Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
BMC Endocr Disord. 2024 Aug 26;24(1):157. doi: 10.1186/s12902-024-01684-4.
Management of type 2 diabetes (T2D) as a chronic disease requires treatment adherence such as controlling the blood glucose level and adopting a healthy lifestyle. The present study aimed to develop and psychometrically evaluate a questionnaire based on the Pender's Health Promotion Model (HPM) to measure treatment adherence and the associated factors among T2D patients.
The present study was conducted in qualitative and the quantitative phases between March 2022 and March 2023. The participants were T2D patients visiting Shahid Mohammadi hospital Diabetes Clinic in Bandar Abbas in the south of Iran. The first draft of items was extracted from the qualitative phase. The present study used interviews with T2D patients, item construction, validity and reliability evaluation of the instrument, and the relevant statistical analyses. It emphasized the significance of content, face, and construct validity, along with reliability testing using Cronbach's alpha and test-retest method. Data were analyzed using SPSS software, V16 and AMOS, V23.
A 97-item questionnaire was developed through the qualitative phase and, after content validity, it was reduced to 86 items. Five items were removed in face validation, and after the test-retest method, 79 items were retained. The confirmatory factors analysis confirmed a 65-item model with appropriate fitness of data. Cronbach's alpha coefficient showed an acceptable reliability of the diabetes treatment adherence questionnaire (α = 0.92).
The questionnaire developed based on the HPM model provides a standard and comprehensive measurement of the degree of adherence to treatment and the associated factors among Iranian T2D patients. This is especially valuable in the Iranian healthcare context, where effective management of chronic diseases such as diabetes is of a top priority. Questionnaires can help identify barriers and facilitators of treatment adherence to inform systematic and goal-oriented interventions. The proposed questionnaire had good psychometric properties, and can be used as a valid and practical instrument to measure the factors related to treatment adherence behaviors.
作为一种慢性病，2 型糖尿病（T2D）的管理需要患者坚持治疗，如控制血糖水平和采取健康的生活方式。本研究旨在基于彭德健康促进模型（HPM）开发和心理测量评估一种问卷，以测量 T2D 患者的治疗依从性及其相关因素。
本研究于 2022 年 3 月至 2023 年 3 月在定性和定量两个阶段进行。参与者为伊朗南部班达尔阿巴斯沙希德·莫哈马迪医院糖尿病诊所的 T2D 患者。项目的初稿从定性阶段提取。本研究采用与 T2D 患者的访谈、项目构建、仪器的有效性和可靠性评估以及相关的统计分析，强调了内容、表面和结构有效性的重要性，以及使用克朗巴赫α和测试 - 重测法进行可靠性测试。数据使用 SPSS 软件、V16 和 AMOS、V23 进行分析。
通过定性阶段开发了一个 97 项的问卷，经过内容有效性后，减少到 86 项。在表面验证中删除了 5 项，在测试 - 重测方法后保留了 79 项。验证性因素分析证实了一个 65 项的模型，数据具有适当的拟合度。糖尿病治疗依从性问卷的克朗巴赫α系数显示出可接受的可靠性（α=0.92）。
基于 HPM 模型开发的问卷为伊朗 T2D 患者提供了一种标准的、全面的治疗依从性程度和相关因素的测量方法。这在伊朗的医疗保健背景下尤其有价值，因为有效管理糖尿病等慢性病是当务之急。问卷可以帮助识别治疗依从性的障碍和促进因素，为系统和有针对性的干预提供信息。提出的问卷具有良好的心理测量特性，可以作为一种有效的、实用的工具，用于测量与治疗依从性行为相关的因素。
