维持性血液透析患者营养知信行问卷的编制及信度效度检验

Development of Nutrition Knowledge,Attitude and Practice Questionnaire for Maintenance Hemodialysis Patients and its reliability and validity test

目的编制维持性血液透析(MHD)患者营养知信行问卷并检验其信度和效度。方法本研究为横断面研究。以知信行理论为框架,在文献分析、半结构式访谈和专家焦点访谈的基础上,通过德尔菲专家函询及预调查形成初始问卷。采用方便抽样法,于2020年7月在安徽医科大学附属六安医院血液净化中心选取200例MHD患者为研究对象开展第1轮问卷调查,进行问卷的项目分析。采用方便抽样法,于2020年8月在同市其他6家血液透析中心选取230例MHD患者为研究对象开展第2轮问卷调查,进行问卷信效度的评价。第1轮问卷调查共发放问卷200份,回收有效问卷183份,有效回收率为91.50%(183/200);第2轮问卷调查共发放问卷230份,回收有效问卷214份,有效回收率为93.04%(214/230)。结果正式问卷包括知识、态度、行为3个维度29个条目。问卷总的Cronbach'sα系数为0.853,重测信度系数为0.880。问卷条目内容效度指数为0.910~1.000。探索性因子分析提取9个公因子,累计方差贡献率为62.89%;验证性因子分析结果显示模型拟合指数理想,聚敛效度中组合信度大于0.700,区分效度相关系数为正数且小于0.500,小于平均提取方差值平方根,区分效度良好。结论MHD患者营养知信行问卷具有较好的信度和效度,可作为评估我国MHD患者对营养知识、态度、行为状况的可靠工具。

Objective To develop the Nutrition Knowledge,Attitude and Practice Questionnaire for Maintenance Hemodialysis(MHD)Patients and test its reliability and validity.Methods This is a cross-sectional study.Based on the theory of knowledge,attitude and practice,and on the basis of literature analysis,semi-structured interviews and expert focus interviews,an initial questionnaire was formed through Delphi expert consultation and pre-survey.In July 2020,200 patients with MHD were selected from the Blood Purification Center of Lu'an Hospital of Anhui Medical University by convenient sampling to carry out the first round of questionnaire survey and conduct item analysis of the questionnaire.In August 2020,230 MHD patients were selected from 6 other Hemodialysis Centers in the same city by convenient sampling to carry out the second round of questionnaire survey and evaluate the reliability and validity of the questionnaire.In the first round of questionnaire survey,a total of 200 questionnaires were distributed,and 183 valid questionnaires were recovered,with an effective recovery rate of 91.50%(183/200).In the second round of questionnaire survey,230 questionnaires were distributed and 214 valid questionnaires were recovered,with an effective recovery rate of 93.04%(214/230).Results The formal questionnaire included 29 items in three dimensions of knowledge,attitude and practice.The total Cronbach'sαcoefficient of the questionnaire was 0.853,and the retest reliability coefficient was 0.880.The item-level content validity index of the questionnaire was 0.910 to 1.000.Exploratory factor analysis extracted 9 common factors,and the cumulative variance contribution rate was 62.89%.The confirmatory factor analysis showed that the fitting index of the model was ideal,the composite reliability in the convergent validity was more than 0.700,the correlation coefficient of the discriminant validity was positive and less than 0.500,less than the square root of average variance extracted,and the discriminant validity was good.Conclusions Nutrition Knowledge,Attitude and Practice Questionnaire for MHD Patients has good reliability and validity,and can be used as a reliable tool to evaluate the nutrition knowledge,attitude and practice of MHD patients in China.