HIV/AIDS患者照护者感知歧视问卷的编制及信效度检验

Development of perceived stigma questionnaire for caregivers of of people living with HIV/AIDS and its test of the reliability and validity

目的编制HIV/AIDS患者照护者感知歧视问卷并检验其信效度。方法结合文献回顾以及团队前期研制的HIV/AIDS患者感知歧视问卷发展条目池,经专家咨询和预调查形成初始问卷。选取2020年7-12月于上海市公共卫生临床中心和广西南宁市第四人民医院定点收治的251例HIV/AIDS患者的主要照护者进行调查,数据经整理后通过项目分析筛选条目,使用SPSS 26.0软件进行信度检验和和探索性因子分析,使用Amos 24.0软件进行验证性因子分析,综合检验问卷的信效度。结果形成的HIV/AIDS患者照护者感知歧视问卷包括健康相关歧视及社交与行为歧视2个维度,共11条目。专家评定的条目、问卷水平内容效度指数=1.00;探索性因子分析结果显示照护者感知歧视发生频率、遭遇歧视时对负性心理的影响程度两方面均提取2个相同的公因子,累计方差贡献率分别为64.284%、64.904%,各条目因子载荷系数均>0.4。验证性因子分析结果显示,歧视发生频率方面健康相关及社交与行为歧视2个维度平均方差提取度(AVE)分别为0.607、0.516,组合信度(CR值)分别为0.815、0.893;歧视影响程度方面2个维度AVE分别为0.545、0.559,CR值分别为0.767、0.909。问卷歧视发生频率、影响程度2个方面的Cronbach′sα系数分别为0.899、0.848,重测信度分别为0.991、0.896(P<0.001)。结论HIV/AIDS患者照护者感知歧视问卷具有较好的信效度,可作为HIV/AIDS患者照护者感知歧视的评估工具。

Objective To develop a perceived stigma questionnaire for caregivers of people living with HIV/AIDS(PLWH)and to test the reliability and validity of the questionnaire.Methods The item pool team was developed based on the literature review and combined with the HIV/AIDS perceived stigma questionnaire developed earlier by the team,and the original questionnaire was formed through Delphi consultation and a pilot test.A total of 251 caregivers of PLWH in Shanghai Public Health Clinical Center and the Fourth People's Hospital of Nanning in Guangxi from July to December 2020 were recruited for the survey,and item was screened through project analysis after data were collated.SPSS(version 26.0)software was used for reliability test and exploratory factor analysis(EFA)while Amos(version 24.0)software was used for confirmatory factor analysis(CFA),and these were comprehensively tested the reliability and validity of the questionnaire.Results The formed questionnaire of perceived discrimination of caregivers of PLWH consists of 2 dimensions(health-related stigma and social and behavioral stigma)and 11 items in total.Item-level and scale-level content validity indexes(I-CVI and S-CVI)were 1.00;In the EFA,two common factors were extracted from both the frequency sub-scale and impact sub-scale with cumulative variance contribution rates of 64.284%and 64.904%,respectively,and factor loading coefficients for all items were above 0.4.In the CFA,the average variance extracts(AVE)of the frequency sub-scale were 0.607 and 0.516,and the composite reliability(CR)were 0.815 and 0.893;In the impact sub-scale,the AVE were 0.545 and 0.559,and CR were 0.767 and 0.909.Cronbach'sαcoefficient of frequency and impact sub-scales were 0.899 and 0.848,the test-retest coefficient were 0.991 and 0.896,respectively(P<0.001).Conclusion The perceived stigma questionnaire for caregivers of PLWH possesses relatively satisfying reliability and validity,and is a competent tool for caregivers'stigma measurement.