Leung Doris Y P, Chan Sophia S C, Lau C P, Wong V, Lam T H
Department of Nursing Studies, Li Ka Shing Faculty of Nursing, The University of Hong Kong, 4/F William MW Mong Block, Pokfulam, Hong Kong.
Nicotine Tob Res. 2008 Aug;10(8):1311-8. doi: 10.1080/14622200802238928.
Smoking cessation can reduce both morbidity and mortality among patients who have heart disease. China has the largest number of smokers in the world, and most smokers have low motivation to quit. Regular smoking cessation services are almost nonexistent in China, and little is known about the psychometric properties of instruments in assessing smoking self-efficacy in Chinese, whose cultures differ greatly from those of Westerners. The present study tested the psychometric properties of the Chinese version of the Smoking Self-Efficacy Questionnaire (SEQ-12) among 1,841 Chinese smokers who had heart disease, including (a) factorial structure using confirmatory factor analysis, (b) reliability with Cronbach's alpha, (c) concurrent validity, and (d) predictive validity of successful quitting. Confirmatory factor analysis of the SEQ-12 revealed a modified two-factor model that provided a good fit to the data; item 6 ("urge to smoke") was an indicator for the external stimuli subscale rather than for the internal stimuli subscale. Internal consistency coefficients (.77 for external stimuli and .88 for internal stimuli) were acceptable. Baseline self-efficacy scores were significantly associated positively with stage of readiness to quit, and negatively with cigarettes smoked per day and Fagerstrom Test for Nicotine Dependence (FTND) score. Multivariate logistic regression analysis showed that successful quitting at 1 month and at 3 months were predicted by higher external stimuli score, fewer cigarettes smoked per day, lower FTND scores, and being in the intervention group. We concluded that the Chinese version of the SEQ-12 is a valid and reliable instrument for Chinese cardiac patients who smoke. The SEQ-12 can be used to assess smokers' self-efficacy so that appropriate smoking cessation interventions can be provided.
戒烟可以降低心脏病患者的发病率和死亡率。中国是世界上吸烟人数最多的国家，大多数吸烟者戒烟的积极性较低。在中国，常规的戒烟服务几乎不存在，而且对于在中国文化背景下评估吸烟自我效能的工具的心理测量特性知之甚少，中国文化与西方文化有很大差异。本研究对1841名患有心脏病的中国吸烟者进行了中文版吸烟自我效能量表（SEQ-12）的心理测量特性测试，包括：（a）使用验证性因素分析的因子结构；（b）用Cronbach's α系数评估信度；（c）同时效度；以及（d）成功戒烟的预测效度。SEQ-12的验证性因素分析揭示了一个修正的双因素模型，该模型与数据拟合良好；项目6（“吸烟冲动”）是外部刺激子量表而非内部刺激子量表的一个指标。内部一致性系数（外部刺激为0.77，内部刺激为0.88）可以接受。基线自我效能得分与戒烟准备阶段呈显著正相关，与每日吸烟量和尼古丁依赖Fagerstrom测试（FTND）得分呈负相关。多变量逻辑回归分析表明，外部刺激得分较高、每日吸烟量较少、FTND得分较低以及属于干预组可预测1个月和3个月时的成功戒烟。我们得出结论，中文版SEQ-12对于中国吸烟心脏病患者是一种有效且可靠的工具。SEQ-12可用于评估吸烟者的自我效能，以便提供适当的戒烟干预措施。
