全膝关节置换术患者居家康复训练依从性量表的编制及信效度检验
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摘要
目的构建全膝关节置换术患者居家康复训练依从性评估工具。方法参考相关文献联合讨论法形成初始全膝关节置换术患者居家康复训练依从性量表(依从性量表),进行2轮专家咨询,发放给176例全膝关节置换术患者检验其信效度。结果专家积极性为84.62%、81.82%,专家协调系数为0.332,专家权威系数为0.839;依从性量表含3个维度11个条目,累积方差贡献率为69.855%;I-CVI为0.889～1.000,S-CVI为0.978,3个维度及量表总的Cronbach′sα系数为0.747～0.885及0.850,各维度与总分的相关系数r为0.622～0.865。结论全膝关节置换术患者居家康复训练依从性量表编制合理,信度效度较好,可作为全膝关节置换术患者居家康复训练依从性评估工具。
Objective To develop an instrument for evaluating adherence to home-based rehabilitation among patients with total knee arthroplasty. Methods Based on literature review and group discussion, we developed an initial home-based rehabilitation adherence scale for patients with total knee arthroplasty. Then a 2-round expert consultation and a pilot survey with 176 patients with total knee arthroplasty were conducted to validate the scale. Results More than eighty percent(84.62% at round 1, 81.82% at round 2) of the experts returned the questionnaire. The Kendall′s coefficient of concordance(W) was 0.332 and the authority coefficient was 0.839. Exploratory factor analysis showed the scale included 3 dimensions and 11 items, which could explain 69.855% of the total variance. The item-level content validity index(CVI) ranged from 0.889 to 1.000 and the scale-level CVI was 0.978. The Cronbach′s α coefficients were 0.747-0.885 for 3 dimensions and 0.850 for the total scale. The correlation coefficients between dimension and the total scale ranged from 0.622 to 0.865. Conclusion The scale can be used to measure adherence to rehabilitation at home among patients with total knee arthroplasty for its rational development process and high reliability and validity.
Objective To develop an instrument for evaluating adherence to home-based rehabilitation among patients with total knee arthroplasty. Methods Based on literature review and group discussion, we developed an initial home-based rehabilitation adherence scale for patients with total knee arthroplasty. Then a 2-round expert consultation and a pilot survey with 176 patients with total knee arthroplasty were conducted to validate the scale. Results More than eighty percent(84.62% at round 1, 81.82% at round 2) of the experts returned the questionnaire. The Kendall′s coefficient of concordance(W) was 0.332 and the authority coefficient was 0.839. Exploratory factor analysis showed the scale included 3 dimensions and 11 items, which could explain 69.855% of the total variance. The item-level content validity index(CVI) ranged from 0.889 to 1.000 and the scale-level CVI was 0.978. The Cronbach′s α coefficients were 0.747-0.885 for 3 dimensions and 0.850 for the total scale. The correlation coefficients between dimension and the total scale ranged from 0.622 to 0.865. Conclusion The scale can be used to measure adherence to rehabilitation at home among patients with total knee arthroplasty for its rational development process and high reliability and validity.
引文
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[12] 潘海卿,席淑新,吴沛霞,等.鼻咽癌放疗患者院外康复训练依从性及其影响因素的调查[J].护理学杂志,2014,29(20):75-78.
[13] Chang C F,Lin K C,Chen W M,et al.Effects of a home-based resistance training program on recovery from total hip replacement surgery:feasibility and pilot testing[J].J Nurs Res,2017,25(1):21-30.
[14] Kim K,Pham D,Schwarzkopf R.Mobile application use in monitoring patient adherence to perioperative total knee arthroplasty protocols[J].Surg Technol Int,2016,28:253-260.
[15] 程宏,张娟芳,任庆宏.髋关节置换术后患者早期功能锻炼的依从性[J].解放军护理杂志,2010,27(3):431-435.
[16] Newman-Beinart N A,Norton S,Dowling D,et al.The development and initial psychometric evaluation of a measure assessing adherence to prescribed exercise:the Exercise Adherence Rating Scale (EARS)[J].Physiotherapy,2017,103(2):180-185.
