尿毒症继发性甲状旁腺功能亢进病人症状群评估量表的编制及信效度检验

Development and reliability and validity test of symptom cluster assessment scale for patients with secondary hyperparathyroidism in uremia

目的:编制尿毒症继发性甲状旁腺功能亢进(SHPT)病人症状群评估量表并检验其信效度,为医务人员评估尿毒症SHPT病人症状提供参考。方法:基于不悦症状理论,运用文献检索、半结构式访谈、德尔菲法、预调查、信度检验及效度检验确定尿毒症SHPT病人症状群评估量表。结果:尿毒症SHPT病人症状群评估量表包括29个条目,消化排泄症状群、皮肤相关症状群、认知症状群、心理-睡眠症状群、活动受限症状群、全身表现症状群6个维度的Cronbach′s α系数分别为0.869,0.839,0.879,0.827,0.884,0.864,各条目内容效度为0.855~0.903,量表总内容效度为0.878;探索性因子结果显示,各条目的因素负荷量均>0.5,交叉载荷均<0.4;验证性因子分析结果显示,拟合指标均符合一般结构方程模型(SEM)研究的标准,模型配适度良好;各维度相关系数为0.401~0.543。结论:尿毒症SHPT病人症状群评估量表科学、实用,具有较高的信效度,可以为医务人员评估尿毒症SHPT病人症状提供参考。

Objective:To develop a symptom cluster assessment scale for patients with secondary hyperparathyroidism(SHPT)in uremia and test its reliability and validity,so as to provide a reference for medical staff to assess the symptoms of SHPT patients in uremia.Methods:Based on the unpleasant symptom theory,the symptom cluster assessment scale for SHPT patients in uremia was determined by literature retrieve,semi-structured interview,Delphi method,pre-investigation,reliability test,and validity test.Results:A total of 29 items from 6 dimensions in the symptom cluster assessment scale for SHPT patients in uremia,including digestive and excretion symptom cluster,skin-related symptom cluster,cognitive symptom cluster,psychological-sleep symptom cluster,activity limitation symptom cluster,and systemic manifestation symptom cluster.The Cronbach′sαcoefficients were 0.869,0.839,0.879,0.827,0.884,0.864,respectively.The content validity of each item was 0.855-0.903,and the total content validity of the scale was 0.878.The exploratory factor results showed that the factor loading of each measurement item was>0.5,and the cross loading was<0.4.The confirmatory factor analysis results showed that the fitting indexes meet the standards of general structural equation model(SEM)research,and the model fit was good.The correlation coefficients of each dimension were 0.401-0.543.Conclusions:The symptom cluster assessment scale for SHPT patients in uremia is scientific and practical,with high reliability and validity,which can provide a reference for medical staff to evaluate the symptoms of SHPT patients in uremia.