Zhang Li-Wei, Peng Yan-Chun, Pan Qiong, Li Sai-Lan, Chen Liang-Wan, Lin Yan-Juan
Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China.
Department of Cardiac Surgery Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China.
Open Med (Wars). 2024 Apr 12;19(1):20240939. doi: 10.1515/med-2024-0939. eCollection 2024.
The aim of this research was to compile a self-management assessment scale for patients with aortic dissection (AD). The questionnaire is useful in making the patient aware of the need for post-operative care in order to contribute to improving the outcome and quality of life.
The initial version of the "postoperative self-management assessment scale for patients with aortic dissection" was developed using the Delphi expert consultation method based on qualitative research results, consultation of self-management-related literature, reference to the existing self-management scale, and self-efficacy theory, combined with the disease characteristics of AD. By using the convenience sampling method, a total of 201 patients with AD who had undergone surgery were selected as the research participants. The initial version of the scale was used for follow-up investigation, and the scale entries were evaluated and exploratory factor analysis carried out to form the formal version of the "postoperative self-management assessment scale for patients with aortic dissection." A total of 214 patients with AD after surgery were selected as the research participants. The formal version of the scale was used for follow-up investigation, and its reliability and validity were evaluated.
The formal version of the scale had 6 dimensions and 35 entries. The Cronbach's coefficient for the total scale was 0.908, the split-half reliability was 0.790, and the test-retest reliability after 2 weeks was 0.471. The content validity index of the total scale was 0.963. Exploratory factor analysis yielded six common factors, and the cumulative contribution rate of variance was 66.303%. Confirmatory factor analysis showed that except for the incremental fit index, Tucker-Lewis index, and comparative fit index >0.85, slightly lower than 0.90, /df <3, root mean square of approximation <0.08, parsimonious goodness-of-fit index, and parsimonious normed fit index >0.50; all other model fitting requirements were satisfied, indicating that the model fitting was acceptable.
We compiled the postoperative self-management assessment scale for patients with AD, which has demonstrated excellent reliability and validity and can be used as a tool to evaluate the postoperative self-management level in patients with aortic dissection.
本研究旨在编制一份主动脉夹层（AD）患者自我管理评估量表。该问卷有助于让患者意识到术后护理的必要性，从而有助于改善治疗效果和生活质量。
基于定性研究结果、自我管理相关文献查阅、现有自我管理量表参考以及自我效能理论，并结合AD的疾病特点，采用德尔菲专家咨询法编制了“主动脉夹层患者术后自我管理评估量表”初始版本。采用便利抽样法，选取201例接受手术的AD患者作为研究对象。使用量表初始版本进行随访调查，对量表条目进行评价并进行探索性因子分析，形成“主动脉夹层患者术后自我管理评估量表”正式版本。选取214例术后AD患者作为研究对象。使用量表正式版本进行随访调查，并对其信效度进行评价。
量表正式版本有6个维度、35个条目。总量表的Cronbach's系数为0.908，分半信度为0.790，2周后重测信度为0.471。总量表的内容效度指数为0.963。探索性因子分析得出6个共同因子，方差累积贡献率为66.303%。验证性因子分析显示，除增值拟合指数、塔克-刘易斯指数和比较拟合指数>0.85，略低于0.90，/df<3，近似均方根<0.08，简约拟合优度指数和简约规范拟合指数>0.50外；其他模型拟合要求均得到满足，表明模型拟合可接受。
我们编制了AD患者术后自我管理评估量表，该量表具有良好的信效度，可作为评估主动脉夹层患者术后自我管理水平的工具。
