Faculty of Graduate Studies, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
Department of Nursing and Midwifery, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
PLoS One. 2023 Oct 20;18(10):e0292938. doi: 10.1371/journal.pone.0292938. eCollection 2023.
The chronic kidney disease is a leading public health concern, particularly in low-to middle-income countries, while the number of patients receiving haemodialysis is rapidly increasing. Adherence to a complex treatment regimen is vital for those patients on maintenance haemodialysis though the precise evaluation is reported inadequately. This study aimed to evaluate the psychometric properties of Sinhalese version of End Stage Renal Disease-Adherence Questionnaire (SINESRD-AQ) to assess treatment adherence behaviour among patients receiving haemodialysis in a Sri Lankan hospital. The cultural adaptation of ESRD-AQ involved forward and back translation, expert committee consolidation and pretesting among patients (n = 10). Face and content validity of the questionnaire was evaluated using a modified Delphi technique. Construct validity of the subscales of SINESRD-AQ was evaluated using confirmatory factor analysis (CFA). A descriptive cross-sectional study among a consecutive sample of 150 patients receiving haemodialysis in a selected Teaching hospital, Sri Lanka was involved in performing CFA. Reliability was confirmed with test-retest reliability. Excellent face and content validity were reported with Item level content validity index (0.83-1.0), Average Item level content validity index for whole scale (0.93), Item level content validity ratio (0.67-1.0) and modified kappa statistic coefficient (0.81-1.0). CFA of two subscales demonstrated better indices closure to the model fit with five- item two factor model for direct adherence behaviour subscale and eight-item two factor model for attitude/perception subscale. The intra class correlation coefficient of 0.837 (p<0.001) and 0.752 (p<0.001) indicated acceptable test-retest reliability of direct adherence behaviour and attitude/perception subscale respectively. The study confirmed SINESRD-AQ as a valid and reliable measure which enables periodic assessment of treatment adherence behaviour of the patients receiving haemodialysis in a Sri Lankan hospital.
慢性肾脏病是一个主要的公共卫生关注点，特别是在中低收入国家，而接受血液透析的患者数量正在迅速增加。尽管对维持性血液透析患者的依从性评估报告不足，但遵守复杂的治疗方案对这些患者至关重要。本研究旨在评估僧伽罗语版终末期肾病依从性问卷（SINESRD-AQ）的心理测量特性，以评估斯里兰卡医院接受血液透析患者的治疗依从行为。ESRD-AQ 的文化适应包括正向和反向翻译、专家委员会整合以及患者预测试（n=10）。使用改良 Delphi 技术评估问卷的表面效度和内容效度。使用验证性因子分析（CFA）评估 SINESRD-AQ 分量表的结构效度。在斯里兰卡一所选定的教学医院，对接受血液透析的连续样本 150 例患者进行描述性横断面研究，以进行 CFA。通过重测信度确认可靠性。报告的表面效度和内容效度均极佳，条目水平内容效度指数（0.83-1.0）、整个量表的平均条目水平内容效度指数（0.93）、条目水平内容效度比（0.67-1.0）和改良 Kappa 统计系数（0.81-1.0）。两个分量表的 CFA 显示，对于直接依从性行为分量表的五条目两因素模型和态度/感知分量表的八条目两因素模型，模型拟合指标更好。0.837（p<0.001）和 0.752（p<0.001）的组内相关系数表明直接依从性行为和态度/感知分量表的重测信度可接受。该研究证实 SINESRD-AQ 是一种有效且可靠的测量工具，可用于定期评估斯里兰卡医院接受血液透析患者的治疗依从行为。
