School of Nursing, Sun Yat-Sen University, Guangzhou, China.
J Adv Nurs. 2012 Jun;68(6):1402-13. doi: 10.1111/j.1365-2648.2011.05835.x. Epub 2011 Sep 29.
This article is a report of the development and psychometric testing of the Treatment Adherence Questionnaire for Patients with Hypertension.
Hypertension is the most prevalent health problem among adult patients affecting approximately 200 million people in China and about 1 billion persons worldwide. Adherence to medication and lifestyle for hypertensive patients result in blood pressure control and reduce adverse outcomes. At present, few specific adherence instruments are available to completely evaluate medication and lifestyle for hypertensive patients.
A multi-phase psychometric questionnaire development method was used to develop the instrument. The item pool was generated using literature review and focus group. Content validity was evaluated by expert panel. Then, the field testing was conducted by a convenience sampling of 278 hypertensive patients from December 2009 to May 2010 in Guangdong Province of China. Exploratory and confirmatory factor analyses were used to test construct validity. Finally, internal consistency and test-retest reliability were assessed.
The new measure consisted of six dimensions with 28 items, explaining 62·54% of the total variance in the data. Confirmative factor analysis supported a good overall fit of the six-factor model. Cronbach's α of the overall questionnaire was 0·86 and 0·82 for test-retest reliability.
The questionnaire was a brief and psychometrically sound instrument to evaluate hypertensive patients' treatment adherence and to be applied in the research and clinical fields.
本文报告了高血压患者治疗依从性问卷的编制及其信度和效度检验。
高血压是成年患者中最常见的健康问题，中国约有 2 亿人患有高血压，全球约有 10 亿人患有高血压。高血压患者坚持药物治疗和改善生活方式可控制血压，降低不良预后。目前，很少有专门的评估高血压患者药物治疗和生活方式的依从性工具。
采用多阶段心理测量问卷开发方法研制该工具。通过文献回顾和焦点小组产生条目池，采用专家小组评估内容效度。然后，于 2009 年 12 月至 2010 年 5 月，采用便利抽样法在中国广东省抽取 278 例高血压患者进行现场测试。采用探索性和验证性因子分析检验结构效度，最后进行内部一致性和重测信度评估。
新量表由 6 个维度 28 个条目组成，可解释数据总方差的 62.54%。验证性因子分析支持 6 因素模型的整体拟合度较好。总量表的克朗巴赫 α系数为 0.86，重测信度为 0.82。
该问卷是一种简短且具有良好心理测量学特性的工具，可用于评估高血压患者的治疗依从性，适用于研究和临床领域。
