高血压治疗态度与信念评价量表的研制及信效度评价  

Development and evaluation of an antihypertensive therapy related attitudes and beliefs scale in hypertensive patients

作　　者：唐红英[1] 李敏 江敏[3] 何海燕[1] 杨燕妮[1] 朱京慈[1] 

机构地区：[1]第三军医大学护理学院基础护理学教研室 [2]心理学教研室,重庆400038 [3]第三军医大学西南医院心血管内科

出　　处：《中华高血压杂志》2011年第9期861-866,共6页Chinese Journal of Hypertension

摘　　要：背景高血压患者对降压治疗的依从性差是血压控制不达标的最主要原因,尽管有研究表明改善患者对降压治疗的态度与信念有助于提高治疗依从性,但缺乏信效度较好的测量工具。目的研制高血压治疗态度与信念量表,并对其信度和效度进行评价。方法根据高血压防治内容,结合文献资料及访谈法建立量表条目池,经研究小组讨论及专家评定后形成预试量表。通过目的抽样方法选取404例来源于3所三级甲等教学医院、3家社区卫生服务中心的高血压患者进行调查。采用探索性因素分析、信度分析、相关分析等对量表的信度和效度进行评价。结果探索性因素分析共提取4个因子,与量表的理论建构基本相符,各条目在其因子的负荷值为0.468~0.846,累计方差解释率为50.75%。各因子与量表总分的相关系数为0.513~0.802（P〈0.01）,各因子之间的相关系数为0.160~0.302（P〈0.01）。服药治疗态度因子分与中文版Morisky服药依从性量表总分呈正相关（相关系数为0.511,P〈0.01）,量表总分与最近一月漏服降压药物次数之间呈负相关（相关系数为-0.481,P〈0.01）。高血压控制达标组的得分高于未达标组（P〈0.01）。量表总的Cronbachα系数为0.804,4个因子的Cronbachα系数为0.841、0.733、0.639、0.643。总量表的重测信度系数为0.922,各因子重测信度系数为0.859~0.936。结论研制的高血压治疗态度与信念量表具有良好的信度和效度,可以作为高血压患者认知评估及干预的测量工具。Background Uncontrolled high blood pressure is mainly caused by poor compliance to antihypertensive therapy in hypertensive patients.Despite some studies have showed that improving antihypertensive therapy related attitudes and beliefs might enhance compliance,a major problem in research is the lack of adequate reliability and validity measurement tool.Objective To develop an antihypertensive therapy related attitudes and beliefs scale（ATRABS）in hypertensive patients,and assess its reliability and validity.Methods The original item pool combining with the contents of Chinese guidelines for prevention and treatment of hypertension,literature review and in-depth interview were developed.After two rounds of research group discussion and experts evaluation,the new scale were developed.A total of 404 patients with hypertension in three community health service centers and three grade-A teaching hospitals were selected by purposive sampling.The reliability and validity of this scale were tested by exploratory factor analysis,reliability analysis and correlation analysis.Results It was found that four common factors extracted by exploratory factor analysis had well corresponded with the theoretical construction.Factor loading of each item ranged between 0.468 and 0.846.The 4 factors explained for 50.75% of total variance.The correlations between the subscales and the total scale were moderate to high,ranging from 0.513-0.802（P〈0.01）.The correlations between the subscales of the scale were moderate to low,ranging from 0.160-0.302（P〈0.01）.The correlations between the medication attitudes subscale and the morisky medication adherence scale was 0.511（P〈0.01）.And the correlation coefficients of the ATRABS scores to the omission times of taking antihypertensive medication was obvious negative-0.481（P〈0.01）.The total scores in blood pressure control group was significantly higher than that in uncontrolled blood pressure group（P〈0.01）.The scale was reliable（α=0.804）,and the subscales Cronb

关 键 词：高血压 态度 信念 量表 信度 效度 

分 类 号：R544.1[医药卫生—心血管疾病]