中国人群慢性病健康素养问卷的汉化及在脑卒中患者中的信效度检验  

Chinese version of chronic disease health literacy questionnaire in Chinese population and its reliability and validity test in stroke patients

作　　者：孙慧君[1] 梁绮雯[2] 张洁[1] SUN Hui-jun;LIANG Qi-wen;ZHANG Jie(Department of Nursing,Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200071,China;School of Nursing,University of Hong Kong,Hong Kong,999077,China)

机构地区：[1]上海中医药大学附属市中医医院护理部,上海200071 [2]香港大学护理学院,中国香港999077

出　　处：《职业与健康》2023年第3期339-345,共7页Occupation and Health

基　　金：上海市医院三年行动计划(SHCD2020CE3098B)。

摘　　要：目的 引入并汉化《中国人群慢性病患者健康素养问卷》,探讨其在脑卒中患者中的适用性。方法 2019年1—7月在上海市4家三级甲等医院采用方便抽样法对539名脑卒中患者采用简体汉化后的中国人群慢性病患者健康素养问卷,通过项目分析、总-分信度、重测信度、结构效度、聚合和区分效度、校标关联效度验证形成正式简体汉化问卷,并对在脑卒中患者中进行验证。结果 简体中文化后的问卷共13个条目高低分组之间差异均有统计学意义(均P<0.05)。总-分相关系数为0.317~0.442(均P<0.01),皮尔森相关系数(Pearson correlation coefficient,PCCs)=0.746(P<0.01)。重测信度PCCs>0.8。取样适当性指数(kaiser-meyer-olkin,measure of sampling adequacy,KMO)=0.914,能够提取探索性因子,验证性因子χ2自由度比值(chi-square of minimum discrepancy/degree of freedom,CMIN/DF)=1.544,均方差残根(root of the mean square residual,RMR)=0.024,比较拟合指数(comparative fit index,CFI)=0.969,规范拟合参数(normed fit index,NFI)=0.918,增值适配指数(incremental fit index,IFI)=0.969,拟合优度指数(goodness-of-fit index,GFI)=0.804,近似误差均方根(root-mean-square error of approximation,RMSEA)=0.066。标准化载荷值范围在0.702~0.991之间,4个维度的组合信度分别为0.980、0.868、0.918和0.936,4个维度的平均方差萃取量(average variance extracted,AVE)分别为0.803、0.623、0.742和0.787。区分效度中4个维度AVE的平方根分别为0.896、0.789、0.861、0.887,脑卒中患者健康素养总均分为(31.51±1.35)分,<36分。结论 中国人群慢性病患者健康素养问卷适用于脑卒中患者,脑卒中患者的健康素养处于中等水平。Objective To introduce and sinicize the Health literacy questionnaire for chronic disease patients in China,explore its applicability in stroke patients. Methods From January to July 2019,539 stroke patients were selected by convenience sampling method in four grade-A tertiary hospitals in Shanghai,and were investigated by the simplified Chinese version of health literacy questionnaire for chronic disease patients in China. The simplified Chinese version questionnaire was formed by the item analysis,total-sub reliability,retest reliability,structural validity,aggregation and differentiation validity,and calibration correlation validity verification,and was verified in stroke patients. Results There were statistically significant differences in 13 items in the simplified Chinese questionnaire between high and low groups(all P<0.05). The total-sub correlation coefficients were 0.317-0.442(all P<0.01),and the Pearson correlation coefficient(PCCs) was 0.746(P<0.01).The PCCs of retest reliability was >0.8. The kaiser-meyer-olkin measure of sampling adequacy(KMO) was 0.914,the exploratory factors were extracted,the chi-square of minimum discrepancy/degree of freedom(CMIN/DF)=1.544,root of the mean square residual(RMR)=0.024,comparative fit index(CFI) =0.969,normed fit index(NFI) =0.918,incremental fit index(IFI) =0.969,goodness-of-fit index(GFI) =0.804,root-meansquare error of approximation(RMSEA)=0.066. The standardized load values range was 0.702-0.991. The combination reliability of four dimensions was 0.980,0.868,0.918 and 0.936,respectively. The average variance extracted(AVE) amount of four dimensions was 0.803,0.623,0.742 and 0.787,respectively. The square root of AVE of the four dimensions in discriminant validity was 0.896,0.789,0.861 and 0.887,respectively. The average score of health literacy level of stroke patients was(31.51±1.35)points,which was <36 points. Conclusion Health literacy questionnaire for chronic disease patients in China is suitable for stroke patients,and the health literacy of stroke pati

关 键 词：脑卒中 健康素养 汉化 修订 

分 类 号：R181.2[医药卫生—流行病学]