Seow Kai Cong, Mohamed Yusoff Diana, Koh Yi Ling Eileen, Tan Ngiap Chuan
National University Singapore Yong Loo Lin School of Medicine, Singapore, Singapore.
SingHealth Polyclinics, Singapore, Singapore.
BMJ Open. 2017 Sep 6;7(9):e016152. doi: 10.1136/bmjopen-2017-016152.
Self-efficacy and self-care measures are key attributes to optimal control of essential hypertension. Self-efficacy can be measured by the Hypertension Self-Care Profile (HTN-SCP) tool but its utility is dependent on the literacy and understanding of the subjects. A Malay version of the HTN-SCP Tool was developed to assess self-efficacy of Malay-literate patients with hypertension in the multi-ethnic Asian population in Singapore. The study aimed to determine the test-retest reliability of this tool which has been translated in Malay language.
145 Malay-literate patients, aged 41-70 years, with essential hypertension were recruited in a polyclinic (primary care clinic) in Singapore. Forty-three percent of them completed both the first and second HTN SCP tool online, with a period of two weeks in between. The Cronbach's alpha and Intra-class correlation coefficient (ICC) were computed to assess its test-retest reliability and internal consistency.
The Cronbach's alpha/ICC for "Behavior" (0.851/0.664)), "Motivation" (0.928/0.655) and "Self-efficacy" (0.945/0.682) domains showed high internal consistency, fair to good reliability and stability. No floor or ceiling effect was found for the "behavior" and "motivation" domains. However, the borderline ceiling effect (15.2) for "self-efficacy" suggested limited discriminating power of the tool for patients with high self-efficacy. Positive association was shown between the HTN-SCP score and reported self-care measures but it was not statistically significant.
Overall, the translated HTN-SCP tool showed satisfactory test-retest reliability and internal consistency amongst the Malay-literate study population. Further research is needed for its application in general practice to identify patients with low self-efficacy for possible intervention.
自我效能感和自我护理措施是原发性高血压最佳控制的关键属性。自我效能感可以通过高血压自我护理概况(HTN-SCP)工具进行测量,但其效用取决于受试者的读写能力和理解能力。开发了马来语版的HTN-SCP工具,以评估新加坡多民族亚洲人群中识字的马来族高血压患者的自我效能感。该研究旨在确定已翻译成马来语的该工具的重测信度。
在新加坡的一家综合诊所(初级保健诊所)招募了145名年龄在41至70岁之间、识字的马来族原发性高血压患者。其中43%的患者在网上完成了第一次和第二次HTN-SCP工具测试,两次测试间隔两周。计算了克朗巴哈系数和组内相关系数(ICC),以评估其重测信度和内部一致性。
“行为”(0.851/0.664)、“动机”(0.928/0.655)和“自我效能感”(0.945/0.682)领域的克朗巴哈系数/ICC显示出较高的内部一致性、尚可至良好的信度和稳定性。“行为”和“动机”领域未发现地板效应或天花板效应。然而,“自我效能感”的临界天花板效应(15.2)表明该工具对自我效能感高的患者的区分能力有限。HTN-SCP评分与报告的自我护理措施之间呈正相关,但无统计学意义。
总体而言,翻译后的HTN-SCP工具在识字的马来族研究人群中显示出令人满意的重测信度和内部一致性。需要进一步研究其在全科医疗中的应用,以识别自我效能感低的患者以便进行可能的干预。