Lai Fenghua, Pei Ling, Yue Shufan, Cao Xiaopei, Xiao Haipeng, Li Yanbing, Li Jin
Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Geriatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
BMJ Open. 2021 Jan 6;11(1):e042432. doi: 10.1136/bmjopen-2020-042432.
Medical overutilisation and underutilisation affect optimal healthcare. The Medical Maximizer-Minimizer Scale (MMS) was developed to assess individual medical maximising and minimising tendencies. Despite significant improvement in the healthcare system over the past four decades, no psychometric scales to examine treatment maximising and minimising preferences are available in China. This study aimed to translate the MMS into Chinese and examine its reliability and validity in a Chinese population.
This cross-sectional study was conducted in December 2019 through an online survey panel.
The MMS was translated into a Chinese version (CN-MMS) using a forward-backward translation procedure. Next, a random online survey of the general population in China was conducted. Exploratory factor analysis (EFA) and confirmatory factor analysis were performed to examine the underlying factor structure of the CN-MMS. The internal consistency reliability of the scale was determined using Cronbach's α coefficient and corrected item-total correlation. A multivariate linear regression analysis was used to examine associations between medical maximising and minimising preferences and demographic variables in the Chinese population.
This study included 984 participants aged 18-80 years. The CN-MMS retained 10 items, and the EFA supported a two-factor structure. The model fit for this two-factor structure of the CN-MMS was acceptable with χ/df=3.7, comparative fit index=0.958, goodness-of-fit index=0.951, Tucker-Lewis Index=0.944 and root mean square error of approximation=0.074. The scale had a Cronbach's α coefficient of 0.864, corrected item-total correlation of 0.451-0.667, and test-retest reliability of 0.815. Significant predictors of CN-MMS total score were nationality and household monthly income.
The CN-MMS showed satisfactory psychometric properties. Therefore, it can be used to investigate the individual medical maximising and minimising tendencies among the general Chinese population.
医疗服务的过度利用和利用不足会影响最佳医疗保健。医学最大化-最小化量表（MMS）旨在评估个体的医疗最大化和最小化倾向。尽管在过去四十年中医疗保健系统有了显著改善，但中国尚无用于检验治疗最大化和最小化偏好的心理测量量表。本研究旨在将MMS翻译成中文，并检验其在中国人群中的信效度。
本横断面研究于2019年12月通过在线调查小组进行。
采用正向-反向翻译程序将MMS翻译成中文版（CN-MMS）。接下来，对中国普通人群进行随机在线调查。进行探索性因素分析（EFA）和验证性因素分析以检验CN-MMS的潜在因素结构。使用Cronbach's α系数和校正的项目-总分相关性来确定量表的内部一致性信度。采用多元线性回归分析来检验中国人群中医疗最大化和最小化偏好与人口统计学变量之间的关联。
本研究纳入了984名年龄在18-80岁之间的参与者。CN-MMS保留了10个项目，EFA支持两因素结构。CN-MMS两因素结构的模型拟合度可接受，χ/df = 3.7，比较拟合指数 = 0.958，拟合优度指数 = 0.951，塔克-刘易斯指数 = 0.944，近似均方根误差 = 0.074。该量表的Cronbach's α系数为0.864，校正的项目-总分相关性为0.451 - 0.667，重测信度为0.815。CN-MMS总分的显著预测因素是国籍和家庭月收入。
CN-MMS显示出令人满意的心理测量学特性。因此，它可用于调查中国普通人群中个体的医疗最大化和最小化倾向。
