尿病患者自我管理知识、态度、行为评价量表的研制

Development on the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale （DSKAB）

目的采用德尔菲法和预试验方法研制具有我国人群社会文化适应性、性能良好的糖尿病患者自我管理知识、态度、行为量表。方法在既往研制的糖尿病患者知识、态度、行为问卷基础上，经查阅文献、小组讨论、专家深入访谈初定量表备选指标清单。通过德尔菲法，确定量表的核心指标，选择糖尿病临床医学、慢性病患者自我管理、慢性病防治、公共卫生等相关领域和专业的专家24名，采用邮政快递和Email相结合的方法发放专家咨询表，要求专家在综合考虑指标目的性、科学性、重要性和适用性的基础上，对每项指标的重要性进行打分，并说明判断依据和熟悉程度。根据专家的积极系数、专家意见的集中程度、专家意见的协调程度、专家权威程度，确定核心指标，形成初始量表。预试验选择27名糖尿病患者，采用面对面调查的方式对患者进行问卷调查。调查完毕，对参加现场调查的工作人员进行小组访谈，调整和修正初始量表，形成糖尿病患者自我管理知识、态度、行为评价量表。结果两轮德尔菲法收回合格的咨询表格均为20份，两轮咨询的专家积极系数分别为83％和100％，专家权威程度分别为0．85±0．10和0．87±0．09，专家协调系数分别为0．16和0．23（X2值分别为283．49、398．00，P值均〈0．001）；经过两轮咨询，确定75个核心指标，其中86．30％（63／75）指标的重要性评分的满分比在0．50以上，形成含有100个条目的初始量表。通过预试验，增加2个条目，删除4个条目，修改2个条目，未修改96个条目，形成含有98个条目，由知识、态度、行为3个分量表组成的糖尿病患者自我管理知识、态度、行为评价量表。结论通过德尔菲法和预试验研制的糖尿病患者自我管理知识、态度、行为评价量表，专家积极系数、权威程度和专家协调系数达到科学要求。

Objective To develop The Diabetes Self-management Knowledge, Attitude, and Behavior Scale （DSKAB） with Chinese population social culture character in a good validity and reliability after Delphi method and pilot study. Methods This study based on former knowledge, attitude, and behavior questionnaires, an index list was established through literature search, group discussion, and expert in-depth interviews. Then we identified the core indexes and developed a primary scale through the Delphi. We selected 24 experts who specialized in the field of diabetes related clinical medicine, non-communicable diseases self-management, non-communicable diseases control and prevention, and public health. The consultation tables were delivered by EMS and Emaih All the experts were asked to grade the evaluation indexes based on overall consideration finality, scientificity, importance, applicability, and to explain the extent of similarity and the basis of judgment. The core indexes of the scale were determined through the positive coefficient, the degree of concentration, the harmonious coefficient, the authoritative coefficient. We selected 27 diabetes patients from the community, and interviewed them face to face. After finishing the field survey, we organized the staff who investigated the patients to participate the panel discussion, to modify and adjust the items formed the scale knowledge attitude behavior of self-management for patients with diabetes mellitus. Results Two rounds of Delphi both reclaimed 20 experts responses, the positive coefficients were 83% and 100% respectively, the authoritative coefficients were 0.85±0.10 and 0.87±0.09, the harmonious coefficients were 0.16 and 0.23 （X2 were 283.49 and 398.00, P〈0.001） respectively. We identified 75 core indexes through two-round Delphi, 86.30% （63/75） indexes had the importance of full marks than in 0.50 above, it developed the primary scale which included 100 items. Based on the pilot study, we increased 2 items, deleted 4 items, reeomposed 2 items and reserved 96 items, the scale consisted of 98 items that were made of three subscales which were the knowledge subseale, the attitude subscale and the behavior subseale. Conclusion For DSKAB through Delphi method and pilot study, the active coefficients, the authoritative coefficients, the harmonious coefficients fulfilled the scientific requires, it also laid the foundation for the good performance of the scale.