慢性病自我护理量表泰语版的跨文化调适及心理测量学分析

Cross-cultural adaptation and psychometric evaluation of the Thai version of Self-Care of Chronic Illness Inventory Version 4.c

目的本研究旨在翻译和验证泰语版慢性病自我护理量表4.c版(Self-Care of Chronic Ilness Inven-tory version 4.c,SC-CII v4.c)在慢性病患者中应用的信效度。方法对SC-CI v4.c量表进行翻译,并通过横断面研究验证其信效度。采用准备、正向翻译、对比、反向翻译、反向翻译审查、调适、认知报告、认知报告审查、定稿、校对9个步骤将英语版本问卷翻译为泰语,并对翻译的有效性进行了评估。于2022年7一11月在泰国南部的16所初级保健中心选取410名至少有1种慢性疾病患者为研究对象。采用结构效度、聚合效度和区分效度评估量表的效度;应用自我护理自我效能量表(the Self-Care Self-Eficacy Scale,SCSES)和自我感知健康量表来评估量表的同时效度;采用Cronbach'sα系数、项目总相关系数和组合信度(composite relia-bility,CR)指数来评估量表的信度。结果泰语版SC-CI v4.c具有很好的翻译效度(卡帕系数为0.99)。泰语版自我护理维持分量表与原始模型拟合度很好,其中健康促进行为和疾病相关行为维度中的条目有较小差异;自我护理监测和自我护理管理分量表与原始模型存在很好的拟合度。验证性因子分析显示,泰语版SC-CII v4.c具有良好的拟合度。量表的平均方差提取值(average variance extracted,AVE)范围为0.23~0.51,异质-单质比率(heterotrait-monotrait ratios,HTMT)范围为0.37~0.88。泰语版SC-CI v4.c及3个分量表得分与SCSES(r=0.25~0.65)和自我感知健康量表(r=0.09~0.35)均呈正相关。除自我护理维持分量表(Cronbach’sα=0.68)外,所有量表Cronbach'sα系数都较高,CR指数显示3个分量表均具有可靠性(范围为0.80~0.82)。除与睡眠有关的条目外,其他条目与总分的相关系数均较好,范围为0.34~0.71。结论泰语版SC-CI v4.c对于评估非特异性慢性病患者的自我护理是有效和可靠的。建议对特定疾病患者进行进一步测试。

Objectives:To translate and validate the Thai Self-Care of Chronic Illness Inventory version 4.c(Thai SCCII v4.c)in individuals with chronic illnesses.Methods:A scale translation and cross-sectional validation study was conducted.The English version was translated for Thai involved nine steps:preparation,forward translation,reconciliation,backtranslation,back-translation review,harmonization,cognitive debriefing,review of cognitive debriefing and finalization,and proofreading.A cross-sectional study was conducted from July to November 2022 at 16 primary care centers in southern Thailand,involving 410 participants with at least one chronic condition.Validity assessments included structural,convergent,and discriminant validity.Concurrent validity examined correlations between SC-CII v4.c with the Self-Care Self-Efficacy Scale(SCSES)and selfperceived health.Internal coherence reliability was calculated using Cronbach’s a coefficient,item-total correlation coefficients,and the composite reliability(CR)index.Results:Thai SC-CII v4.c demonstrated excellent translational validity(k?0.99).The specified Self-Care Maintenance model fit well,with minor differences in health promoting behavior and illness-related behavior items compared to the original model.The original Self-Care Monitoring,and Self-Care Management models fit well with Thai data.Simultaneous confirmatory factor analysis confirmed a satisfactory fit of the full SC-CII v4.c.Convergent validity had partial support(average variance extracted?0.23e0.51),and discriminant validity was established(heterotrait-monotrait ratios?0.37 e0.88).Concurrent validity was supported by positive correlations between each scale and overall SC-CII v.4c with SCSES(r?0.25e0.65)and self-perceived health(r?0.09e0.35).The Cronbach’s a coefficient were adequate for all scales except the Self-Care Maintenance scale(Cronbach’s a?0.68),but the CR estimate improved the reliability of all three scales(ranging 0.80e0.82).All items had satisfactory itemtotal correlation coefficients(ranging 0.34e0.71),except the one pertaining to sleep.Conclusions:The Thai SC-CII v4.c is valid and reliable for assessing self-care in various chronic illnesses.Further testing is recommended for patients with specific diseases.