脑卒中患者病耻感量表的编制及信效度检验
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摘要
目的编制脑卒中患者病耻感量表并进行信效度检验,为脑卒中患者病耻感测量提供评估工具。方法在质性访谈及文献回顾的基础上,根据脑卒中患者病耻感感知理论框架形成条目池;经过专家咨询后形成原始量表。采用原始量表对288例脑卒中住院患者进行调查。结果脑卒中患者病耻量表包括4个维度16个条目。各条目内容效度为0. 910～1. 000,量表内容效度为0. 989。探索性因子分析提取躯体障碍、社会交往、受歧视经历和自我感受4个因子,方差累积贡献率为68. 051%。量表及各维度得分与焦虑评分分呈正相关(P <0. 01)。总量表Cronbach'sα为0. 916,各维度Cronbach'sα为0. 771～0. 864。量表重测信度为0. 924(均P <0. 01),各维度重测信度为0. 735～0. 886(均P <0. 01)。结论脑卒中患者病耻量表具有较好的信效度,可从躯体障碍、社会交往、受歧视经历和自我感受4个方面有效地评估脑卒中患者病耻感状态,可作为脑卒中患者病耻感客观的评价工具。
Objective To compile the Stroke Stigma Scale,to test its reliability and validity,and to provide an evaluation tool for measuring stigma of stroke patients. Methods On the basis of qualitative interviews and literature review,an item pool was formed according to the theoretical framework of stigma perception in stroke patients. The original scale was formed after consultation. A total of 288 inpatients with stroke were selected,and were investigated by the original scale. Results The Stroke Stigma Scale consisted of 4 dimensions,totaling 16 items. The content validity indexes of the items ranged from 0.910 to 1.000,and the content validity index of the scale was 0.989. Four factors( physical disorder,social interaction,experience of discrimination and self-perception) were extracted through exploratory factor analysis,while the cumulative contribution rate of variance was 68. 051%. There was a positive correlation between total and dimension scores of stigma and scores of anxiety( all P < 0. 01). The Cronbach's α coefficient was 0. 916 for the scale,and 0. 771-0. 864 for the dimensions. The retest reliability coefficient was 0. 924 for the scale( P < 0. 01),and 0. 735-0. 886 for the dimensions( all P < 0. 01).Conclusion The Stroke Stigma Scale is reliable and valid,which can serve as an objective tool to evaluate stigma of stroke patients from four aspects: physical impairment,social communication,experience of discrimination and self-perception.
Objective To compile the Stroke Stigma Scale,to test its reliability and validity,and to provide an evaluation tool for measuring stigma of stroke patients. Methods On the basis of qualitative interviews and literature review,an item pool was formed according to the theoretical framework of stigma perception in stroke patients. The original scale was formed after consultation. A total of 288 inpatients with stroke were selected,and were investigated by the original scale. Results The Stroke Stigma Scale consisted of 4 dimensions,totaling 16 items. The content validity indexes of the items ranged from 0.910 to 1.000,and the content validity index of the scale was 0.989. Four factors( physical disorder,social interaction,experience of discrimination and self-perception) were extracted through exploratory factor analysis,while the cumulative contribution rate of variance was 68. 051%. There was a positive correlation between total and dimension scores of stigma and scores of anxiety( all P < 0. 01). The Cronbach's α coefficient was 0. 916 for the scale,and 0. 771-0. 864 for the dimensions. The retest reliability coefficient was 0. 924 for the scale( P < 0. 01),and 0. 735-0. 886 for the dimensions( all P < 0. 01).Conclusion The Stroke Stigma Scale is reliable and valid,which can serve as an objective tool to evaluate stigma of stroke patients from four aspects: physical impairment,social communication,experience of discrimination and self-perception.
引文
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[14]Anderson S,Whitfield K.Social identity and stroke:"they don't make me feel like,there's something wrong with me"[J].Scand J Caring Sci,2013,27(4):820-830.
[15]唐海玉.脑卒中患者病耻感的质性研究[J].护理实践与研究,2017,14(5):123-125.
[16]德威利斯·罗伯特.量表编制:理论与应用[M].重庆:重庆大学出版社,2004:62-64.
[17]梁瑞琼.心理评估与测量学[M].广州:高等教育出版社,2016:214-215.
