马来西亚慢性药物治疗患者中马来西亚药物依从性评估工具（MyMAAT）马来语版本的验证性因素分析
Confirmatory Factor Analysis of the Malay Version of the Malaysia Medication Adherence Assessment Tool (MyMAAT) Among Patients with Chronic Medications.
作者信息
Ong Gaik Tian, Abdullah Sarimah, Bachok Norsa'adah Binti
机构信息
Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
出版信息
Patient Prefer Adherence. 2024 Dec 21;18:2609-2620. doi: 10.2147/PPA.S475738. eCollection 2024.
PURPOSE
The bilingual Malaysia Medication Adherence Assessment Tool (MyMAAT) was developed using the Exploratory Factor Analysis (EFA) and the current study intended to confirm the measurement model, dimensionality and ensure the factor structure by the Confirmatory Factor Analysis (CFA). The objective of this study was to validate the Malay version of the MyMAAT in measuring medication adherence among participants with chronic medications.
PATIENTS AND METHODS
A cross-sectional study was conducted using a self-report questionnaire at five health clinics and a hospital in Kuala Lumpur and Putrajaya region between May to November 2023. The participants were selected using quota sampling and written informed consent was obtained from each participant prior to data collection. There are two constructs in the MyMAAT, namely the Specific Medication-Taking Behaviour (Factor 1) and the Social-Cognitive Theory of Self-Efficacy and Social Support (Factor 2).
RESULTS
Two hundred and thirty-five patients participated in the CFA study. The final model for the Malay version of the MyMAAT retained the two constructs and 12 items with good fit: CFI = 0.978, TLI = 0.973, RMSEA = 0.036 (90% CI 0.001,0.067) and with good composite reliability CR 0.790 for Factor 1 and 0.787 for Factor 2. The factor loadings ranged from 0.413 to 0.832 with -value < 0.001. The AVE for Factor 1 was 0.664 and for Factor 2 was 0.491. There was a strong correlation ( = 0.507, < 0.001) between the Malay version of the MyMAAT and the Malay version of the MMAS-8 by adherence category from the data of 191 participants. Twenty-six participants completed the test-retest after five to ten days from the first administration. The Malay version of the MyMAAT showed moderate to excellent with ICC 0.932 (95% CI: 0.661,0.986) for Factor 1 and poor to excellent for with ICC 0.956 (95% CI:0.325,0.997) for Factor 2 by using the Two-Way Mixed Model and Consistency type.
CONCLUSION
It is concluded that the Malay version of the MyMAAT is valid and reliable in measuring medication adherence among patients with chronic medications.
目的
双语版马来西亚药物依从性评估工具（MyMAAT）是通过探索性因素分析（EFA）开发的，本研究旨在通过验证性因素分析（CFA）来确认测量模型、维度并确保因素结构。本研究的目的是验证MyMAAT马来语版本在测量慢性药物治疗参与者的药物依从性方面的有效性。
患者与方法
2023年5月至11月期间，在吉隆坡和布城地区的五家健康诊所和一家医院使用自填式问卷进行了一项横断面研究。采用配额抽样选择参与者，并在数据收集前从每位参与者处获得书面知情同意书。MyMAAT中有两个结构，即特定用药行为（因素1）和自我效能与社会支持的社会认知理论（因素2）。
结果
235名患者参与了CFA研究。MyMAAT马来语版本的最终模型保留了这两个结构和12个项目，拟合良好：CFI = 0.978，TLI = 0.973，RMSEA = 0.036（90%置信区间0.001,0.067），因素1的组合信度CR为0.790，因素2的组合信度CR为0.787。因素载荷范围为0.413至0.832，p值<0.001。因素1的AVE为0.664，因素2的AVE为0.491。根据191名参与者的数据，MyMAAT马来语版本与MMAS-8马来语版本在依从性类别上存在强相关性（r = 0.507，p < 0.001）。26名参与者在首次给药后五至十天完成了重测。使用双向混合模型和一致性类型，MyMAAT马来语版本在因素1上的ICC为0.932（95%置信区间：0.661,0.986），显示出中等至优秀的信度，在因素2上的ICC为0.956（95%置信区间：0.325,0.997），显示出较差至优秀的信度。
结论
得出结论，MyMAAT马来语版本在测量慢性药物治疗患者的药物依从性方面是有效且可靠的。
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