Ayiesah R, Leonard J H, Chong C Y
Physiotherapy Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Clin Ter. 2014;165(3):123-8. doi: 10.7417/CT.2014.1708.
Non-adherence is a serious issue among the participants in pulmonary rehabilitation program (PRP). Till date, no clinical tool is available to screen participants who will show poor adherence towards PRP. This study aimed to develop and validate a tool called "Adherence to Pulmonary Rehabilitation Questionnaire (APRQ)", a self-administered questionnaire to screen the risk of non-adherence to PRP among the patients with chronic obstructive pulmonary disease. APRQ comprises of 6 main constructs such as disease management behaviour, perceived treatment benefits, emotional factors, perceived severity of disease, barriers towards treatment and coping attitude.
This was a preliminary validity study carried out in the physiotherapy department and respiratory clinic in an university teaching hospital. A total of 109 patients with average age of 58.8 ± 1 year participated in the study. The inclusion criteria for subjects were: patients diagnosed with chronic obstructive pulmonary diseases (COPD) (Stage II and III). Exclusion criteria include those COPD patients with mental problems and disabled patients. The tool was developed based on thematic analysis and in-depth interview with focus group and literature search on the factors that lead to non-adherence among the PRP's participants. Principal component analysis was carried out to examine the construct validity and content validity of APRQ.
A total of 20 items were created under 6 constructs. However, 2 items (smoking and hospital admission) were eliminated due to poor correlations. Thus, the final version of APRQ was developed and validated with 18 items. Reliability was measured using internal consistency and achieved Cronbach's Alpha of 0.762.
The findings from this preliminary study supports that APRQ may be a valid and reliable tool to screen adherence towards PRP among chronic lung disease patients.
在肺康复计划（PRP）参与者中，不依从是一个严重问题。迄今为止，尚无临床工具可用于筛查对PRP依从性差的参与者。本研究旨在开发并验证一种名为“肺康复依从性问卷（APRQ）”的工具，这是一种自我管理的问卷，用于筛查慢性阻塞性肺疾病患者中不依从PRP的风险。APRQ由6个主要结构组成，如疾病管理行为、感知到的治疗益处、情绪因素、感知到的疾病严重程度、治疗障碍和应对态度。
这是一项在大学教学医院的理疗科和呼吸诊所进行的初步效度研究。共有109名平均年龄为58.8±1岁的患者参与了该研究。受试者的纳入标准为：被诊断为慢性阻塞性肺疾病（COPD）（II期和III期）的患者。排除标准包括患有精神问题的COPD患者和残疾患者。该工具是基于主题分析、对焦点小组的深入访谈以及对导致PRP参与者不依从的因素的文献检索而开发的。进行主成分分析以检验APRQ的结构效度和内容效度。
在6个结构下共创建了20个项目。然而，由于相关性较差，2个项目（吸烟和住院）被剔除。因此，最终版本的APRQ由18个项目组成并经过了验证。使用内部一致性来测量信度，Cronbach's Alpha系数为0.762。
这项初步研究的结果支持，APRQ可能是一种有效且可靠的工具，用于筛查慢性肺病患者对PRP的依从性。
