HIV感染者和获得性免疫缺陷综合征患者歧视体验问卷的编制及信效度检验

Development and psychometric test of discrimination experience questionnaire for HIV/acquired immunodeficiency syndrome patients

目的编制HIV感染者及获得性免疫缺陷综合征(AIDS)患者歧视体验问卷并检验其信效度。方法基于文献回顾、半结构式访谈明确HIV/AIDS患者歧视体验的操作性定义,发展条目池,经过2轮专家咨询和预调查形成初始问卷。选取2020年7—12月就诊于复旦大学附属上海公共卫生临床中心的410例HIV/AIDS患者进行调查,通过项目分析筛选问卷条目,使用SPSS 22.0软件进行信度检验和探索性因子分析,使用AMOS 21.0软件进行验证性因子分析,检验问卷信效度。结果形成的HIV/AIDS患者歧视体验问卷包括外在的歧视和内在的歧视2个维度,共10个条目。探索性因子分析显示,歧视发生频率方面和歧视经历对患者负性心理影响程度方面,均提取2个相同的公因子,累积方差贡献率分别为48.367%和55.403%。验证性因子分析显示,歧视发生频率方面卡方自由度比值(χ^(2/df))=2.831,P<0.05,近似误差均方根(RMSEA)=0.093,拟合优度指数(GFI)=0.928,比较拟合指数(CFI)=0.925,递增拟合指数(IFI)=0.926;歧视经历对患者负性心理影响程度方面χ^(2/df)=1.740,P<0.05;RMSEA=0.076,GFI=0.925,CFI=0.936,IFI=0.938。问卷内容效度指数为0.9,Cronbachα系数为0.811,重测信度为0.862(P<0.01)。结论HIV/AIDS患者歧视体验问卷具有较好的信效度,可作为HIV/AIDS患者歧视的评估工具。

Objective To develop the discrimination experience questionnaire for HIV/acquired immunodeficiency syndrome(AIDS)patients and test the reliability and validity of the questionnaire.Methods Based on the literature review and semi-structured interviews to clarify the operational definition of discrimination for HIV/AIDS and develop the item pool.The questionnaire was developed though 2 rounds Delphi consultation and a pilot test.A total of 410 HIV/AIDS patients in Shanghai Public Health Clinical Center of Fudan University from June to December 2020 were selected to investigate the questionnaire,item analysis was used to screen items.SPSS 22.0 software was used for reliability test and exploratory factor analysis,the AMOS 21.0 software was used for confirmatory factor analysis to test the reliability and validity of the questionnaire.Results The questionnaire consisted 2 dimensions(external discrimination and internal discrimination)and 10 items.Exploratory factor analysis showed that two common factors were extracted from the frequency of discrimination and the degree of negative psychological impact of discrimination experience on patients,and the cumulative variance contribution rates were 48.367%and 55.403%,respectively.The confirmatory factor analysis on the frequency of discrimination showed that Chi square degree of freedom ratio(χ^(2/df))was 2.831,P<0.05,root mean square of approximation error(RMSEA)was 0.093,goodness of fit index(GFI)was 0.928,comparative fit index(CFI)was 0.925,incremental fit index(IFI)was 0.926;the confirmatory factor analysis on the negative psychological impact of discrimination experience on patients showed thatχ^(2/df) was 1.740,P<0.05;RMSEA was 0.076,GFI was 0.925,CFI was 0.936,IFI was 0.938.The content validity of the questionnaire was 0.9.The Cronbachαcoefficientof questionnaire was 0.811,and the test-retest coefficient was 0.862(P<0.01).Conclusions The discrimination experience questionnaire for HIV/AIDS patients has good reliability and validity,and it can be used to measure the discrimination for HIV/AIDS patients.