精神分裂症患者自我管理量表的编制

Development of the Schizophrenia Self-Management Instrument Scale

目的:编制一套适用于精神分裂症患者的自我管理量表,并对其进行条目筛选。方法:基于前期定性研究中有关患者自我管理的经历以及文献中自我管理量表中的条目,形成了75个条目的精神分裂症患者自我管理量表(Schizophrenia Self-Management Instrument Scale,SSMIS)草本。经专家及患者审核,保留48个条目,形成了精神分裂症患者自我管理量表初稿。选取在北京市海淀区4所社区卫生服务中心辖区内随访的精神分裂症患者200名,采用离散程度法、t检验法、相关系数法及因子分析法进行条目筛选。结果:经4种客观条目分析方法以及咨询相关领域专家,并结合专业意义进行综合分析,最终共删除15个条目,保留33个条目。将保留的33个条目进行探索性因子分析,结果显示量表分为6个因子,累计方差贡献率为61.70%。将6个因子分别命名为:服药依从、药物的管理、精神症状的管理、维持日常生活及社会功能、利用资源及支持以及自我效能。将6因子模型进行验证性因素分析,结果显示模型与数据拟合程度较好(χ2/df=4.35,GFI=0.81,RM SEA=0.10)。结论:经过严格的条目筛选后,保留的条目符合代表性好、独立性强、敏感性高、区分性好的原则,达到了编制的要求。

Objective： To develop a self-management instrument for patients with schizophrenia and select items from item pool. Methods： The instrument was developed based on a literature review and previous qualitative study about patients＇self-management experience. Item pool included 75 items. After consulting with experts and patients, 48 items were remained. Methods of items selection included dispersion degree, t-test, correlation coefficient, and factor analysis. Totally 200 patients with schizophrenia within 4 community health centers in Beijing were tested during items selection. Results： By using 4 methods of items selection and consulting with expert, 15 items were fi- nally deleted, and 33 items were remained. Exploratory factor analysis of the instrument with 33 items resulted in 6 factors, namely, medication compliance, medication management, symptom management, maintain daily life and social functioning, manage health recourse and support, and self-efficacy. The six-factor solution accounted for 61.70% of the total variance. Confirmed factor analysis was used to test the six factor model, result fit the model. Conclusion： It suggests that after selection, items of the self-management instrument for Chinese people with schizophrenia have good representation, independence and discrimination.