实现健康生活方式的倾向性量表的汉化及信效度检验

Reliability and validity of the Chinese version of Propensity to Achieve Healthy Lifestyle Scale

目的对实现健康生活方式的倾向性量表(PAHLS)进行汉化,并检验其在高血压人群中的信效度,为医护人员提供一种对高血压患者实现健康生活方式倾向性评估的工具。方法采用横断面研究方法。基于Brislin翻译模型对源量表进行双向翻译、专家校正、文化调适和预调查,形成中文版PAHLS。采用便利抽样法,于2023年2—5月选取天津市河北区铁东路街社区卫生服务中心、天津市东丽区军粮城医院的420例高血压患者开展量表调查。采用临界比值法、Pearson相关分析法进行量表条目分析;采用内容效度、结构效度和收敛效度进行效度分析;采用Cronbachα系数和折半信度进行信度分析。结果最终纳入400例患者,年龄为(71.69±7.25)岁,男177例,女223例。中文版PAHLS包括6个条目,条目分析显示量表各条目与量表整体反映的内容一致程度较高;量表水平的内容效度指数和条目水平的内容效度指数均为1.00;探索性因子分析后共提取出1个公因子,累计总方差解释率为72.24%;验证性因子分析显示,卡方/自由度=0.53,近似误差均方根<0.01,均方根残差=0.02,拟合优度指数=1.00,比较拟合指数=1.00,标准拟合指数=1.00,调整拟合优度指数=0.98,增值拟合指数=1.00,Tucker-Lewis指数=1.01;组合信度=0.86且平均方差抽取量=0.53。中文版PAHLS整体Cronbachα系数为0.91,各条目Cronbachα系数为0.87~0.91,折半信度为0.89。结论中文版PAHLS具有良好的信效度,可用于我国文化背景下医护人员对高血压患者实现健康生活方式的倾向性评估,增加对高血压患者行为改变决策的了解,促进其与患者共同制订行为改变方案。

Objective To translate Propensity to Achieve Healthy Lifestyle Scale(PAHLS)into Chinese and test its reliability and validity in patients with hypertension to provide the reliable assessment tool for medical staff to evaluate the propensity to achieve healthy lifestyle in hypertensive patients.Methods This was a cross-sectional study.The original scale was translated according to Brislin model.After expert correction,cultural adjustment and pre-investigation,the items for Chinese version of PAHLS were determined.From February to May 2023,400 patients with hypertension were selected as the participants from Tianjin Hebei District Tiedong Road Street Community Healthcare Center,Tianjin Dongli District Junliang Cheng Hospital by convenience sampling method.Critical ration and correlation analysis were used for item analysis.Content validity,exploratory factor analysis and confirmatory factor analysis were used to evaluate the validity of the Chinese version of PAHLS.Cronbach′sαcoefficient and split-half reliability were used to evaluate the reliability of the scale.Results A total of 400 patients were included in this study ultimately,aged(71.69±7.25)years old,177 males and 223 females.The Chinese version of the PAHLS included 6 items,and the results of item analysis showed that the content of each item was highly consistent with that of overall scale.The content validity indexes of the Chinese version of PAHLS at both the scale level and item level were 1.Only one factor was extracted based on exploratory factor analysis,with a cumulative variance contribution rate of 72.24%.Confirmatory factor analysis indicated a good fit,with the fitting indexes ofχ^(2)/df=0.53,root mean square error of approximation(RMSEA)<0.01,root of mean square residual(RMR)=0.02,goodness-of-fit index(GFI)=1.00,comparative fit index(CFI)=1.00,normed fit index(NFI)=1.00,adjust goodness-of-fit index(AGFI)=0.98,incremental fit index(IFI)=1.00,Tucker-Lewis index(TLI)=1.01,Convergent validity:composite reliability(CR)=0.86 and average vriance extracted(AVE)=0.53.The overall Cronbach′sαcoefficient of the scale was 0.91 and Cronbach′sαcoefficients of item level were from 0.87 to 0.91,with split-half reliability value of 0.89.Conclusions The Chinese version of the PAHLS has good reliability and validity,which can be used by medical staff to evaluate the propensity to achieve healthy lifestyle in hypertensive patients under Chinese cultural background,to increase understanding of decision-making on behavioral change in hypertensive patients and promote medical staff to jointly develop behavioral change plans with hypertensive patients.