摘要： 目的·完成腹膜透析（腹透）患者居家透析操作过程中自我管理水平量表的编制及信度、效度分析。方法·通过患者访谈、专家咨询、查阅文献等方式，在结合腹透患者管理临床经验的基础上完成对初始量表的编制。采用方便抽样的方式发放问卷，通过临界比值法、同质性检验筛选条目，探索性因子分析评估结构效度，最终确定量表共同因素数目及条目。计算Cronbach’s
α系数、折半系数对量表信度进行分析。结果·初始量表由5个维度26个条目组成，共发放136份问卷，收集有效问卷132份。根据项目分析结果，除条目3未达到校正题项与总分相关性、共同性、因素负荷量的筛选条件外，其余条目均满足入选标准。因条目3是考察患者无菌意识的关键步骤，经专家咨询后保留该条目至因素分析。初始量表取样适切性量数（KMO）值为0.880，Bartlett
’s球形检验
χ2值为2 272.938（
P=0.000），提示总体的相关矩阵有共同因素存在，适合进行因素分析。根据量表初始设计条目初衷，限定萃取5个共同因素，采取直交转轴的最大变异法，最终删除条目7、11、16，根据各因素构面包含的条目变量特性，提取的共同因素分别命名为“对腹透并发症和腹透充分性评价的知晓度”“腹透规范化操作能力”“药物管理能力”“饮食管理能力”“腹透效果评估和监测能力”，形成5个维度23个条目的正式量表，各维度的特征值分别为4.604、3.286、3.207、2.817、2.140，累积方差贡献率为66.428%。最终总量表Cronbach’s
α系数为0.930，折半系数为0.946。结论·腹透患者自我管理水平量表具有良好的信度和效度，可用于腹透患者自我管理能力测评。
关键词: 腹膜透析, 患者自我管理, 量表, 信度, 效度 Abstract: Objective·To complete the compilation and reliability and validity analysis of the self-management scale for peritoneal dialysis (PD) patients during home dialysis operations.
Methods·The preparation of the initial scale was based on patient interviews, expert consultation, literature review, and clinical experience in PD patient management. Convenient sampling was used to distribute questionnaires. Critical ratio method and homogeneity test were used to screen items. With the help of exploratory factor analysis to evaluate the validity of the structure, the number of common factors and items of the scale were finally determined, and the reliability of the scale was verified by the Cronbach′s α coefficient and the half coefficient.
Results·The initial scale was composed of 26 items in 5 dimensions, and 136 questionnaires were distributed and 132 valid questionnaires were collected. According to the results of the project analysis, except item 3 that did not meet the criteria for the corrected correlation between the item and the total score, commonality, and factor loading, all the other items met the selection criteria. Since this item was a key step in investigating the patients′ awareness of sterility, this item was retained for factor analysis after expert consultation. The Kaiser-Meyer-Olkin measure of sampling adequacy (KMO) of the initial questionnaire was 0.880, and the χ2 value of Bartlett′s spherical test was 2 272.938 (P=0.000). The results suggested that the overall correlation matrix had common factors, which was suitable for factor analysis. According to the original intention of the initial design items of the scale, 5 common factors were limited and extracted, and the maximum variation method of orthogonal rotation axis was adopted, and finally items 7, 11, and 16 were deleted. According to the variable characteristics contained in each factor construct, the extracted common factors were named as “recognition of dialysis complications and adequacy evaluation” “peritoneal standardized operation” “drug management” “dietary management” and “dialysis effect evaluation and monitoring”, respectively, to form a formal questionnaire with 23 items in 5 dimensions. The eigenvalues of each dimension were 4.604, 3.286, 3.207, 2.817, and 2.140, and the cumulative variance contribution rate was 66.428%. The Cronbach′s α coefficient of the total scale was 0.930, and the half coefficient was 0.946.
Conclusion·The self-management scale for PD patients has good reliability and validity, which can be used to evaluate the self-management ability of PD patients.
Key words: peritoneal dialysis (PD), patient self-management, scale, reliability, validity PDF全文下载地址:
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