） was 0.85; ~/v was 3.93; Bentler and Bonett＇s nonned fit index （NFI）, incremental fit index （IFI）, and comparative fit index （CFI） were all larger than 0.9. [ Conclusion ] The Health Literacy Scale for Patients with Chronic Disease should he composed of 24 items covering 4 dimensions： information acquisition ability, communicative interaction ability, health improvement willingness, economic support willingness.