DAP-R中文版修订及在中老年基督教信徒中的应用
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
【目的】
     译制并修订中文版死亡态度描绘量表-修订版(Death Attitude Profile-Revised,DAP-R),并验证中文版量表在中老年基督教信徒中应用的信度和效度,为今后开展死亡态度研究提供一个简便易行的测量工具;了解中老年基督教信徒的死亡态度现状并分析中老年基督教信徒死亡态度的影响因素。
     【方法】
     遵循“翻译-回译-文化调适-预实验”的量表修订程序,首先完成了中文版DAP-R量表翻译和回译,经专家咨询及小样本访谈研究修正后,确定量表题目内容;对150名中老年基督教信徒进行调查,采用SPSS16.0软件包进行有效问卷的数据输入、处理和分析,对基本信息采用百分率、均数进行描述性统计,然后对数据进行因子分析、相关分析及信效度分析,用相关系数及内部一致性Cronbach'sα系数和Split-half折半系数等共同评价中文版DAP-R量表的信度和效度;最后采用均数、标准差、t检验、方差分析、相关分析等方法分析中老年基督教信徒死亡态度现状及其影响因素。
     【结果】
     中文版DAP-R量表包括5个维度,25个条目,每个维度有5个条目;各维度的Cronbach'sα系数在0.585~0.853之间,各维度的Split-half折半系数在0.598~0.809之间,总量表的Cronbach'sα系数和折半系数分别为0.840、0.843;量表条目的敏感性分析显示各条目的“去掉当前条目问卷的a系数”值均在0.835左右,变化幅度较小;因子分析产生7个因子,能解释总变异的67.075%,量表各条目均在其中一个公因子上有较高的负荷值,范围在0.529~0.872,且多数条目进入各自维度内,仅少数条目进入其他公因子;各条目与所属维度的相关系数在0.432~0.850之间(P<0.01);变异共同度分析显示公因子方差在0.505~0.790之间,均大于0.5,即原始标量信息有至少50%以上的方差可以由公因子来解释;被调查者趋近接受维度得分最高,其次是自然接受维度,死亡恐惧维度得分最低;被调查者的死亡态度(尤其是死亡恐惧维度)在信仰时间、阅读宗教相关书籍的频率,日常祷告频率、接受教会洗礼的支持因素、文化程度及居住方式上表现出不同;而在性别和健康状况上无差异性;死亡态度与年龄、文化程度及宗教行为如阅读书籍、祷告、忏悔等存在一定的相关性。
     【结论】
     DAP-R量表中文版作为跨文化应用工具,在中老年基督教信徒应用证实有较好的可接受性、信度及效度,符合测量学要求,具有较高的科学性和使用价值,仍需在更大样本更多人群中进行验证;中老年基督教信徒能正确认识和接受死亡,但是由于自身宗教信仰的原因,其趋近接受维度得分偏高。
[Objective]
     To develop a chinese version of Death Attitude Profile-Revised (DAP-R) and evaluate its feasibility, reliability and validity using in the chinese Christians, supply a simple and convenient instrument for Carrying out research on death attitudes; and assesse the attitude of death and analyze the influential elements of middle-aged Christians.
     [Methods]
     The standard of cross-culture adaptation was used to developed the chinese cersion of DAP-R. After undergoing forward and backward translation of the DAP-R by expert consultation and in-depth interview,150 Christians over 40 years old were recruited to complete the questionnaire and statistical analyses were performed with the SPSS 16.0 statistics package. The descriptive statistics were calculated including percentage、means and standard deviations(SD)for the domains of the scale;As well, factor analysis、correlation analysis、the Cronbach'sαand split-half coefficient were applied to establish the scale's construct validity and reliability. Finally,using T-test、variance analysis and correlation analysis to assesse the attitude of death and analyzing the factors that influencing the level of death attitudes of middle-aged Christians.
     [Results]
     The validated chinese version of DAP-R comprises of 25 items covering five dimensions;The Cronbach's a and Split-half coefficient of five domains were shown to be 0.585~0.853 and 0.598~0.809 respectivelity, the Cronbach's a and Split-half cofficient for the whole scale were 0.840 and 0.843 respectively; The result of the sensitivity analysis display that "Cronbach's Alpha if Item Deleted" of items were 0.835 or so with Small amplitude; The varimax rotation factor analysis of the DAP-R identified seven principal factors and explained for 67.075% variances; The majority of items has moderate to strong loading on its corresponding factors, they were from 0.529~0.872; The correlation coefficient between each item and its domain was from 0.432~0.850 (statistically significant); The result of the communalities analysis showed that extraction for each item was over 0.5. Middle-aged christians are able to understand and accept death correctly, furthermore, the score of approach acceptable is on the high side due to themselves' religious belief. Univariate analysis revealed a significant association between the respondents' death attitude and education level、Mode of living and religious informations, particularly in the dimension of fear of death,but there is no differences in gender and health; Besides, there is correlation between the respondents' death attitude and age、education level and religious informations.
