患者参与用药安全行为量表在恶性肿瘤患者中应用的结构效度检验

The Structural Validity test for Patient Medication Safety Scale Developed in Malignant Tumor Patients

目的探讨基于结构方程的患者参与用药安全量表在恶性肿瘤患者中应用的结构效度,以明确其在肿瘤患者用药安全行为测量中的有效性。方法应用便利抽样的方法,选取2018年1—11月收治于广西中医药大学第一附属医院的恶性肿瘤患者169例,采用患者参与用药安全行为量表进行评估,应用结构方程模型从基本适配度指标、整体模型适配度指标、模型内在结构适配度指标验证性分析患者参与用药安全行为量表的结构效度。结果修正后量表的基本适配度指标基本达标;最终模型整体适配度指标分别为:χ^2/df=2.425,RMSEA=0.049,GFI=0.837,CFI=0.904,PGFI=0.669,23个条目的因子载荷分布在0.453~0.856之间;模型内在结构适配度:3个维度组合信度为0.801~0.823,3个维度潜在变量的平均方差抽取量(AVE)为0.556~0.624,各维度受限模型及非受限模型比较,差异均有统计学意义(P<0.05)。结论患者参与用药安全行为量表除条目25的维度归属需进一步研究外,量表的基本适配度、整体模型适配度及模型内在结构适配度均基本达标,可用于恶性肿瘤患者临床用药安全行为测量与评估。

Objective To explore the construct validity of patient medication safety scale developed based on SEM structural equation in the application on malignant tumor patients so as to determine its effectiveness in the measurement of medication safety of tumor patients.Methods A total of 169 malignant tumor patients admitted to the First Affiliated Hospital of Guangxi University of Chinese Medicine from January to November 2018 were selected by convenience sampling.The patient medication safety scale was used for evaluation,and the construct validity of the scale was analyzed by applying the SEM structural equation with basic fitness index,overall fitness index and intrinsic structural fitness index.Results The basic fitness indexes of the modified scale basically met the criteria;the overall fitness indexes of the final model were:χ^2/df=2.425,RMSEA=0.049,GFI=0.837,CFI=0.904 and PGFI=0.669;the factor loadings of 23 items were distributed between 0.453~0.856;the intrinsic structural indexes of the model were as follows:the composite reliability of 3 dimensions was 0.801~0.823,the average variance extracted(AVE)of latent variables in 3 dimensions was 0.556~0.624,and comparing the restricted and unrestricted models in each dimension,the differences were statistically significant(P<0.05).Conclusion In addition that the dimensional attribution of item 25 for the patient medication safety scale requires further study,the basic fitness,overall fitness and intrinsic structural fitness of the scale all basically met the criteria,which can be used to measure and evaluate the clinical medication safety of malignant tumor patients.