糖尿病肾病血液透析患者自我管理量表的编制及测评

Drawing up and evaluation of self-management scale in patients with the diabetic nephropathy hemodialysis

目的 研制糖尿病肾病血液透析患者自我管理量表并进行信效度检验,为评估糖尿病肾病血液透析患者的自我管理状况提供测评工具.方法 在文献回顾及现有的慢性病自我管理测评工具基础上建立条目池,经专家评议及预调查后形成糖尿病肾病血液透析患者自我管理预测问卷.采用预测问卷对150例糖尿病肾病血液透析患者进行测评,筛选条目确定量表,最后检测量表的信度和效度.结果 可接受度测试回收率90.7％,有效率94.1％；量表的总体Cronbach＇s α系数为0.836,各维度的Cronbach＇s α系数为0.701 ～0.822;重测信度为0.970;内容效度指数（CVI）为0.925；以慢性病自我效能量表为校标,量表各维度及总分与自我效能呈正相关（P＜0.01）；因子分析提取6个公因子,累积方差贡献率为54.042％,与预想结构吻合.结论 糖尿病肾病血液透析患者自我管理量表具有良好的信度、效度及可行性,可作为评估糖尿病肾病血液透析患者自我管理状况较可信的工具.

Objective To develop diabetic nephropathy hemodialysis （DN HD） self-management scale and evaluate its reliability and validity, and to provide a measurement tool for the assessment of self management status in patients with DN HD. Methods The original item pool was formulated through literature review and the theory of chronic disease self-management. After specialist evaluation and pre-investigation, the preliminary scale was developed,then it was used to investigate 150 DN HD patients, and a series of statistic analysis was conducted to deduce the items to 30, the reliability and validity of the scale also were tested. Results The response rate of acceptance test was 90.7% and effective rate was 94.1%. The total Cronbaeh＇ s o~ coefficient was 0. 836, and the Cronbach＇ s ct coefficient of each dimension of the scale ranged from 0.701 to O. 822 ; the retest reliability was 0. 970 ; the content validity index （ CVI ） was 0. 925. Self-efficacy for managing chronic disease scale was used as the criterion, positive correlation was found between self-efficacy and self-management （P〈0.01）. Six common factors were extracted by factor analysis, and the cumulative contribution rate was 54.042%, these were consistency with the expected structure. Conclusions The DN HD self-management scale has good reliability, validity and feasibility, which can be applied to evaluate the self-management status of DN HD patients.