     [Conclusions]
     The chinese version of DAP-R possesses acceptable validity and reliability in the setting of Christians and well meet the psychometric. And more in-depth study on the scale needs to be done in a wider population; Middle-aged christians are able to understand and accept death correctly, furthermore, the score of approach acceptable is on the high side due to themselves' religious belief.
引文
[1]陈四光,金艳,郭斯萍.西方死亡态度研究综述[J].国外社会科学,2006,(01):65-68.
    [2]陈四光,王美娟,郭斯萍.国外死亡态度量表发展述评[J].通化师范学院学报,2006,27(3):71-73,
    [3]周德新.死亡态度论[J].湖南文理学院学报(社会科学版),2008,33(2):21-23.
    [4]Lester D.Experimental and correlational studies of the fear of death[J].Psychol Bull,1967,67(1):27-36.
    [5]Templer DI. Death anxiety as related to depression and health of retired persons [J]. J Gerontol,1971,26(4):521-523.
    [6]Klug L, Boss M. Factorial structure of the death concern scale[J].Psychol Rep, 1976,38(1):106.
    [7]Conte HR, Weiner MB, Plutchik R. Measuring death anxiety:conceptual, psychometric,and factor-analytic aspects[J].J Pers Soc Psychol,1982, 43(4):775-785.
    [8]Wong P,Reker G,Gesser G. Death Attitude Profile-Revised:A multidimensional measure of attitude toward death,in book, Neimeyer RA,Death Anxiety Handbook, [M].Washington DC:Taylor&Francis.1994:121-148.
    [9]Iranmanesh S,Savenstedt S,Abbaszadeh A.Student nurses' attitudes towards death and dying in south-east Iran[J].Int J Palliat Nurs,2008,14(5):214-219.
    [10]Dunn KS,Otten C,Stephens E.Nursing experience and the care of dying patients[J].Oncol Nurs Forum,2005,32(1):97-104.
    [11]Matsui M, Braun K. Nurses' and care workers' attitudes toward death and caring for dying older adults in Japan[J].Int J Palliat Nurs,2010,16(12):593-598.
    [12]陈四光,安献丽.436名大学生死亡态度分析[J].中国心理卫生杂志,2009,23(4):303-304.
    [13]马国亮.护理学校学生死亡态度现状研究[J].中共郑州市委党校学报,2008,(3):110-111.
    [14]尹慧丽.统计工作中调查问卷设计的质量控制[J].科学决策,2008,(9):31-33.
    [15]方积乾,陆盈.现代医学统计学[M].北京:人民卫生出版社,2002:127-131.
    [16]张文彤,董伟SPSS统计分析高级教程[M].北京:高等教育出版社2004:218-226.
    [17]张建端.《12~36月龄幼儿情绪社会性评估量表》修订研究[D].武汉:华中科技大学,2009.
    [18]孙振球,徐勇勇.医学统计学[M].北京:人民卫生出版,2007:531-541.
    [19]高宏杰.15FQ+量表中文版的修订及初步应用[D].西安:第四军医大学,2005.
    [20]Beck CT, Bernal H, Froman RD.Methods to document semantic equivalence of a translated scale[J].Res Nurs Health,2003 Feb,26(1):64-73.
    [21]Hilton A, Skrutkowski M.Translating instruments into other languages: development and testing processes[J].Cancer Nurs.2002 Feb;25(1):1-7.
    [22]Flaherty JA, Gaviria FM, Pathak D, et al. Developing instruments for cross-cultural psychiatric research[J].J Nerv Ment Dis,1988 May,176(5):257-263.
    [23]方积乾,陆盈.现代医学统计学[M].北京:人民卫生出版社,2002:124-127.
    [24]郝元涛,方积乾.生存质量测定量表等价性评价研究[J].中国行为医学科,2003,12(3):338-340.
    [25]卢奕云,田琪,郝元涛,等.儿童生存质量测定量表PedsQL4.0中文版的信度和效度分析[J].中山大学学报,2008,29(3):328-331.