[18]Chai Q,Yuan Z,Jin Y,et al.Factors influencing acceptance of disability among stroke patients in Tianjin,China:a cross-sectional study[J].NeuroRehabilitation,2016,38(1):37-44.
[19]孙振球,徐勇勇.医学统计学[M].4版.北京:人民卫生出版社,2014:490-492.
[20]史静琤,莫显昆,孙振球.量表编制中内容效度指数的应用[J].中南大学学报(医学版),2012,37(2):49-52.
[21]Visser M J,Kershaw T,Makin J D,et al.Development of parallel scales to measure HIV-related stigma[J].AIDS Behavior,2008,12(5):759-771.
[22]Paiva C E,Barroso E M,Carneseca E C,et al.A critical analysis of test-retest reliability in instrument validation studies of cancer patients under palliative care:a systematic review[J].BMC Med Res Methodol,2014,14(1):8.
[2]董强,郭起浩,罗本燕,等.卒中后认知障碍管理专家共识[J].中国卒中杂志,2017,12(6):519-531.
[3]周宏珍,周君桂.脑卒中健康管理[M].北京:军事医学科学出版社,2015:16-22.
[4]Link B,Yang L,Phelan J,et al.Measuring mental illness stigma[J].Schizophr Bull,2004,30(3):511-541.
[5]Mukherjee D,Levin R L,Heller W.The cognitive,emotional,and social sequelae of stroke:psychological and ethical concerns in post-stroke adaptation[J].Top Stroke Rehabil,2006,13(4):26-35.
[6]Sarfo F S,Nichols M,Qanungo S,et al.Stroke-related stigma among west Africans:patterns and predictors[J].JNeurol Sci,2017,375(4):270-274.
[7]邓翠玉,卢琦,赵岳.社区脑卒中患者病耻感现状及影响因素的研究[J].中国实用护理杂志,2017,33(14):1093-1097.
[8]邓翠玉,赵岳,卢琦.脑卒中患者病耻感的研究进展[J].中华护理杂志,2016,51(6):733-737.
[9]邓翠玉,卢琦,赵岳.慢性病病耻感量表的汉化及其在脑卒中患者中的信效度研究[J].中国全科医学,2017,20(34):4304-4309.
[10]Rao D,Choi S W,Victorson D,et al.Measuring stigma across neurological conditions:the development of the Stigma Scale for Chronic Illness(SSCI)[J].Qual Life Res,2009,18(5):585-595.
[11]中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379.
[12]Berger B E,Ferrans C E,Lashley F R.Measuring stigma in people with HIV:psychometric assessment of the HIVStigma Scale[J].Res Nurs Health,2001,24(6):518-529.
[13]Cataldo J K,Slaughter R,Jahan T M,et al.Measuring stigma in people with lung cancer:psychometric testing of the Cataldo Lung Cancer Stigma Scale[J].Oncol Nurs Forum,2011,38(1):E46-E54.
[14]Anderson S,Whitfield K.Social identity and stroke:"they don't make me feel like,there's something wrong with me"[J].Scand J Caring Sci,2013,27(4):820-830.
[15]唐海玉.脑卒中患者病耻感的质性研究[J].护理实践与研究,2017,14(5):123-125.
[16]德威利斯·罗伯特.量表编制:理论与应用[M].重庆:重庆大学出版社,2004:62-64.
[17]梁瑞琼.心理评估与测量学[M].广州:高等教育出版社,2016:214-215.
[18]Chai Q,Yuan Z,Jin Y,et al.Factors influencing acceptance of disability among stroke patients in Tianjin,China:a cross-sectional study[J].NeuroRehabilitation,2016,38(1):37-44.
[19]孙振球,徐勇勇.医学统计学[M].4版.北京:人民卫生出版社,2014:490-492.
[20]史静琤,莫显昆,孙振球.量表编制中内容效度指数的应用[J].中南大学学报(医学版),2012,37(2):49-52.
[21]Visser M J,Kershaw T,Makin J D,et al.Development of parallel scales to measure HIV-related stigma[J].AIDS Behavior,2008,12(5):759-771.
[22]Paiva C E,Barroso E M,Carneseca E C,et al.A critical analysis of test-retest reliability in instrument validation studies of cancer patients under palliative care:a systematic review[J].BMC Med Res Methodol,2014,14(1):8.