Zhang Yuying, Luo Li, Du Shuaihui, Hou Die, Zhang Yaling, He Limin, Zhou Lihua
Department of VIP Clinic Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
PLoS One. 2025 Jan 3;20(1):e0309630. doi: 10.1371/journal.pone.0309630. eCollection 2025.
The purpose of this study is to develop and validate the scale of health education demand of patients with HPV infection based on KANO model, so as to provide a tool for further exploring the types of health education demand and influencing factors of patients with HPV infection.
This study is a scale development and validation study using a three-stage cross-sectional design. In stage 1, a preliminary item pool is formed using literature review, semi-structured interviews and the Delphi method. In stage 2, six experts were invited to assess content validity. A cross-sectional survey was conducted on 1169 patients with HPV infection, Questionnaire results from 583 patients were used for exploratory factor analysis. In stage 3, the remaining 586 patients to validate the factor structure through confirmatory factor analysis.
In stage 1, an initial 35-item scale was developed and the items were transformed positive and reverse based on KANO model. In stage 2, Exploratory factor analysis formed a scale of 28 items in 5 factors: disease information demand, social support, emotional demand, family support and health education style demand. Cronbach's alpha was 0.940 for the entire scale and 0.7630.908 for the five subscales in the positive items, 0.955 for the entire scale and 0.7390.946 for the five subscales in reverse items. The content validity index of the scale: S-CVI/UA = 0.91, S-CVI/Ave = 0.98. In stage 3, the confirmatory factor analysis showed that the χ2/df, RMSEA, CFI and TLI of the positive items after four model modifications were 3.650, 0.067, 0.901, 0.888, and the SRMR value was < 0.001. The fitting of the five-factor model was good.
The KANO model based questionnaire on health education demand of HPV infected patients has good reliability and validity, and is suitable for the investigation of health education demand of HPV infected patients.
本研究旨在基于卡诺模型开发并验证HPV感染患者健康教育需求量表，为进一步探究HPV感染患者健康教育需求类型及影响因素提供工具。
本研究采用三阶段横断面设计进行量表开发与验证研究。第一阶段，通过文献回顾、半结构化访谈及德尔菲法形成初步条目池。第二阶段，邀请6名专家评估内容效度。对1169例HPV感染患者进行横断面调查，将583例患者的问卷结果用于探索性因素分析。第三阶段，对其余586例患者通过验证性因素分析验证因素结构。
第一阶段，初步形成了35个条目的量表，并根据卡诺模型对条目进行了正向和反向转化。第二阶段，探索性因素分析形成了一个包含28个条目的量表，分为疾病信息需求、社会支持、情感需求、家庭支持和健康教育方式需求5个因子。正向条目中整个量表的Cronbach's α系数为0.940，5个分量表的Cronbach's α系数为0.7630.908；反向条目中整个量表的Cronbach's α系数为0.955，5个分量表的Cronbach's α系数为0.7390.946。量表的内容效度指标：S-CVI/UA = 0.91，S-CVI/Ave = 0.98。第三阶段，验证性因素分析显示，经过4次模型修正后，正向条目的χ2/df、RMSEA、CFI和TLI分别为3.650、0.067、0.901、0.888，SRMR值<0.001。五因素模型拟合良好。
基于卡诺模型的HPV感染患者健康教育需求问卷具有良好的信效度，适用于HPV感染患者健康教育需求的调查。