    [26]Beaton DE,Bombardier C,Guilemin F, et al. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures [J].Spine. 2000,25(24):3186-3191.
    [27]方积乾.医学统计学与电脑实验[M].上海:上海科学技术出版社2001:246-251.
    [28]方积乾,孙振球.卫生统计学[M].北京:人民卫生出版社,2008:270-276.
    [29]孙海双.临床统计方法及SPSS应用[M].北京:科学出版社,2009:226-237.
    [30]MacCallum RC,Widaman KF,Zhang S.et al. Sample size in factor analysis [J].Psychol Methods.1999,4:84-99.
    [31]Wikstrom BM.Work of art dialogues:an educational technique by which students discover personal knowledge of empathy[J].Int J Nurs Pract.2001 Feb;7(1):24-9.
    [32]崔以泰,黄天中.关怀学—理论与实践[M].北京:中国医药科技出版社1992:95-101.
    [33]董佩芳,沈晓如,金莉莉,等.216例老年住院患者死亡态度的调查分析[J]. 中华护理杂志,2008,43(1):84-86.
    [34]董诗圆,曹新妹,董佩芳,等.住院老年患者对死亡的接受态度及其影响因素[J].上海护理,2004,4(1):11-14.
    [35]杨晶,刘玉春,杨萍.老年病房护士对死亡的态度与其个人经历的关系[J].现代护理,2006,12(1):91-92.
    [36]崔光成,赵阿勐,陈力.中年基督教信仰者心理健康状况及其影响因素的调查[J].神经疾病与精神卫生,2008,8(4):256-259.
    [37]Pevey CF,Jones TJ,Yarber A.How religion comforts the dying:a qualitative inquiry[J].Omega(westport),2008-2009,58(1):41-59.
    [38]Leung KK, Liu WJ, Cheng SY,et al.What do laypersons consider as a good death[J].Support Care Cancer,2009,17(6):691-699.
    [39]Grumann MM, Spiegel D.Living in the face of death:interviews with 12 terminally ill women on home hospice care[J].Palliat Support Care, 2003,1(1):23-32.
    [40]曾五一,黄炳艺.调查问卷的可信度和有效度分析[J].统计与信息论坛,2005,20(6):11-15.
    [41]Hays RD,Anderson R,Revicki D.Psychometric considerations in evaluating health-related quality of life measures[J].Quality of Life Research,1993, 2(6):441-449.
    [42]Iranmanesh S,Dargahi H,Abbaszadeh A. Attitudes of Iranian nurses toward caring for dying patients[J].Palliat Support Care,2008,6(4):363-369.
    [43]Braun M,Gordon D,Uziely B.Associations between oncology nurses' attitudes toward death and caring for dying patients.[J].Oncol Nurs Forum,2010 Jan,37(1):E43-9.
    [44]陈平雁,黄浙明SPSS13.0统计软件应用教程[M].北京:人民卫生出版社,2005:247-254.
    [45]Brazier JE,Harper R,Jones NM,etal. Validating the SF-36 health survey questionnaire:new outcome measure for primary care[J].BMJ,1992,Jul 18, 305(6846):160-164.
    [46]刘朝杰.问卷的信度与效度评价[J].中国慢性病预防与控制,1997,5(4):174-177.
    [47]王家良.临床流行病学-临床科研设计、测量与评价[M].上海:上海科学技术出版社,2009:365-368.
    [48]张晓萍.儿童家庭护理评估表的研制[D].上海:第二军医大学,2009.
    [49]姚祚星.中文版患者学习需求量表(PLNS)的研制及在冠心病患者中的初步应用[D].福州:福建中医学院,2009.
    [50]郭秀花.实用医学调查分析技术[M].北京:人民军医出版社,2005:261-301.
    [51]削顺贞.护理研究[M].北京:人民卫生出版社,2006:86-91.
    [52]王瑞.新疆高校维吾尔族女大学生宗教观现状调查分析[D].乌鲁木齐:新疆师范大学,2007.
    [53]沈晓茹,董佩芳,李慧文,等.住院老年患者死亡观及影响因素的调查分析[J].中华护理杂志,2004,39(8):568-570.
    [54]汪和美,刘丽华.84例晚期肺癌病人死亡态度的调查分析[J].中华护理杂志,2005,40(7):552-554.
    [55]Leung KK, Liu WJ, Cheng SY, etal.What do laypersons consider as a good death[J].Support Care Cancer,2009,17(6):691-699.
