Ren Jing, Han Dongfang, Zhang Jingjun, Wang Yingli, Huang Qiaoqiao, Tian Tian, Li Xiaomei
School of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an City, People's Republic of China.
Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an City, People's Republic of China.
Patient Prefer Adherence. 2021 Oct 5;15:2267-2278. doi: 10.2147/PPA.S330225. eCollection 2021.
Patients affected by tuberculosis have diverse unmet supportive care needs (SCN) that may seriously affect their treatment adherence. Accurately assessing patients' SCN is important for providing efficient patient-centred care, but few instruments are suitable for use in clinical practice. Therefore, the purpose of this study was to develop an SCN scale for patients with tuberculosis (SCN-TB) and to evaluate its psychometrical properties.
Based on the SCN framework, the SCN-TB was designed via a literature review, Delphi consultation and pilot study. Then, 550 patients from four tuberculosis specialist hospitals in Shaanxi Province were enrolled by convenience sampling to further test the validity and reliability of the SCN-TB.
A total of 518 patients completed the survey. The final scale encompasses 25 items in five domains: physical, practical, psycho-emotional, social, and informational. The content validity for the scale was 0.93, with that for each item ranging from 0.80 to 1.00. Five factors that explained 80.38% of the variance were identified in exploratory factor analysis. A five-factor model was then confirmed with confirmatory factor analysis using maximum likelihood estimation with bootstrapping. The model fit indices were /=1.062 (Bollen-Stine =281.382, =265, <0.001), CFI=0.997, RMSEA=0.016, SRMR=0.053, NFI=0.951, and GFI=0.929. All factors had acceptable convergent and discriminant validity. The Cronbach's α, split-half, and test-retest reliability coefficients of the scale were 0.884, 0.883, and 0.854, respectively.
The SCN-TB is a valid and reliable theory based tool for assessing the needs of patients with tuberculosis and can be applied in both clinical practice and research.
结核病患者存在多种未满足的支持性护理需求（SCN），这可能严重影响其治疗依从性。准确评估患者的SCN对于提供以患者为中心的高效护理很重要，但很少有工具适用于临床实践。因此，本研究的目的是开发一种用于结核病患者的SCN量表（SCN-TB）并评估其心理测量特性。
基于SCN框架，通过文献综述、德尔菲咨询和预试验设计了SCN-TB。然后，采用便利抽样法从陕西省四家结核病专科医院招募了550例患者，以进一步检验SCN-TB的有效性和可靠性。
共有518例患者完成调查。最终量表涵盖五个领域的25个条目：身体、实际、心理情感、社会和信息。该量表的内容效度为0.93，各条目的内容效度范围为0.80至1.00。在探索性因素分析中确定了五个解释80.38%方差的因素。然后使用带有自抽样的最大似然估计，通过验证性因素分析确认了一个五因素模型。模型拟合指数为χ²/df =1.062（Bollen-Stine χ² =281.382，df =265，p<0.001），CFI =0.997，RMSEA =0.016，SRMR =0.053，NFI =0.951，GFI =0.929。所有因素均具有可接受的聚合效度和区分效度。该量表的克朗巴赫α系数、分半系数和重测信度系数分别为0.884、0.883和0.854。
SCN-TB是一种有效且可靠的基于理论的工具，可用于评估结核病患者的需求，可应用于临床实践和研究。
