针对心力衰竭患者的巴西版数字健康素养工具的心理测量学特性评估。
Evaluation of the psychometric properties of the Brazilian version of the Digital Health Literacy Instrument for individuals with heart failure.
作者信息
Aprile Daniele Cristina Bosco, da Costa Karina Aparecida Lopes, Ferretti-Rebustini Renata Eloah de Lucena, Santos Vinicius Batista, Yamaguchi Mirian Ueda, Lopes Camila Takáo
机构信息
Escola Paulista de Enfermagem, Universidade Federal de São Paulo, 754 Napoleão de Barros St, Zip code 04024-002, Vila Clementino, São Paulo-SP, Brazil.
Escola de Enfermagem da Universidade de São Paulo, 419 Dr. Enéas de Carvalho Aguiar Av, Zip code 05403-000, Cerqueira César, São Paulo-SP, Brazil.
出版信息
Int J Nurs Stud Adv. 2025 Jul 30;9:100391. doi: 10.1016/j.ijnsa.2025.100391. eCollection 2025 Dec.
BACKGROUND
Digital health literacy is a critical skill for heart failure self-care, which should be assessed through valid and reliable instruments.
OBJECTIVE
To evaluate the psychometric properties of the Brazilian version of the Digital Health Literacy Instrument in individuals with heart failure.
DESIGN
A psychometric study analyzing internal structure validity and reliability.
SETTINGS
The participants were recruited at the cardiomyopathy outpatient clinic of a public hospital in São Paulo, Brazil.
PARTICIPANTS
Outpatients with heart failure who used the internet.
METHODS
The instrument was administered to 127 individuals, with bootstrapping to 500. Internal structure validity and reliability were assessed through Exploratory and Confirmatory Factor Analyses. Dimensionality was determined via Parallel Analysis, and data extraction employed Robust MORGANA factor analysis. Measure of Sampling Adequacy and Kaiser-Meyer-Olkin were expected to be close to 1 and Bartlett's test should have < 0.05. Target explained variance was approximately 60 %, with factor loadings >0.3 and communalities >0.4. Fit indices (Comparative Fit Index, Tucker-Lewis Index and Goodness of Fit Index) should be approximately 1 and Root Mean Square Error of Approximation should be 0.05-0.08. Reliability was measured using ordinal alpha and McDonald's omega (>0.9).
RESULTS
A unidimensional model emerged. Five items were removed due to factor loadings <0.2, Heywood case, excessive residuals, and double saturation. The final 16-item model had Kaiser-Meyer-Olkin = 0.86, Measure of Sampling Adequacy >0.75, explained variance = 59 %, factor loadings 0.53-0.86, and communalities 0.28-0.74. Reliability was high (alpha= 0.94, omega= 0.95). The adjusted model showed Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99 and Goodness of Fit Index = 0.98 and Root Mean Square Error of Approximation = 0.07.
CONCLUSIONS
The Brazilian version of the Digital Health Literacy Instrument demonstrated strong internal structure validity and reliability for individuals with heart failure, supporting its use in research and clinical practice.
背景
数字健康素养是心力衰竭自我护理的一项关键技能，应通过有效且可靠的工具进行评估。
目的
评估巴西版数字健康素养工具在心力衰竭患者中的心理测量特性。
设计
一项分析内部结构效度和信度的心理测量研究。
地点
研究对象在巴西圣保罗一家公立医院的心肌病门诊招募。
参与者
使用互联网的心力衰竭门诊患者。
方法
该工具对127名个体进行施测，并进行500次自抽样。通过探索性和验证性因素分析评估内部结构效度和信度。通过平行分析确定维度，采用稳健的摩根纳因素分析进行数据提取。抽样适当性度量和凯泽 - 迈耶 - 奥尔金值预计接近1，巴特利特检验的p值应<0.05。目标解释方差约为60%，因子载荷>0.3，共同度>0.4。拟合指数（比较拟合指数、塔克 - 刘易斯指数和拟合优度指数）应约为1，近似误差均方根应为0.05 - 0.08。使用有序阿尔法系数和麦克唐纳欧米伽系数（>0.9）测量信度。
结果
出现了一个单维模型。由于因子载荷<0.2、海伍德情况、过多残差和双重饱和，删除了5个项目。最终的16项模型的凯泽 - 迈耶 - 奥尔金值 = 0.86，抽样适当性度量>0.75，解释方差 = 59%，因子载荷为0.53 - 0.86，共同度为0.28 - 0.74。信度较高（阿尔法系数 = 0.94，欧米伽系数 = 0.95）。调整后的模型显示比较拟合指数 = 0.99，塔克 - 刘易斯指数 = 0.99，拟合优度指数 = 0.98，近似误差均方根 = 0.07。
结论
巴西版数字健康素养工具在心力衰竭患者中显示出强大的内部结构效度和信度，支持其在研究和临床实践中的应用。
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