Taylor-Piliae Ruth E, Froelicher Erika Sivarajan
Department of Physiological Nursing, School of Nursing, University of California, 2 Koret Way, Box 0610, San Francisco, CA 94143-0610, USA.
Eur J Cardiovasc Nurs. 2004 Dec;3(4):287-94. doi: 10.1016/j.ejcnurse.2004.09.001.
Improvement in aerobic capacity and reduction in blood pressure after Tai Chi exercise programs in persons with coronary heart disease (CHD) or with CHD risk factors have been reported. Self-efficacy has been shown to be a consistent predictor of behavioral outcomes, now being applied to Tai Chi exercise.
To assess the utility and appropriateness of existing tools measuring aspects of Tai Chi exercise self-efficacy (TCSE) in a new population, ethnic Chinese with CHD risk factors. Specific objectives were: (1) examine acceptability and feasibility; (2) determine score distributions; (3) assess the reliability and known-groups validity; (4) translate tool into an equivalent Chinese version and determine if there were any differences between ethnic Chinese and non-Chinese.
Following a review of the literature, two existing tools used with Caucasians were found and modified; a 9-item exercise self-efficacy tool developed by Resnick and Jenkins [Resnick B, Jenkins LS, Testing the reliability and validity of the Self-Efficacy for Exercise scale. Nurs. Res. 49(3) (2000) 154-159], and a 3-item tool developed by Li et al. [Li F, McAuley E, Harmer P, Duncan TE, Chaumeton NR, Tai Chi enhances self-efficacy and exercise behavior in older adults. J. Aging Phys. Act. 9 (2001) 161-171] to assess gradations of the challenge to perform Tai Chi among elderly populations. The modified TCSE tool was translated into Chinese and back-translated. A pilot study was conducted to pre-test the modified 14-item TCSE tool in ethnic Chinese and non-Chinese.
A total of 18 subjects (mean age = 60 years, S.D. = 18.4) participated. Seven subjects (39%) identified themselves as ethnic Chinese. Ten subjects (56%) had experience performing Tai Chi, ranging from 3 months to 17 years (mean = 5.0 years, S.D.=5.0). Half of the subjects reported having a history of hypertension (n = 9, 50%), while nearly one-third reported having high cholesterol (n = 5, 28%). No significant difference in TCSE mean scores was found between ethnic Chinese and non-Chinese (p > 0.05). Internal consistency estimates were very high (TCSE Barriers, r = 0.95; TCSE Performance, r = 0.97). A statistically significant difference was found in the TCSE mean scores between Tai Chi practitioners and non-practitioners (TCSE Barriers, t = -3.3, p = 0.01; TCSE Performance, t = -2.7, p = 0.03), with Tai Chi practitioners reporting higher self-efficacy; thus providing initial evidence of known-groups validity.
Measurement of self-efficacy to overcome barriers to Tai Chi exercise (TCSE Barriers) and self-efficacy to perform Tai Chi (TCSE Performance) functioned well in this sample. The acceptability and feasibility of this tool was established and known-groups validity was confirmed. Further research using this tool among ethnic Chinese with CHD or CHD risk factors, including those with less than high school education or low literacy, is recommended as the next step in development of TCSE.
据报道，冠心病（CHD）患者或有冠心病危险因素的人群在进行太极拳锻炼计划后，有氧能力得到改善，血压降低。自我效能已被证明是行为结果的一致预测因素，目前正应用于太极拳锻炼。
评估现有测量太极拳锻炼自我效能（TCSE）方面的工具在新人群——有冠心病危险因素的华裔人群中的实用性和适用性。具体目标为：（1）检查可接受性和可行性；（2）确定分数分布；（3）评估信度和已知群体效度；（4）将工具翻译成等效的中文版，并确定华裔与非华裔之间是否存在差异。
在文献回顾之后，发现并修改了两个用于高加索人的现有工具；一个由雷斯尼克和詹金斯开发的9项锻炼自我效能工具[雷斯尼克B，詹金斯LS，测试锻炼自我效能量表的信度和效度。护理研究。49(3)（2000）154 - 159]，以及一个由李等人开发的3项工具[李F，麦考利E，哈默P，邓肯TE，乔梅顿NR，太极拳增强老年人的自我效能和锻炼行为。老年体育活动杂志。9（2001）161 - 171]，用于评估老年人群中进行太极拳挑战的不同程度。修改后的TCSE工具被翻译成中文并进行回译。进行了一项试点研究，以在华裔和非华裔中对修改后的14项TCSE工具进行预测试。
共有18名受试者（平均年龄 = 60岁，标准差 = 18.4）参与。7名受试者（占39%）自认为是华裔。10名受试者（占56%）有太极拳锻炼经历，从3个月到17年不等（平均 = 5.0年，标准差 = 5.0）。一半的受试者报告有高血压病史（n = 9，占50%），而近三分之一报告有高胆固醇（n = 5，占28%）。华裔和非华裔之间的TCSE平均得分没有显著差异（p > 0.05）。内部一致性估计值非常高（TCSE障碍，r = 0.95；TCSE表现，r = 0.97）。在太极拳练习者和非练习者之间的TCSE平均得分发现有统计学显著差异（TCSE障碍，t = -3.3，p = 0.01；TCSE表现，t = -2.7，p = 0.03），太极拳练习者报告的自我效能更高；从而提供了已知群体效度的初步证据。
在该样本中，测量克服太极拳锻炼障碍的自我效能（TCSE障碍）和进行太极拳的自我效能（TCSE表现）效果良好。该工具的可接受性和可行性得到确立，已知群体效度得到证实。建议下一步在有冠心病或冠心病危险因素的华裔人群中，包括那些受教育程度低于高中或识字水平较低的人群中，使用该工具进行进一步研究，作为TCSE开发的下一步。
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