预立医疗照护计划准备度量表的编制及信度效度研究
|
摘要
目的:开发中国文化背景下的预立医疗照护计划(ACP)准备度测量工具,检测其信度和效度。方法:结合文献回顾、患者访谈及专家咨询结果初步拟定量表的维度和条目,通过对113例慢性病患者的调查检验其信度和效度。结果:ACP准备度量表由态度、动机、信念3个维度,22个条目组成。量表条目水平的内容效度指数(I-CVI)为0.8～1.0,量表水平的平均内容效度指数(S-CVI/Ave)为0.986。因子分析提取出3个公因子,累计方差贡献率为59.998%。整个量表的Cronbach’sα系数为0.923,态度、信念、动机维度的Cronbach’sα系数分别为0.900、0.880和0.835。结论 :量表具有较好的信度、效度和可行性,可作为我国慢性病患者ACP准备度的评价工具。
Objective: To develop an Advance Care Planning(ACP) Readiness Scale in Chinese cultural background and to test its reliability and validity, and to provide an evaluation measurement for scientific research and practice in hospice care. Methods: Based on the literature review results, interviews of patients and experts, dimensions and items of ACP Readiness Scale were proposed. Totally 113 cases of community chronic disease patients were investigated to testify validity and reliability of ACP Readiness Scale. Results: The ACP readiness scale consists of three dimensions, including attitude, belief, and motivation, and totally 22 items. The I-CVI was 0.8-1.0, and the S-CVI/Ave was 0.986. The Cronbach's αcoefficient of the scale was 0.923, and the Cronbach's α coefficients of attitude, belief, and motivation dimensions are 0.900,0.880, and 0.835, respectively. The cumulative explanatory variable of the three factors of structural validity was 59.998%,which was within the acceptable range of measurements. Conclusion: The ACP Readiness Scale is with good reliability,validity and feasibility, and can be used as an evaluation tool for ACP readiness in Chinese chronic disease patients.
Objective: To develop an Advance Care Planning(ACP) Readiness Scale in Chinese cultural background and to test its reliability and validity, and to provide an evaluation measurement for scientific research and practice in hospice care. Methods: Based on the literature review results, interviews of patients and experts, dimensions and items of ACP Readiness Scale were proposed. Totally 113 cases of community chronic disease patients were investigated to testify validity and reliability of ACP Readiness Scale. Results: The ACP readiness scale consists of three dimensions, including attitude, belief, and motivation, and totally 22 items. The I-CVI was 0.8-1.0, and the S-CVI/Ave was 0.986. The Cronbach's αcoefficient of the scale was 0.923, and the Cronbach's α coefficients of attitude, belief, and motivation dimensions are 0.900,0.880, and 0.835, respectively. The cumulative explanatory variable of the three factors of structural validity was 59.998%,which was within the acceptable range of measurements. Conclusion: The ACP Readiness Scale is with good reliability,validity and feasibility, and can be used as an evaluation tool for ACP readiness in Chinese chronic disease patients.
引文
[1]World Health Organization.2014年非传染性疾病国家概况.http://www.who.int/nmh/countries/chn_zh.pdf.
[2]傅华.慢性病的自我管理.中华预防医学杂志,2013,47(11):988-990.Fu H.Self-management of chronic diseases.Chin J Prevent Med,2013,47(11):988-990.
[3]张春华,丁贤彬,毛德强,等.重庆市80岁及以上高龄老人临终前慢性病患病情况及医疗负担分析.中国慢性病预防与控制,2016,24(12):921-924.Zhang CH,Ding XB,Mao DQ,et al.Analysis of prevalence and medical burden of chronic diseases among elderly people aged 80 and over in Chongqing.Chin J Prevent Control Chronic Dis,2016,24(12):921-924.
[4]Katarzyna BD,Dariusz Z.The impact of socioeconomic status on the quality of life in patients with chronic obstructive pulmonary disease.Pneumonol Alergol Pol,2010,78(1):3-13.
[5]邓仁丽,陈柳柳,史宝欣,等.中国文化背景下预立医疗照护计划的研究进展.中华护理杂志,2015,50(9):1117-1121.Deng RL,Chen LL,Shi BX,et al.Research progress on Advance Care Planning under the background of Chinese culture.Chin J Nurs,2015,50(9):1117-1121.
[6]Jezewski MA,Meeker MA,Schrader M.Voices of oncology nurses:what is needed to assist patients with advance directives.Cancer Nurs,2003,26(2):105.
