基于计划行为理论的服药依从性影响因素问卷的信效度研究

The Reliability and Validity of the Theory of Planned Behavior Questionnaire for Medication Adherence

目的对基于计划行为理论的服药依从性影响因素问卷进行汉化和修订,并在冠状动脉粥样硬化性心脏病(简称冠心病)经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后患者中验证其信效度。方法2017年10月至2018年11月,采用便利抽样法选取在广州市某2所三级甲等医院接受PCI治疗后≥1个月的300例冠心病患者为研究对象,采用翻译-回译法汉化基于计划行为理论的服药依从性影响因素问卷并进行修订,对患者进行调查,评价问卷的信效度。结果修订后的问卷包含21个条目,条目分析和问卷内容效度均达到标准。探索性因子分析提取5个公因子,累积方差贡献率为79.47%,其中源问卷的“服药态度”因子被分为情感性态度和工具性态度2个因子,其他因子与源问卷相同;验证性因子分析显示,5因子模型拟合指标良好。问卷预测效度评价显示问卷能很好预测服药行为。5个维度的Cronbach’sα系数为0.846~0.952,重测信度系数为0.622~0.896。结论中文版基于计划行为理论的服药依从性影响因素问卷在PCI术后患者中具有较好的测评性能,5因子结构与源问卷4因子结构略有差异,但两者的概念内涵一致。今后尚可在其他疾病人群中进一步验证该问卷的测评性能。

Objective To localize and revise the theory of planned behavior questionnaire for medication adherence and to test its reliability and validity among coronary heart disease patients after percutaneous coronary intervention(PCI).Methods By convenience sampling method,300patients with coronary heart diseases were selected from October 2017to November 2018.Using translation-backtranslation methods to transform the questionnaire and then revised it.The reliability and validity of the questionnaire were tested among 300patients after PCI.Results The revised questionnaire contained 21items,the item analysis and content validity test were in line with the criteria.According to the results of the exploratory factor analysis, five factors were extracted which explained 79.47%of the total variance.Medication attitude of the original questionnaire which was divided into affective attitude and instrumental attitude and the other three factors were consistent with the original questionnaire.Confirmatory factor analysis indicated the 5-factor model had good fitting indexes.The questionnaire could well predict medication behavior.The Cronbach'sα coefficients were 0.846~0.954.The test-retest reliability coefficients were 0.622~0.917.Conclusions The Chinese version of the theory of planned behavior questionnaire for medication adherence is an instrument of high reliability and validity in patients after PCI.The structure of 5-factor model is slightly different from the 4-factor structure but their conceptual connotations were the same.More studies are needed to further evaluate the psychometric properties of the questionnaire.