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对患有哮喘控制不佳的非裔美国儿童的低收入照料者的医学结局研究社会支持的评估。

Evaluation of MOS social support in low-income caregivers of African American children with poorly controlled asthma.

作者信息

Margolis Rachel, Bellin Melissa H, Sacco Paul, Harrington Donna, Butz Arlene

机构信息

a School of Social Work, University of Maryland , Baltimore , MD , USA.

b Department of Pediatrics, The Johns Hopkins University School of Medicine , Freeland , MD , USA.

出版信息

J Asthma. 2019 Sep;56(9):951-958. doi: 10.1080/02770903.2018.1510504. Epub 2018 Oct 1.

Abstract

The purpose of this study was to examine the factor structure of the Medical Outcomes Study Social Support Survey (MOS-SSS) in a sample of low-income, urban caregivers of African American children with poorly controlled asthma. Although the MOS-SSS is a commonly used measure of social support, its psychometric properties have not been studied in this population. Confirmatory factor analysis was conducted to determine the most appropriate factor structure for the MOS-SSS in caregivers of African American children with frequent Emergency Department visits for uncontrolled asthma. The following models were tested and compared using established fit statistics: an 18-item second-order four factor model, an 18-item four factor model, a bifactor model and an 18-item one factor model with nested models. Participating caregivers were single (75.6%) and female (97%). An 18-item one factor version of the scale had the best fit statistics compared to the other models tested: (142) = 308.319,  > 0.001; Root mean square error of approximation (RMSEA) = 0.077; CFI (Comparative Fit Index) = 0.990; and Tucker-Lewis Index (TLI) = 0.988. Construct validity was supported by a statistically significant negative relationship between our final MOS-SSS model and caregiver depressive symptoms ( = -0.374,  < 0.001). The 18-item one factor MOS-SSS may be appropriate for use in research and clinical practice with caregivers of African American children with poorly controlled asthma. It appears promising as a mechanism to advance understanding of relationships between social support and asthma outcomes in this vulnerable population.

摘要

本研究的目的是在患有哮喘控制不佳的非裔美国儿童的低收入城市照料者样本中,检验医学结果研究社会支持调查(MOS - SSS)的因子结构。尽管MOS - SSS是常用的社会支持测量工具,但其心理测量特性尚未在该人群中进行研究。进行验证性因子分析,以确定在因哮喘控制不佳而频繁就诊急诊科的非裔美国儿童照料者中,MOS - SSS最合适的因子结构。使用既定的拟合统计量对以下模型进行测试和比较:一个18项二阶四因子模型、一个18项四因子模型、一个双因子模型以及一个带有嵌套模型的18项单因子模型。参与研究的照料者均为单身(75.6%)且为女性(97%)。与其他测试模型相比,该量表的18项单因子版本具有最佳的拟合统计量:卡方值(χ²)(142) = 308.319,p > 0.001;近似均方根误差(RMSEA) = 0.077;比较拟合指数(CFI) = 0.990;塔克 - 刘易斯指数(TLI) = 0.988。最终的MOS - SSS模型与照料者抑郁症状之间存在统计学显著的负相关关系(r = -0.374,p < 0.001),支持了结构效度。18项单因子MOS - SSS可能适用于对患有哮喘控制不佳的非裔美国儿童照料者的研究和临床实践。作为一种增进对这一弱势群体中社会支持与哮喘结局之间关系理解的机制,它似乎很有前景。

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