    [56]胡金生,中村俊哉,董光恒.大学生生死观量表的修订[J].中国心理卫生杂志,2005,19(7):470-472.
    [57]Nelson LD.Structual conductivness,personality characteristics and death anxiety [J]Omega(westport),2001,43(4):331-347.
    [58]Madnawat AV,Kachhawa PS. Age, gender and living circumstances: discriminating older adults on death anxiety[J].Death Stud,2007,31(8):763-769.
    [59]Power TL, Smith SM.Predictors of fear of death and self-mortality:an Atlantic Canadian perspective[J].Death Stud,2008,32(3):253-72.
    [60]Tang CS, Wu AM, Yan EC.Psychosocial correlates of death anxiety among Chinese college students[J].Death Stud,2002,26(6):491-499.
    [61]曾凡,曾铁英.护生对死亡的态度及其影响因素调查[J].护理学杂志,2007,10.22(20):6-8.
    [62]Suhail K,Akram S.correlates of death anxiety in pakistan[J].Death Stud,2002,26(1):39-50.
    [63]吴辉,曾铁英.医护人员对癌症终末治疗和死亡的态度及其影响因素的研究[J].护士进修杂志,2009,24(6):484-487.
    [64]Abdel Khalek AM,Lester D.Death anxiety as related to somatic symptoms in two cultures[J].Psychol Rep,2009,105(2):409-410.
    [65]Lockhart LK, Bookwala J,et al.Older adults' attitudes toward death:links to perceptions of health and concerns about end-of-life issues[J].Omega (Westport),2001,43(4):331-347.
    [66]梁丽萍.社会转型与宗教皈依:以基督教徒为对象的考察[J].世界宗教研究,2006,(2):72-81.
    [67]孙毅.试论新约的死亡观[J].复旦学报(社会科学版),2003,6:53-58.
    [68]Thune-Boyle IC,Stygall JA,Keshtgar MR,et al.Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature[J].Soc Sci Med,2006,63(1):151-164.
    [69]赵博伦,姜安丽.美国《护理学基础》教材思想性的评介[J].中华护理杂志,2006,41(10):956-958.
    [1]史宝欣.生命的尊严与临终护理[M].重庆:重庆出版社,2007,330-362.
    [2]陈四光,金艳,郭斯萍.西方死亡态度研究综述[J].国外社会科学,2006,(01):65-68.
    [3]刘自觉.死亡的多维界定及意义[J].太原师范学院学报(社会科学版),2007,6(1):52-56.
    [4]李小寒,尚少梅.基础护理学[M].北京:人民卫生出版社,2006,336-337.
    [5]王平,李海燕.死亡与医学伦理[M].武汉:武汉大学出版社,2005,15-21.
    [6]孟宪武.临终关怀[M].天津:天津科学技术出版社,2002,28-31.
    [7]郑晓江.宗教之生死智慧与人类的灵性关怀[J].南京师范大学文学学报,2005,12(4): 1-8.
    [8]周德新.死亡态度论[J].湖南文理学院学报(社会科学版),2008,33(2):21-23.
    [9]马国亮.护理学校学生死亡态度现状研究.郑州大学硕士学位论文.2006.
    [10]陈四光,王美娟,郭斯萍.国外死亡态度量表发展述评[J].通化师范学院学报,2006,27(3):71-73.
    [11]胡金生,中村俊哉,董光恒.大学生生死观量表的修订[J].中国心理卫生杂志,2005,19(7):470-472.
    [12]Russac RJ,Gatliff C,Reece M,et al. Death anxiety across the adult years:an ecamination of age and gender effects [J].Death Stud,2007,31(6):549-61.
    [13]陈金香.试析当代中国老年人生死观与生死态度之矛盾及其解决途径[J].江西师范大学学报,2008,41(1):36-41.
    [14]Power TL, Smith SM.Predictors of fear of death and self-mortality:an Atlantic Canadian perspective[J].Death Stud,2008,32(3):253-72.
    [15]Tang CS, Wu AM, Yan EC.Psychosocial correlates of death anxiety among Chinese college students[J].Death Stud,2002,26(6):491-499.
    [16]曾凡,曾铁英.护生对死亡的态度及其影响因素调查[J].护理学杂志,2007,22(20):6-8.
    [17]Suhail K,Akram S.correlates of death anxiety in pakistan[J].Death Stud,2002, 26(1):39-50.
    [18]吴辉,曾铁英.医护人员对癌症终末治疗和死亡的态度及其影响因素的研究[J].护士进修杂志,2009,24(6):484-487.