[7]Teno JM,Hill TP,O'Connor MA.Advance Care Planning priorities for ethical and empirical research.Hastings Cent Rep,1994,24(6):S1.
[8]Hui E,Ma HM,Tang WH,et al.A new model for end-of-life care in nursing homes.J Am Med Dir Assoc,2014,15(4):287-289.
[9]Bischoff KE,Sudore R,Miao Y,et al.Advance Care Planning and the quality of end-of-life care in older adults.J Am Geriatr Soc,2013,61(2):209-214.
[10]Detering KM,Hancock AD,Reade MC,et al.The impact of advance care planning on end of life care in elderly patients:randomised controlled trial.BMJ,2010(340):1345.
[11]Pere K.Does readiness to engage in advance care planning matters for patients with heart failure?.SP Care,2015,5(Suppl 2):S61.
[12]Walczak A,Butow PN,Davidson PM,et al.Patient perspectives regarding communication about prognosis and end-of-life issues:how can it be optimised?.Patient Educ Couns,2013,90(3):307-314.
[13]Simon J,Porterfield P,Bouchal SR,et al.‘Not yet’and‘Just ask’:barriers and facilitators to advance care planning-a qualitative descriptive study of the perspectives of seriously ill,older patients and their families.BMJ Support Palliat Care,2015,5(1):54-62.
[14]Simpson DD.A conceptual framework for transferring research to practice.J Subst Abuse Treat,2002,22(4):171.
[15]Oetting ER,Jumper-Thurman P,Plested B,et al.Community readiness and health services.Subst Use Misuse,2001,36(6/7):825.
[16]Goodman RM,Wandersman A,Chinman M,et al.An ecological assessment of communitybased interventions for prevention and health promotion:approaches to measuring community coalitions.Am J Community Psychol,1996,24(1):33.
[17]Tripken JL,Elrod C,Bills S.Factors influencing Advance Care Planning among older adults in two socioeconomically diverse living communities.Am J Hosp Palliat Care,2018,35(1):69-74.
[18]Fried TR,Redding CA,Robbins ML,et al.Promoting Advance Care Planning as health behavior change:development of scales to assess decisional balance,medical and religious beliefs,and processes of change.Patient Educ Couns,2012,86(1):25-32.
[19]Lai PSM,Mudri SM,Chinna K,et al.The development and validation of the advance care planning questionnaire in Malaysia.BMC Med Ethics,2016,17(1):61.
[20]Armenakis AA,Harris SG,Mossholder KW.Creating Readiness for organizational change.Human Relations,1993,46(6):681-704.
[21]Chan HY,Pang SM.Readiness of Chinese frail old age home residents towards end-of-life care decision making.J Clin Nurs,2011,20(9/10):1454-1461.
[22]Shaw M,Hewson J,Hogan DB,et al.Characterizing readiness for Advance Care Planning from the perspective of residents,families,and clinicians:an interpretive descriptive study in supportive living.Gerontologist,2018,58(4):739-748.
[23]Levy D,Strand J,Mcmahon GT.Evaluating residents'readiness to elicit advance care plans.JGrad Med Educ,2015,7(3):364-368.
[24]史静琤,莫显昆,孙振球.量表编制中内容效度指数的应用.中南大学学报:医学版,2012,37(2):152-155.Han JZ,Mo XK,Sun ZQ.Content validity index in scale development.J Cent South Univ.Med Sci,2012,37(2):152-155.
[25]吴明隆.SPSS统计应用实务:问卷分析与应用统计.北京:科学出版社,2003.Wu ML.SPSS statistical application practice:questionnaire analysis and application statistics.Beijing:Science Publishing House,2003.
[26]罗伯特·F·德威利斯.量表编制:理论与应用.重庆:重庆大学出版社,2016.Devellis RF.Scale development:theory and application.Chongqing:Chongqing University Press,2016.
[2]傅华.慢性病的自我管理.中华预防医学杂志,2013,47(11):988-990.Fu H.Self-management of chronic diseases.Chin J Prevent Med,2013,47(11):988-990.
[3]张春华,丁贤彬,毛德强,等.重庆市80岁及以上高龄老人临终前慢性病患病情况及医疗负担分析.中国慢性病预防与控制,2016,24(12):921-924.Zhang CH,Ding XB,Mao DQ,et al.Analysis of prevalence and medical burden of chronic diseases among elderly people aged 80 and over in Chongqing.Chin J Prevent Control Chronic Dis,2016,24(12):921-924.
