中文版患者授权量表在老年慢性病患者中的信效度研究

Reliability and Validity of the Chinese Version of Patient Empowerment Scale among the Elderly with Chronic Diseases

目的对英文版患者授权量表进行翻译,并对翻译后的量表进行信效度分析,评价其在老年慢性病患者中的适用性。方法于2015年4—6月,采取便利抽样法抽取郑州大学第一、第二附属医院的60岁以上,符合各专科慢性病诊断标准的患者为研究对象。遵循Brislin翻译原则对英文版患者授权量表进行了汉化,利用专家咨询法调试条目,形成中文版患者授权量表。2周后随机选取30例患者进行重复测量。采用SPSS 17.0统计学软件和AMOS 17.0软件进行数据处理。内容效度采用专家内容效度指数(CVI)进行评价;结构效度采用探索性因子分析;通过主成分分析和最大方差正交旋转的方法提取公因子;运用极大似然法进行验证性因子分析;信度分析采用Cronbach's α系数、分半信度及重测信度。结果共发放问卷300份,回收有效问卷284份,有效回收率为94.7%。中文版患者授权量表各条目得分与总分的相关系数(r值)为0.570~0.828(P<0.01)。高分组与低分组在20个条目上的得分比较,差异均有统计学意义(P<0.05)。量表水平的内容效度指数(S-CVI)=0.96,条目水平的内容效度指数(I-CVI)为0.90~1.00。探索性因子分析结果显示:KMO=0.851,Bartlett's球形检验χ~2=1 099.428(P<0.01)。共提取出4个公因子,累积方差贡献率为73.458%。验证性因子分析显示:最终模型显著性概率值P=0.348,各项拟合指标均在参考范围内。中文版患者授权量表总体Cronbach's α系数为0.931,分半信度为0.814,重测信度为0.820(P<0.01)。结论中文版患者授权量表信效度良好,可用于老年慢性病患者授权评估。

Objective To translate the English version of Patient Empowerment Scale（ PES） into Chinese,and to test the reliability and validity, and assess the serviceability of the Chinese version of PES among the elderly with chronic diseases. Methods We adapted the English version of PES following the Brislin＇ s classic model for translation and validation of instruments guidelines for cross-cultural research,including translation,back translation,expert consultation for adjusting the items,then,after a pilot survey using the initial scale,we developed the formal Chinese version of PES. Three hundred elderly patients with chronic diseases who were older than 60 selected by convenient sampling from the First Affiliated Hospital of Zhengzhou University and the Second Affiliated Hospital of Zhengzhou University were surveyed by the Chinese version of PES between April and June 2015. Thirty participants were selected from those who had actively responded to the survey for the test-retest two weeks later. SPSS 17. 0 and AMOS 17. 0 were used for data analysis. The content validity index（ CVI） was used to measure the content validity; exploratory factor analysis was used to measure the construct validity; common factors were extracted with principal component analysis and maximum variance orthogonal rotation,and maximum likelihood method was used for confirmatory factor analysis. The Cronbach＇s α,split half,and test-retest were used for reliability analysis. Results A total of 94. 7%（ 284/300） of the participants actively responded to the initial questionnaire survey. The item-total correlation coefficient in the Chinese version of PES ranged from 0. 570 to 0. 828（ P〈0. 01）. There were significant differences in the scores of 20 items between the high-score group and low-score group（ P〈0. 05）. The S-CVI was 0. 96. I-CVI ranged from0. 90 to 1. 00. The KMO value for the scale by exploratory factor analysis was 0. 851,and result of Bartlett＇s test of sphericity was χ^2= 1 099. 428（ P〈0. 01）. Four common factors were extracted by exploratory factor analysis,which could explain 73. 458% of the total variance. The confirmatory factor analysis revealed a good model fit, P = 0. 348. The Cronbach＇ s α of the Chinese version of PES was 0. 931,split-half reliability was 0. 814,test-retest reliability was 0. 820（ P〈0. 01）. Conclusion The Chinese version of PES is reliable and valid, so it can be used to assess the empowerment of elderly patients with chronic diseases.