Allahverdipour Hamid, Badri Majid, Shaghaghi Abdolreza, Mahmoodi Hassan, Heizomi Haleh, Shirzadi Shayesteh, Asghari-Jafarabadi Mohammad
Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Health Education & Promotion Department, Tabriz University of Medical Sciences, Tabriz, Iran.
Health Promot Perspect. 2023 Sep 11;13(3):212-218. doi: 10.34172/hpp.2023.26. eCollection 2023.
Proper elucidation of medication non-adherence reasoning especially in older adults might pave the way for an auspicious therapeutic outcome. The main aim of this study was to develop and psychometrically test the Medications Non-adherence Reasoning (MedNARS) questionnaire for application in research and probably practice settings.
A mixed methods design was utilized to develop the MedNARS. The item pool was mainly generated based on a qualitative query and literature review. The expert panel approved version of the MedNARS was psychometrically assessed on a convenience sample of 220 older patients with chronic disease. The internal consistency, test-retest reliability, content and face validity of the scale were appraised and its construct validity was assed using exploratory and confirmatory factor analyses.
A nine-item version of the MedNARS was drafted based on the classical item analysis procedures and its estimated internal consistency measure of the Cronbach's alpha (0.85) and test-retest reliability (0.96) were in the vicinity of acceptable range. The exploratory factor analysis (EFA) output revealed a unidimensional structure for the MedNARS and the conducted confirmatory factor analysis (CFA) indicated an acceptable data fit for the extracted one-factor model. The goodness of fit indices were as the followings: χ /df=1.63(90% CI: 0.02 to 0.11), root mean squared error of approximation (RMSEA)=(0.07), comparative fit index (CFI)=0.95, Tucker-Lewis index (TLI)=0.93 and standardized root mean squared residual (SRMSR)=(0.05).
The study findings were indicative of MedNARS's applicability and feasibility for use in assessment of medication non-adherence reasoning among the elderly patients with chronic diseases. The MedNARS as a brief and elder-friendly instrument can be applied both in research and practice settings to enhance efficiency, safety, and health outcomes of the therapeutic recommendations.
正确阐释药物治疗不依从的原因，尤其是在老年人中，可能为实现良好的治疗效果铺平道路。本研究的主要目的是开发并对药物治疗不依从原因（MedNARS）问卷进行心理测量学测试，以用于研究以及可能的实践环境中。
采用混合方法设计来开发MedNARS。项目池主要基于定性查询和文献综述生成。在220名患有慢性病的老年患者的便利样本上对专家小组批准的MedNARS版本进行了心理测量学评估。评估了该量表的内部一致性、重测信度、内容效度和表面效度，并使用探索性和验证性因素分析评估了其结构效度。
基于经典项目分析程序起草了一个九项版本的MedNARS，其估计的Cronbach's alpha内部一致性测量值（0.85）和重测信度（0.96）在可接受范围内。探索性因素分析（EFA）结果显示MedNARS具有单维结构，进行的验证性因素分析（CFA）表明提取的单因素模型的数据拟合度可接受。拟合优度指标如下：χ²/df = 1.63（90% CI：0.02至0.11），近似均方根误差（RMSEA）= 0.07，比较拟合指数（CFI）= 0.95，塔克 - 刘易斯指数（TLI）= 0.93，标准化均方根残差（SRMSR）= 0.05。
研究结果表明MedNARS在评估老年慢性病患者药物治疗不依从原因方面具有适用性和可行性。MedNARS作为一种简短且对老年人友好的工具，可应用于研究和实践环境中，以提高治疗建议的效率、安全性和健康结果。
