School of Nursing, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.
The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, 410013, Changsha, China.
BMC Geriatr. 2023 Apr 22;23(1):245. doi: 10.1186/s12877-023-03879-1.
Using accurate assessment tools to assess patients in clinical practice is important to mining influencing factors and implementing interventions. However, most evaluation tools for the self-management of elderly patients with hypertension lack a theoretical basis and wide applicability, which makes the intervention effect insignificant.
Based on the Capability, Opportunity, and Motivation-Behaviour (COM-B) model, combined with literature review and qualitative research, a questionnaire item pool was initially formulated; then the initial items were screened and adjusted through expert consultation and pre-testing to form an initial scale. A field survey of 450 elderly hypertensive patients was then performed using the initial scale to test the reliability and validity of the scale. Cronbach's alpha, test-retest reliability and composite reliability were used to test the reliability of the scale, and the validity of the scale was evaluated from two aspects: content validity and construct validity. The evaluation results of the content validity of the scale by experts were used as the content validity index; the results of exploratory factor analysis and confirmatory factor analysis were used as the structural validity index to further verify the model structure of the scale and develop a formal scale.
The final self-management scale included 4 dimensions and 33 items. The Scale-Content Validity Index was 0.920. Exploratory factor analysis extracted four factors that explained 71.3% of the total variance. Cronbach's alpha of the formal scale was 0.867, test-retest reliability was 0.894, and composite reliability of the 4 dimensions were within 0.943 ~ 0.973. Confirmatory factor analysis showed the scale had good construct validity.
The Self-management Capability, Support and Motivation-Behaviour scale for elderly hypertensive patients has good reliability and validity, providing a tool for medical staff to evaluate the self-management level of elderly hypertensive patients.
在临床实践中使用准确的评估工具来评估患者对于挖掘影响因素和实施干预至关重要。然而，大多数用于评估老年高血压患者自我管理的评估工具缺乏理论基础和广泛适用性，这使得干预效果不明显。
基于能力、机会和动机-行为（COM-B）模型，结合文献回顾和定性研究，初步制定了问卷条目池；然后通过专家咨询和预测试对初始条目进行筛选和调整，形成初始量表。然后使用初始量表对 450 名老年高血压患者进行现场调查，以测试量表的信度和效度。使用克朗巴赫's alpha、重测信度和组合信度来测试量表的信度，从内容效度和结构效度两个方面评估量表的有效性。专家对量表内容效度的评价结果作为内容效度指数；探索性因子分析和验证性因子分析的结果作为结构效度指数，进一步验证量表的模型结构，并开发正式量表。
最终的自我管理量表包括 4 个维度和 33 个条目。量表的内容效度指数为 0.920。探索性因子分析提取了四个因子，解释了总方差的 71.3%。正式量表的克朗巴赫's alpha 为 0.867，重测信度为 0.894，四个维度的组合信度在 0.943 至 0.973 之间。验证性因子分析表明，该量表具有良好的结构效度。
老年高血压患者自我管理能力、支持和动机-行为量表具有良好的信度和效度，为医务人员评估老年高血压患者的自我管理水平提供了工具。
