Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Jalan Prima Selayang 7, Batu Caves 68100, Selangor, Malaysia.
Institute of Pathology, Laboratory & Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh 47000, Selangor, Malaysia.
Int J Environ Res Public Health. 2021 Sep 6;18(17):9405. doi: 10.3390/ijerph18179405.
Self-management support is one of the most important components of the Chronic Care Model (CCM). The EMPOWER-SUSTAIN Global Cardiovascular Risks Self-Management Booklet was developed for patients with Metabolic Syndrome (MetS), inspired by the CCM. Assessing usability of a self-management tool is important in chronic disease management. However, there was no available instrument to assess usability of a self-management booklet, as most instruments were developed to assess usability of mobile application. Therefore, this study aimed to adapt (SKAMA) into the EMPOWER-SUSTAIN Usability Questionnaire (E-SUQ) and to determine its validity and reliability in assessing usability of a self-management booklet. A cross-sectional validation study was conducted among patients with MetS attending a university primary care clinic in Selangor, Malaysia. Content validation, adaptation and face validation of E-SUQ were performed according to recommended guidelines. It underwent two rounds of content validation as major revision was required for item 5. Subsequently, the revised E-SUQ was face-validated by 10 participants. Psychometric evaluation was conducted using principal component analysis with varimax rotation to determine the underlying structure of E-SUQ. Internal consistency reliability was assessed using Cronbach's α coefficient and the test-retest reliability was assessed using intraclass correlation coefficient (ICC (2,k)). A total of 205 patients participated in the study. The item-level content-validity-index (I-CVI) for item 5 improved from 0.57 to 1.0 after the second round of content validation. The final S-CVI/Ave value for ESUQ was >0.90. The item-level face-validity-index (I-FVI) ranged between 0.9 and 1.0. Kaiser-Meyer-Olkin value of 0.871 and Bartlett's test of sphericity -value of <0.05 indicated good sample adequacy for factor analysis. Two factors with eigenvalues of >1 were extracted according to the Kaiser's Criteria. The two extracted factors explained 60.6% of the cumulative percentage of variance. The elbow of the scree plot occurred between the second and third component, suggesting two factors to be retained. The two factors were consistent with "Positive" and "Negative" tone model. The overall Cronbach's α coefficient was 0.77, indicating good internal reliability. The overall ICC was 0.85, indicating good reproducibility. The E-SUQ is shown to be valid, reliable and stable to measure the usability of a self-management booklet among patients with MetS in a university primary care clinic in Malaysia.
自我管理支持是慢性护理模式 (CCM) 中最重要的组成部分之一。EMPOWER-SUSTAIN 全球心血管风险自我管理手册是为代谢综合征 (MetS) 患者开发的，灵感来自 CCM。评估自我管理工具的可用性在慢性病管理中很重要。然而，由于大多数工具都是为评估移动应用程序的可用性而开发的，因此没有可用的工具来评估自我管理手册的可用性。因此，本研究旨在将 (SKAMA) 改编为 EMPOWER-SUSTAIN 可用性问卷 (E-SUQ)，并确定其在评估代谢综合征患者自我管理手册可用性方面的有效性和可靠性。在马来西亚雪兰莪州的一所大学初级保健诊所，进行了一项横断面验证研究。根据建议的指南进行了 E-SUQ 的内容验证、改编和表面验证。由于需要对第 5 项进行重大修订，因此进行了两轮内容验证。随后，由 10 名参与者对修订后的 E-SUQ 进行了表面验证。使用主成分分析和最大方差旋转进行心理测量评估，以确定 E-SUQ 的潜在结构。使用 Cronbach's α 系数评估内部一致性信度，使用组内相关系数 (ICC(2,k)) 评估重测信度。共有 205 名患者参加了这项研究。经过第二轮内容验证，第 5 项的项目水平内容有效性指数 (I-CVI) 从 0.57 提高到 1.0。E-SUQ 的最终 S-CVI/Ave 值>0.90。项目水平的表面有效性指数 (I-FVI) 介于 0.9 和 1.0 之间。Kaiser-Meyer-Olkin 值为 0.871，Bartlett 球形检验值<0.05 表明因子分析的样本充足。根据 Kaiser 标准，提取了两个特征值>1 的因子。这两个提取的因子解释了累积方差的 60.6%。碎形图的肘点出现在第二和第三个因子之间，这表明保留两个因子。这两个因子与“积极”和“消极”基调模型一致。总体 Cronbach's α 系数为 0.77，表明内部信度良好。总体 ICC 为 0.85，表明可重复性良好。E-SUQ 被证明在马来西亚一所大学初级保健诊所的代谢综合征患者中具有有效性、可靠性和稳定性，可用于测量自我管理手册的可用性。
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