[4]Katarzyna BD,Dariusz Z.The impact of socioeconomic status on the quality of life in patients with chronic obstructive pulmonary disease.Pneumonol Alergol Pol,2010,78(1):3-13.
[5]邓仁丽,陈柳柳,史宝欣,等.中国文化背景下预立医疗照护计划的研究进展.中华护理杂志,2015,50(9):1117-1121.Deng RL,Chen LL,Shi BX,et al.Research progress on Advance Care Planning under the background of Chinese culture.Chin J Nurs,2015,50(9):1117-1121.
[6]Jezewski MA,Meeker MA,Schrader M.Voices of oncology nurses:what is needed to assist patients with advance directives.Cancer Nurs,2003,26(2):105.
[7]Teno JM,Hill TP,O'Connor MA.Advance Care Planning priorities for ethical and empirical research.Hastings Cent Rep,1994,24(6):S1.
[8]Hui E,Ma HM,Tang WH,et al.A new model for end-of-life care in nursing homes.J Am Med Dir Assoc,2014,15(4):287-289.
[9]Bischoff KE,Sudore R,Miao Y,et al.Advance Care Planning and the quality of end-of-life care in older adults.J Am Geriatr Soc,2013,61(2):209-214.
[10]Detering KM,Hancock AD,Reade MC,et al.The impact of advance care planning on end of life care in elderly patients:randomised controlled trial.BMJ,2010(340):1345.
[11]Pere K.Does readiness to engage in advance care planning matters for patients with heart failure?.SP Care,2015,5(Suppl 2):S61.
[12]Walczak A,Butow PN,Davidson PM,et al.Patient perspectives regarding communication about prognosis and end-of-life issues:how can it be optimised?.Patient Educ Couns,2013,90(3):307-314.
[13]Simon J,Porterfield P,Bouchal SR,et al.‘Not yet’and‘Just ask’:barriers and facilitators to advance care planning-a qualitative descriptive study of the perspectives of seriously ill,older patients and their families.BMJ Support Palliat Care,2015,5(1):54-62.
[14]Simpson DD.A conceptual framework for transferring research to practice.J Subst Abuse Treat,2002,22(4):171.
[15]Oetting ER,Jumper-Thurman P,Plested B,et al.Community readiness and health services.Subst Use Misuse,2001,36(6/7):825.
[16]Goodman RM,Wandersman A,Chinman M,et al.An ecological assessment of communitybased interventions for prevention and health promotion:approaches to measuring community coalitions.Am J Community Psychol,1996,24(1):33.
[17]Tripken JL,Elrod C,Bills S.Factors influencing Advance Care Planning among older adults in two socioeconomically diverse living communities.Am J Hosp Palliat Care,2018,35(1):69-74.
[18]Fried TR,Redding CA,Robbins ML,et al.Promoting Advance Care Planning as health behavior change:development of scales to assess decisional balance,medical and religious beliefs,and processes of change.Patient Educ Couns,2012,86(1):25-32.
[19]Lai PSM,Mudri SM,Chinna K,et al.The development and validation of the advance care planning questionnaire in Malaysia.BMC Med Ethics,2016,17(1):61.
[20]Armenakis AA,Harris SG,Mossholder KW.Creating Readiness for organizational change.Human Relations,1993,46(6):681-704.
[21]Chan HY,Pang SM.Readiness of Chinese frail old age home residents towards end-of-life care decision making.J Clin Nurs,2011,20(9/10):1454-1461.
[22]Shaw M,Hewson J,Hogan DB,et al.Characterizing readiness for Advance Care Planning from the perspective of residents,families,and clinicians:an interpretive descriptive study in supportive living.Gerontologist,2018,58(4):739-748.
[23]Levy D,Strand J,Mcmahon GT.Evaluating residents'readiness to elicit advance care plans.JGrad Med Educ,2015,7(3):364-368.
[24]史静琤,莫显昆,孙振球.量表编制中内容效度指数的应用.中南大学学报:医学版,2012,37(2):152-155.Han JZ,Mo XK,Sun ZQ.Content validity index in scale development.J Cent South Univ.Med Sci,2012,37(2):152-155.
[25]吴明隆.SPSS统计应用实务:问卷分析与应用统计.北京:科学出版社,2003.Wu ML.SPSS statistical application practice:questionnaire analysis and application statistics.Beijing:Science Publishing House,2003.
[26]罗伯特·F·德威利斯.量表编制:理论与应用.重庆:重庆大学出版社,2016.Devellis RF.Scale development:theory and application.Chongqing:Chongqing University Press,2016.