临床医生循证医学能力自我评估量表(EBP-KAPF)的汉化与信效度验证

Chinese version of evidence-based practice-knowledge,attitude,application,anticipated future use(EBP-KAPF)scale and its reliability and validity

目的:对循证医学能力自我评估(EBP-KAPF)量表进行汉化并评价中文版量表的信度和效度。方法:通过翻译、调适、回忆、审阅和预调查等步骤确定中文版EBP-KAPF量表。2022年7-8月采用方便抽样选取28个省(自治区、直辖市)250名临床工作者为对象,采用自制问卷,调查对象的基本情况、《循证医学》课程及相关软件学习和使用情况等,采用中文版EBP-KAPF量表调查临床医生循证医学能力。对中文版EBP-KAPF进行条目分析、效度评价和信度评价。结果:中文版EBP-KAPF量表包括知识掌握、态度、个人应用和未来使用4个维度26个条目。共发出调查表265份(包括自制问卷和中文版EBP-KAPF量表),获得有效调查表250份,总有效率94.3%。中文版EBP-KAPF量表总得分为(102.85±17.48)分,知识掌握、态度、个人应用和未来使用子量表得分分别为(27.22±4.47)、(13.56±7.70)、(20.07±6.78)和(42.00±9.00)分;除量表条目16外,各条目均与量表总得分相关,相关系数范围为0.456~0.828;删除量表条目16后,其他25个条目决断值范围为4.287~18.262( P<0.001);逐一删除各条目后,量表Cronbach′s α系数范围为0.870~0.888。删除条目16后,中文版25条目EBP-KAPF量表有较好的内容效度、结构效度和判别效度,条目水平的内容效度指数(I-CVI)范围为0.875~1.000,全体一致量表水平的内容效度指数(S-CVI/UA)为0.615,平均S-CVI(S-CVI/Ave)值为0.952,校正概率( K*)为0.87~1.00;验证性因子分析结果显示结构拟合优度较好(比较拟合指数CFI=0.962,非归准适配指数TLI=0.957,近似误差均方根RMSEA=0.060,χ^(2)/ df=1.889);判别效度分析显示:年龄、《循证医学》课程学习情况、相关软件使用情况不同的临床医生EBP-KAPF总得分差异有统计学意义( P<0.05)。删除条目16后,25条目中文版EBP-KAPF的Cronbach′s α系数为0.893,各维度Guttman分半系数分别为0.915、0.901、0.812和0.906,条目得分相关系数范围分别为0.902~0.982、0.507~0.953、0.517~0.744和0.632~0.986。 结论:中文版EBP-KAPF量表简明易懂、无歧义,具有良好的效度和信度。

ObjectiveTo translate Evidence-based Practice-knowledge,attitude,application,anticipated future use(EBP-KAPF)scale into Chinese,and evaluate its reliability and validity.MethodsThe Chinese version of the EBP-KAPF scale was determined through translation,adaptation,recall,review and pre-investigation.From July to August 2022,250 clinicians from 28 provinces(autonomous regions and municipalities directly under the Central Government)were selected by using the convenience sampling method.A self-made questionnaire was used to investigate the EBP-KAPF scale in Chinese to investigate the EBM ability of clinicians,including the basic information of the respondents,the learning and use of Evidence-based medicine courses and related software.The item analysis,validity and reliability evaluation of the Chinese version of the EBP-KAPF scale were performed.ResultsThe Chinese version of the EBP-KAPF scale included 26 items in four dimensions:knowledge mastery,attitude,personal application and future use.A total of 265 questionnaires were sent out(including self-made questionnaires and the Chinese version of the EBP-KAPF scale),and 250 effective questionnaires were obtained,with a total effective rate of 94.3%.The total score of the Chinese version of the EBP-KAPF scale was(102.85±17.48)points,and the scores of knowledge mastery,attitude,personal application and future use sub-scales were(27.22±4.47),(13.56±7.70),(20.07±6.78),and(42.00±9.00)points,respectively.Except for item 16,all items were correlated with the total score of the scale,and the correlation coefficient ranged from 0.456 to 0.828.After item 16 was deleted,the determination values of the remaining 25 items ranged from 4.287 to 18.262(P<0.001).After item was removed one by one,the Cronbach′sαcoefficient of the scale ranged from 0.870 to 0.888.After item 16 was removed,the Chinese version of the 25-item EBP-KAPF scale had good content validity,structural validity and discriminant validity.The content validity index(I-CVI)at the item level ranged from 0.875 to 1.000,and the content validity index at the overall agreement scale level was 0.615.The average S-CVI values were 0.952,and the probability of correction(K*)values were 0.87 to 1.00.The results of confirmatory factor analysis showed that the structure fit was good[comparative fit index(CFI)=0.962,Tucker-Lewis index(TLI)=0.957,root mean square error of approximation(RMSEA)=0.060,χ^(2)/df=1.889].Discriminant validity analysis showed that there were statistically significant differences in the EBP-KAPF scores among clinicians of different ages,evidence-based medicine course learning and related software use(P<0.05).After item 16 was removed,the Cronbach′sαcoefficient of the Chinese version of the EBP-KAPF scale was 0.893,and the Guttman half coefficients of each dimension were 0.915,0.901,0.812 and 0.906,respectively.The correlation coefficients were 0.902-0.982,0.507-0.953,0.517-0.744 and 0.632-0.986,respectively.ConclusionThe Chinese version of the EBP-KAPF scale is simple,easy to understand,unambiguous,and has good validity and reliability.