吸入药物依从性量表（IMAS）的目的：使用计划行为理论开发一种新的评估慢性阻塞性肺疾病（COPD）患者吸入药物依从性的工具。
The Intention of Inhaled Medication Adherence Scale (IMAS): The Development of a New Instrument for Assessing Inhaled Medication Adherence Among Patients with Chronic Obstructive Pulmonary Disease (COPD) Using Theory of Planned Behavior.
机构信息
Department of Respiratory Therapy, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan.
出版信息
Int J Chron Obstruct Pulmon Dis. 2023 Aug 2;18:1655-1664. doi: 10.2147/COPD.S420001. eCollection 2023.
PURPOSE
Inhaled medication adherence is an important issue for patients with chronic obstructive pulmonary disease (COPD) because adhering to inhaled medications could substantially improve their health. However, patients with COPD may not be always adhere to the prescribed inhaled medications. Therefore, understanding the underlying reasons for patients with COPD adhering to inhaled medications is important. The present study used Theory of Planned Behavior (TPB) as a theoretical framework to develop the Intention of Inhaled Medication Adherence Scale (IMAS) and assess its psychometric properties.
PATIENTS AND METHODS
After reviewing papers using the TPB to design psychometric scales and the TPB scale development guidelines, 28 items were generated for expert evaluation. Eight experts reported that the 28 items all had good content validity (content validity index ranged from 0.88 to 1.00 at item-level; and from 0.981 to 0.987 at scale-level) comprising four factors. Following initial development, 235 patients with COPD (mean age 73.12 years; 93.6% males) completed the IMAS via interview with a respiratory therapist and a research assistant. The four-factor structure of the IMAS was evaluated using confirmatory factor analysis (CFA).
RESULTS
Nine IMAS items were removed because of low factor loadings or offending estimates. The 19-item IMAS was confirmed as having a four-factor structure supported by the CFA results (comparative fit index=1.00; Tucker-Lewis index=1.00; root mean square error of approximation=0.00; standardized root mean square residual=0.06).
CONCLUSION
The 19-item IMAS had satisfactory psychometric properties in construct validity. The 19-item IMAS is an instrument that could help healthcare providers understand potential factors associated with adherence to inhaled medications among people with COPD.
目的
吸入药物依从性是慢性阻塞性肺疾病（COPD）患者的一个重要问题，因为坚持使用吸入药物可以显著改善他们的健康状况。然而，COPD 患者并不总是坚持使用处方吸入药物。因此，了解 COPD 患者坚持使用吸入药物的潜在原因很重要。本研究以计划行为理论（TPB）为理论框架，开发了吸入药物依从性意向量表（IMAS），并评估了其心理测量学特性。
方法
在回顾了使用 TPB 设计心理测量量表的论文以及 TPB 量表开发指南后，生成了 28 个项目进行专家评估。8 位专家报告称，这 28 个项目的内容效度均良好（项目水平的内容效度指数范围为 0.88 至 1.00；量表水平的内容效度指数范围为 0.981 至 0.987），包含四个因素。初始开发后，235 名 COPD 患者（平均年龄 73.12 岁；93.6%为男性）通过呼吸治疗师和研究助理的访谈完成了 IMAS。采用验证性因子分析（CFA）评估 IMAS 的四因素结构。
结果
由于因子负荷或估计值不佳，有 9 个 IMAS 项目被删除。19 项 IMAS 被确认为具有四因素结构，这一结构得到了 CFA 结果的支持（比较拟合指数=1.00；塔克-刘易斯指数=1.00；均方根误差近似值=0.00；标准化均方根残差=0.06）。
结论
19 项 IMAS 在结构效度方面具有良好的心理测量学特性。19 项 IMAS 是一种工具，可以帮助医疗保健提供者了解 COPD 患者中与吸入药物依从性相关的潜在因素。
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