造口患者居家沐浴知信行评估问卷的编制及信效度检验

Development of a knowledge-attitude-practice assessment questionnaire for the investigation of home bathing status of ostomy patients and the test of its reliability and validity

目的编制造口患者居家沐浴知信行评估问卷,并检验其信效度。方法以知信行理论为指导,通过查阅文献、半结构式访谈、课题研究小组讨论、2轮专家函询和预调查,形成初始调查问卷。采用便利抽样法,选取2022年7月—12月于浙江省某三级甲等医院造口专科门诊随访且符合条件的造口患者进行调查,收集有效问卷386例,进行信度和效度检验。结果形成的造口患者居家沐浴知信行评估问卷包括知识、态度、行为3个维度,共24个条目,问卷各条目的内容效度为0.800~1.000,平均内容效度为0.932;经2次探索性因子分析后显示,累计方差贡献率为67.181%。验证性因子分析结果显示,模型拟合度较好,其中卡方/自由度比为1.510,拟合优度指数为0.878、比较拟合优度指数为0.948,近似误差平方根为0.049。问卷总的Cronbach’sα系数为0.922,3个维度的Cronbach’sα系数分别为0.920、0.862、0.897;2周后各维度的重测信度为0.856、0.942、0.926。结论该研究编制的造口患者居家沐浴知信行评估问卷具有良好的信度和效度,可为医护人员开展造口患者居家沐浴现状评估提供参考。

Objective To develop a knowledge-attitude-practice assessment questionnaire for home bathing status of ostomy patients and to test its reliability and validity.Methods Based on the theory of knowledge,attitude and practice,the initial questionnaire was generated through literature review and group meetings.The final questionnaire was formulated by 2 rounds of Delphi expert consultations and pilot-testing.A convenience sample of 386 stoma patients who visited the stoma outpatient clinic of a tertiary hospital in Zhejiang Province from July to December 2022 were selected to examine the reliability and validity of the questionnaire.Results The final knowledge-attitude-practice assessment questionnaire included 3 dimensions of knowledge,attitude and behavior,with a total of 24 items.The CVI of each item in the questionnaire ranged from 0.800 to 1.000,with an average of 0.932.Exploratory factor analysis showed that cumulative contribution rate was 67.181%.Confirmatory factor analysis showed that the assessment questionnaire had a good fit:the chi-square degree of freedom ratio(χ2/df)was 1.510;the fitting goodness index(GFI)was 0.878;the comparative goodness of fit index(CFI)was 0.948;the root means square error of approximation(RMSEA)was 0.049.The total Cronbach’sαcoefficient of the questionnaire was 0.922,and the Cronbach’s alpha coefficient of each dimension was 0.920,0.862,0.897;the test-retest reliability coefficient of each dimension was 0.856,0.942,0.926.Conclusion The knowledge-attitude-practice assessment questionnaire has good reliability and validity,and it can be used as a valid tool for medical staff to carry out assessment and education of home bathing for patients with stoma.