慢性阻塞性肺疾病患者自我管理量表的编制与考评  

Development and Evaluation of Self-Management Scale for Chinese Patients with Chronic Obstructive Pulmonary Disease

作　　者：张彩虹[1] 何国平[2] 李继平[1] 蔡小霞[1] 张华[1] 王海花[1] 

机构地区：[1]海南医学院国际护理学院,海南省海口市571101 [2]中南大学护理学院

出　　处：《中国全科医学》2011年第28期3219-3223,共5页Chinese General Practice

基　　金：海南省卫生厅立项课题(琼卫2009-40)

摘　　要：目的编制适合我国慢性阻塞性肺疾病(COPD)患者的自我管理量表。方法采用理论与经验相结合的方法,以Bandura社会认知理论、自我效能理论及自我决定理论作为编制量表的基本理论框架,通过专家咨询及访谈,形成初始问卷,然后选取443名COPD患者施测,形成包括5个分量表的COPD患者自我管理量表的预试本,最后,应用预试本对413名COPD患者施测,对问卷的信度、效度进行了检验。结果研制出由症状管理、日常生活管理、情绪管理、信息管理、自我效能五个维度共51个条目的 COPD患者自我管理量表。COPD患者自我管理量表3周重测信度为0.87,Cronbach'sα系数为0.92,分半信度系数为0.90,概化研究交互效应占总方差的68.62%,量表概化系数Ep2为0.92,可靠性指数Φ为0.90。COPD患者自我管理量表与慢性病自我管理行为量表总分相关系数为0.610,与慢性病自我效能量表总分相关系数为0.663,与第1 s用力呼气容积(FEVl)占预计值百分比的相关系数为-0.549,均具有统计学意义(P<0.05)。结论 COPD患者自我管理量表是可靠、有效、灵敏的,可应用于COPD患者的自我管理水平评价。Objective To develop self-management scale（SMS） for Chinese patients with chronic obstructive pulmonary disease（COPD）. Methods The development of SMS was based on the framework of Social-Cognitive Theory,Self-Efficacy Theory,Self-Determination Theory by Bandura via the combination of theories and experience.A total of 443 patients with COPD were interviewed and suggestions from experts had been considered before the initial questionnaire was formed.A preliminary scale consisting of 5 factors was developed.The reliability and validity of the scale were examined in 413 COPD patients. Results A SMS of 51 items involving 5 demensions（symptom management,daily life management,emotion management,information management and self-efficacy）for patients with COPD were developed and showed good reliability and validity.The test-retest correlation coefficient Cronbach′s α coefficient and split-half reliability coefficient of SMS for patients with COPD were 0.87,0.92 and 0.90,respectively.The generalizability analysis showed that generalizability coefficient Ep2 and reliability index were 0.92 and 0.90,respectively.The scale′s correlations with Chronic Disease Self-management Behavior Scale and Chronic Disease Self-efficacy Scale and FEV1 percent of predicted normal were 0.610,0.663,-0.549（P0.05）. Conclusion SMS for patients with COPD is reliable,valid and sensitive,and can be used to evaluate the self-management levels of patients with COPD.

关 键 词：肺疾病 慢性阻塞性 自我管理 信度 效度 

分 类 号：R563[医药卫生—呼吸系统]