用药生活问卷的汉化及其在社区老年多重用药患者中的信效度分析  

Development,Validity and Reliability of the Chinese Version of Living with Medicines Questionnaire in Communityliving Elderly Patients with Polypharmacy:a Cross-cultural Adaptation

作　　者：王永利[1] 张振香[1] 林蓓蕾[1] 郭亚雯 符博 WANG Yongli;ZHANG Zhenxiang;LIN Beilei;GUO Yawen;FU Bo(School of Nursing and Health,Zhengzhou University,Zhengzhou 450001,China)

机构地区：[1]郑州大学护理与健康学院,河南省郑州市450001

出　　处：《中国全科医学》2020年第15期1864-1872,共9页Chinese General Practice

基　　金：河南省重大科技专项科技攻关项目(182102310198);河南省教育厅人文社会科学研究项目(2018-ZZJH-547);郑州大学护理与健康学院社区多重慢病患者药物素养及服药自我管理干预研究项目(2018-hlxyxk-11)。

摘　　要：背景多重用药负担是影响患者用药信念、用药依从性和用药安全的核心要素,医务人员以患者用药负担为中心进行评估,可及时发现其用药过程中亟需解决的问题、制定科学化的药物干预方案,但目前国内尚且缺乏科学、有效的工具来评价患者多重用药负担。目的汉化用药生活问卷(LMQ)并分析其在社区老年多重用药患者中的信效度,为明确社区老年多重用药患者用药负担现况提供测量工具。方法采用正译、校对、回译、专家审核、认知性访谈、预调查对LMQ进行汉化,最终形成了包括8个维度39个条目的中文版LMQ(初始版)。2019年4-8月,采用便利抽样法选取郑州市3家社区卫生服务中心〔郑州市社区卫生服务中心(东二街)、林山寨社区卫生服务中心、高新区科学大道社区卫生服务中心〕下属社区中老年多重用药患者为调查对象。本研究第一阶段收集数据用于探索性因子分析,最终确定样本量为260例;第二阶段用于重测信度评估,重测间隔时间为2~4周,最终确定样本量为30例(从第一阶段患者中采用随机数字表法选取);第三阶段用于验证性因子分析,最终确定样本量为373例。采用一般资料调查问卷、中文版LMQ(初始版)对其进行调查,评价中文版LMQ(初始版)的信效度。结果第一阶段共发放问卷260份,回收有效问卷242份,有效回收率为93.1%;第二阶段共发放问卷30份,回收有效问卷30份,有效回收率为100.0%;第三阶段共发放问卷373份,回收有效问卷350份,有效回收率为93.8%。项目分析结果显示,中文版LMQ(初始版)各条目得分与其总分的相关系数为0.317~0.658(P<0.01);中文版LMQ(初始版)各条目决断值(CR)均>3.0。探索性因子分析结果显示,中文版LMQ(初始版)的KMO值为0.875,Bartlett's球形检验的χ^2=8139.877,P<0.01,表明适合做因子分析;共提取出特征根>1.000的公因子有8个,累积方差贡献率为76.780%,各条目�Background Polypharmacy burden is a core factor that affect patients'medication beliefs,medication compliance,and medication safety.By evaluating the patient's medication burden in time,healthcare workers may find out the problems that need to be solved in the process of medicine use,by which a scientific drug intervention plan may be formulated.However,at present,there is a lack of scientific and effective tools to evaluate the patient's polypharmacy burden in China.Objective To translate the English version of Living with Medicines Questionnaire(LMQ)into Chinese,and test its reliability and validity in community-living elderly patients with polypharmacy,to provide a tool for assessing the medication burden in this group.Methods The Chinese version of LMQ(initial version)including 8 dimensions and 39 items was formed by using forward translation,proofreading,back translation,expert review,cognitive interview and presurvey.From April to August 2019,convenience sampling was used to select elderly chronic disease patients with polypharmacy from communities served by three community health centers〔Zhengzhou Community Health Center(East 2nd Street),Linshanzhai Community Health Center,Science Avenue Community Health Center of Zhengzhou National High&New Industries Development Zone〕in Zhengzhou as the participants.In the first stage of this study,the data were collected for exploratory factor analysis,and the sample size was 260 cases.In the second stage,the reliability of the initial version of questionnaire was retested 2-4 weeks later in a sample of 30 cases randomly selected from the above-mentioned 260 cases.In the third stage,the data were collected for confirmatory factor analysis,with a sample of 373 cases.The investigation used the General Data Questionnaire and the Chinese version of LMQ(initial version).The validity and reliability of the final Chinese version of LMQ were evaluated overall.Results The questionnaire results of effective responders in the first,second,and third stages of this study〔242(9

关 键 词：多种药物疗法 老年人 社区 用药生活问卷 问卷调查 信度 效度 

分 类 号：R453[医药卫生—治疗学]