妊娠期糖尿病患者饮食依从性量表的编制与信效度检验

Development of Dietary Compliance Scale for Patients with Gestational Diabetes Mellitus and Its Reliability and Validity Test

目的 研制适合妊娠期糖尿病(GDM)患者饮食依从性测评的量表,并检验其信度和效度.方法 以计划行为理论(TPB)为基础,通过文献回顾、专家咨询和专家小组讨论,并且经过两轮Delphi专家函询,拟定GDM患者饮食依从性量表初稿.采用量表初稿对 300 名 GDM患者的饮食依从性进行问卷调查,并检验量表的信效度.结果 最终形成的 GDM患者饮食依从性量表包括 3 个维度,13 个条目.探索性因子分析提取 3 个公因子,累计方差贡献率为 52.65%.量表总的内容效度指数(S-CVI)为 0.96,各条目的内容效度指数(I-CVI)为 0.8~1.0.总量表的Cronbach's α系数为 0.825,2 周后重测信度为 0.989.验证性因子分析得出近似误差均方根(RMSEA)=0.052,整体拟合系数卡方自由度比值(CMIN/df)=1.803,比较拟合指数(CFI)=0.949,拟合优度指数(GFI)=0.894,递增拟合指数(IFI)=0.950,Tucker-Lewis 指数(TLI)=0.936,调整拟合优度指数(AGFI)=0.866.结论 编制的GDM患者饮食依从性量表具有良好的信度和效度,能够客观、真实地反映 GDM患者饮食依从状况,可用于临床GDM患者饮食依从性的测评.

Objective To develop a scale for the assessment of dietary compliance in patients with gestational diabetes mellitus(GDM),and to test its reliability and validity.Methods Based on the theory of planned behavior,the draft of dietary compliance scale for patients with GDM was developed through literature review,expert consultation,expert group discussion and two rounds of Delphi expert consultation.The dietary compliance was investigated by questionnaire using the draft among 300 patients with GDM,and the reliability and validity were tested.Results The final dietary compliance scale for patients with GDM included 3 dimensions and 13 items.Three common factors were extracted by exploratory factor analysis,and the contribution rate of cumulative variance was 52.65%.The scale content validity index(S-CVI)was 0.96,and the item content validity index(I-CVI)was 0.8-1.0.The Cronbach’sαcoefficient of the total scale was 0.825,and the test-retest reliability was 0.989 after 2 weeks.Confirmatory factor analysis showed a goodness of fit(RMSEA=0.052,CMIN/df=1.803,CFI=0.949,GFI=0.894,IFI=0.950,TLI=0.936,AGFI=0.866).Conclusion The dietary compliance scale has good reliability and validity,and can objectively and truly reflect and evaluate the dietary compliance of patients with GDM.