[17] Hardage J,Peel C,Morris D,et al.Adherence to Exercise Scale for Older Patients (AESOP):a measure for predicting exercise adherence in older adults after discharge from home health physical therapy[J].J Geriatr Phys Ther,2007,30(2):69-78.
[18] Hawley-Hague H,Horne M,Skelton D A,et al.Review of how we should define (and measure) adherence in studies examining older adults′participation in exercise classes[J].BMJ Open,2016,6(6):e011560.
[19] McLean S,Holden M A,Potia T,et al.Quality and acceptability of measures of exercise adherence in musculoskeletal settings:a systematic review[J].Rheumatology,2017,56(3):426-438.
[2] World Health Organization.Adherence to long-term the-rapies:evidence for action[EB/OL].(2003-09-01) [2017-08-03].http://www.who.int/chp/knowledge/publications/adherence_full_report.pdf
[3] Frost R,Levati S,McClurg D,et al.What adherence measures should be used in trials of home-based rehabilitation interventions?A systematic review of the validity,reliability,and acceptability of measures[J].Arch Phys Med Rehabil,2017,98(6):1241-1256.
[4] 徐志晶,夏海鸥.德尔菲法在护理研究中的应用现状[J].护理学杂志,2008,23(6):78-80.
[5] 王海燕,许燕玲,胡三莲,等.自我效能增强干预对膝关节置换术病人膝关节功能的影响[J].护理研究,2015,29(7B):2526-2528.
[6] 芦凤娟.乳腺癌术后患者院外功能锻炼依从性及其影响因素的研究[D].广州:中山大学,2008.
[7] 林蓓蕾,张振香,孙玉梅,等.社区脑卒中患者功能锻炼依从性量表的编制及信效度检验[J].中国康复医学杂志,2013,28(6):574-578.
[8] 胡雁.护理研究[M].4版.北京:人民卫生出版社,2012:116-117.
[9] Insall J N,Ranawat C S,Aglietti P,et al.A comparison of four models of total knee-replacement prostheses[J].J Bone Joint Surg Am,1976,58(6):754-765.
[10] 崔念奇,甘秀妮,张传来,等.基于德尔菲法构建ICU患者身体约束评估量表[J].护理学杂志,2018,33(2):62-64.
[11] 吴明隆.问卷统计分析实务——SPSS操作与应用[M].重庆:重庆大学出版社,2010:158-235.
[12] 潘海卿,席淑新,吴沛霞,等.鼻咽癌放疗患者院外康复训练依从性及其影响因素的调查[J].护理学杂志,2014,29(20):75-78.
[13] Chang C F,Lin K C,Chen W M,et al.Effects of a home-based resistance training program on recovery from total hip replacement surgery:feasibility and pilot testing[J].J Nurs Res,2017,25(1):21-30.
[14] Kim K,Pham D,Schwarzkopf R.Mobile application use in monitoring patient adherence to perioperative total knee arthroplasty protocols[J].Surg Technol Int,2016,28:253-260.
[15] 程宏,张娟芳,任庆宏.髋关节置换术后患者早期功能锻炼的依从性[J].解放军护理杂志,2010,27(3):431-435.
[16] Newman-Beinart N A,Norton S,Dowling D,et al.The development and initial psychometric evaluation of a measure assessing adherence to prescribed exercise:the Exercise Adherence Rating Scale (EARS)[J].Physiotherapy,2017,103(2):180-185.
[17] Hardage J,Peel C,Morris D,et al.Adherence to Exercise Scale for Older Patients (AESOP):a measure for predicting exercise adherence in older adults after discharge from home health physical therapy[J].J Geriatr Phys Ther,2007,30(2):69-78.
[18] Hawley-Hague H,Horne M,Skelton D A,et al.Review of how we should define (and measure) adherence in studies examining older adults′participation in exercise classes[J].BMJ Open,2016,6(6):e011560.
[19] McLean S,Holden M A,Potia T,et al.Quality and acceptability of measures of exercise adherence in musculoskeletal settings:a systematic review[J].Rheumatology,2017,56(3):426-438.