经皮冠状动脉介入术后患者药物素养量表的编制及信效度检验

doi:10.3761/j.issn.1672-9234.2024.08.016

摘要/Abstract

摘要：

目的编制经皮冠状动脉介入术（percutaneous coronary intervention，PCI）后患者药物素养量表，为术后患者的药物素养水平提供评估工具。方法 2023年5月—10月，以药物素养概念模型为框架，通过文献分析、访谈初步构建量表条目，通过德尔菲法对25名专家进行2轮函询形成量表初稿，通过对50例PCI术后患者的预调查完善量表条目表述，便利选取568例PCI术后患者进行调查，筛选量表条目并检验其信效度。结果 2轮专家函询的积极系数分别为93%（25/27）、100%（25/25），专家权威系数分别为0.906、0.944；肯德尔和谐系数分别为0.35、0.39（P<0.05）。探索性因子分析共提取出5个公因子，累计方差贡献率77.730%。验证性因子分析显示χ²/df=2.848、RMSEA=0.076、CFI=0.927、IFI=0.927、TLI=0.916。最终形成的经皮冠状动脉介入术后患者药物素养量表包括药物信念、功能性药物素养、互动性药物素养、评判性药物素养、行为性药物素养5个维度、共25个条目。条目水平的内容效度指数为0.880~1.000，量表水平的内容效度指数为0.917。总量表的Cronbach’s α系数、折半信度、重测信度分别为0.951、0.865、0.933。结论经皮冠状动脉介入术后患者药物素养量表具有良好的信效度，可用于评估术后患者的药物素养水平。

关键词: 经皮冠状动脉介入术, 药物素养, 信度, 效度

Abstract:

Objective To develop a self-rating scale for drug literacy of patients after percutaneous coronary intervention，and to provide an evaluation tool for evaluating the level of drug literacy of patients after percutaneous coronary intervention. Methods From May to October 2023，the scale items were preliminarily constructed through literature analysis and qualitative interviews based on the conceptual model of drug literacy. The first draft of the scale was formed by two rounds of consultation with 25 experts through the Delphi method. After that，the expression of scale items was improved with the pre-survey of 50 patients after PCI，and 568 patients after PCI in investigation. Then，the scale items were screened and their reliability and validity were tested to form the final version. Results The positive coefficients of the two rounds of expert consultation were 93%（25/27） and 100%（25/25），the expert authority coefficients were 0.906 and 0.944，and the Kendall harmony coefficients were 0.35 and 0.39，respectively. A total of five common factors were extracted by exploratory factor analysis，and the cumulative variance contribution rate reached 77.730%. Confirmatory factor analysis showed a well fit model with χ²/df=2.848，RMSEA=0.076，CFI=0.927，IFI=0.927，and TLI=0.916. The final drug literacy scale for patients after percutaneous coronary intervention included 25 items in five dimensions，including drug belief，functional drug literacy，interactive drug literacy，evaluative drug literacy，and behavioral drug literacy. The content validity index at the item level was 0.880-1.000，and the content validity index at the scale level was 0.917. The Cronbach’s α coefficient，half-fold reliability and test-retest reliability of the total scale were 0.951，0.865 and 0.933，respectively. Conclusion The drug literacy assessment scale of patients after percutaneous coronary intervention holds good reliability and validity，and can be used in the evaluation of drug literacy level of patients after percutaneous coronary intervention.

Key words: Percutaneous coronary intervention, Drug literacy, Reliability, Validity

张紫莹, 丁雯, 王茹, 曾美玲, 潘婷, 蒙浩莹. 经皮冠状动脉介入术后患者药物素养量表的编制及信效度检验[J]. 中华护理教育, 2024, 21(8): 993-999.

ZHANG Ziying, DING Wen, WANG Ru, ZENG Meiling, PAN Ting, MENG Haoying. Development and examination of drug literacy scale for patients after percutaneous coronary intervention[J]. Chinese Journal of Nursing Education, 2024, 21(8): 993-999.

图/表 3

参考文献 18

[1]	殷钰喆, 孔羽, 朱佳佳, 等. 经皮冠状动脉介入术后患者互联网医疗管理的研究进展[J]. 中国医药, 2023, 18(2):292-296.
[2]	程婷, 涂惠, 熊晓云, 等. 经皮冠状动脉介入治疗术后老年患者多重用药管理方案的构建[J]. 中华护理杂志, 2023, 58(12):1476-1482. doi: 10.3761/j.issn.0254-1769.2023.12.010
[3]	Zheng F, Ding SQ, Lai L, et al. Relationship between medica-tion literacy and medication adherence in inpatients with coronary heart disease in Changsha,China[J]. Front Pharmacol, 2019, 10:1537. doi: 10.3389/fphar.2019.01537 pmid: 32009954
[4]	Shi SJ, Shen ZY, Duan YL, et al. Association between medi-cation literacy and medication adherence among patients with hypertension[J]. Front Pharmacol, 2019, 10:822.
[5]	Pouliot A, Vaillancourt R, Stacey D, et al. Defining and identi-fying concepts of medication literacy:an international perspec-tive[J]. Res Social Adm Pharm, 2018, 14(9):797-804. doi: S1551-7411(17)30290-5 pmid: 29191647
[6]	渠吉皊. 老年冠心病患者药物素养对健康结局影响的纵向研究[D]. 扬州: 扬州大学, 2022.
[7]	秦宁, 段应龙, 石双姣, 等. 心血管疾病患者药物素养评估工具的研究进展[J]. 中华护理杂志, 2023, 58(2):186-191. doi: 10.3761/j.issn.0254-1769.2023.02.008
	Qin N, Duan YL, Shi SJ, et al. Research progress of assessment tools for medication literacy in patients with cardiovascular disease[J]. Chin J Nurs, 2023, 58(2):186-191. doi: 10.3761/j.issn.0254-1769.2023.02.008
[8]	Neiva Pantuzza LL, Nascimento ED, Crepalde-Ribeiro K, et al. Medication literacy:a conceptual model[J]. Res Social Adm Pharm, 2022, 18(4):2675-2682.
[9]	陈婷婷, 周云仙. 护理领域描述性质性研究的现状与建议[J]. 护理与康复, 2020, 19(1):22-24.
[10]	张先庚, 刘珊, 刘林峰, 等. 基于德尔菲法构建初级医养结合老年护理人才岗位胜任力评价指标体系[J]. 解放军护理杂志, 2022, 39(3):24-27.
[11]	倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4):378-380.
[12]	秦浩, 陈景武. 医学量表条目的筛选考评方法及其应用[J]. 中国行为医学科学, 2006(4):375-376.
[13]	孙梦晨, 冯芳茗, 何佳倩, 等. 癌症患者自杀风险评估量表的编制及信效度检验[J]. 护理学报, 2023, 30(13):13-17.
[14]	赵雪. 老年慢性病患者药物素养量表的研制[D]. 兰州: 兰州大学, 2023.
[15]	史静琤, 莫显昆, 孙振球. 量表编制中内容效度指数的应用[J]. 中南大学学报(医学版), 2012, 37(2):49-52.
[16]	张静. 《冠心病合理用药指南(第2版)》出版:倍他乐克联合治疗心律失常的有效率分析[J]. 介入放射学杂志, 2021, 30(6):后插5.
[17]	石瑞. 冠心病患者二级预防和心脏康复护理循证实践方案的构建[D]. 太原: 山西医科大学, 2021.
[18]	中国医师协会心血管内科医师分会. 氯吡格雷/阿司匹林单片复方制剂抗血小板治疗中国专家共识[J]. 中国介入心脏病学杂志, 2021, 29(6):306-312.