    [19]Abdel Khalek AM,Lester D.Death anxiety as related to somatic symptoms in two cultures[J].Psychol Rep,2009,105(2):409-410.
    [20]Lockhart LK, Bookwala J,et al.Older adults' attitudes toward death:links to perceptions of health and concerns about end-of-life issues[J].Omega(Westport), 2001,43(4):331-347.
    [21]汪和美,刘丽华.84例晚期肺癌病人死亡态度的调查分析[J].中华护理杂志,2005,40(7):552-554.
    [22]董佩芳,沈晓如,金莉莉,等.216例老年住院患者死亡态度的调查分析[J].中华护理杂志,2008,43(1):84-86.
    [23]Nelson LD.Structual conductivness,personality characteristics and death anxiety [J]Omega(westport),2001,43(4):331-347.
    [24]崔以泰,黄天中.临终关怀学—理论与实践[M].北京:中国医药科技出版社,1992:202-224.
    [25]董诗圆,曹新妹,董佩芳,等.住院老年患者对死亡的接受态度及其影响因素[J].上海护理,2004,4(1):11-14.
    [26]Pevey CF,Jones TJ,Yarber A.How religion comforts the dying:a qualitative inquiry[J].Omega(westport),2008-2009,58(1):41-59.
    [27]Grumann MM, Spiegel D.Living in the face of death:interviews with 12 terminally ill women on home hospice care[J].Palliat Support Care,2003, 1(1):23-32.
    [28]Leung KK, Liu WJ, Cheng SY, et al.What do laypersons consider as a good death[J]. Support Care Cancer,2009,17(6):691-699.
    [29]Weaver AJ, Flannelly KJ.The role of religion/spirituality for cancer patients and their caregivers[J].South Med J,2004,97(12):1210-1214.
    [30]Dezutter J,Soenens B,Luyckx K,et al.The role of religion in death attitudes: distinguishing between religious belief and style of processing religious contents[J]. Death Stud,2009,33(1):73-92.
    [31]Abdel Khalek A,Lester D.Religiosity and death anxiety:no association in Kuwait [J].Psychol Rep,2009,104(3):770-772.
    [32]Thune Boyle IC,Stygall JA,Stygall JA,et al.Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature[J].Soc Sci Med,2006,63(1):151-164.
    [33]周德新,黄向阳.论死亡教育[J].职业时空,2009,5(1):168-169.
    [34]Kim EH,Lee E.Effects of a death education program on life satisfaction and attitude toward death in college students[J].Korean Acad Nurs,2009,39(1):1-9.
    [35]钟小勤,李晓霞.死亡教育对住院肿瘤患者生死观及生存质量的影响[J].护理学杂志,2009,24(5):28-30.
    [36]Wong WY.The growth of death awareness through death education among University students in hong kong [J].Omega (westport),2009,59(2):113-28.
    [37]Iranmanesh S,Dargahi H, Abbaszadeh A, et al.Attitudes of Iranian nurses toward caring for dying patients[J].Palliat Support Care,2008,6(4):363-369.
    [38]Harrawood LK,White LJ, Benshoff JJ, et al.Death anciety in a national sample of united states funeral directors and its relationship with death exposure,age and sex[J].Omega(westport),2008-2009,58(2):129-146.
    [39]Dunn KS,Otten C,Stephens E.Nursing experience and the care of dying patients [J].Oncol Nurs Forum,2005,32(1):97-104.
    [40]梁红霞,陈爱初,萧美云.临床护士的死亡观和临终关怀心态的调查研究[J].护理研究,2007,21(5A):1164-1167.
    [41]陈四光,安献丽.436名大学生死亡态度分析[J].中国心理卫生杂志,2009,23(4):303-304.
    [42]Yang SC,Chen SF.The study of personal constructs of death and fear of death among Taiwanese adolescents[J].Death Stud,2009,33(10):913-940.
    [43]Madnawat AV,Kachhawa PS. Age, gender and living circumstances: discriminating older adults on death anxiety[J].Death Stud,2007,31(8):763-769.
    [44]Lester D.Experimental and correlational studies of the fear of death[J].Psychol Bull,1967,67(1):27-36.
    [45]Templer DI. Death anxiety as related to depression and health of retired persons [J]. J Gerontol,1971,26(4):521-523.
    [46]Klug L, Boss M. Factorial structure of the death concern scale[J].Psychol Rep, 1976,38(l):106.
    [47]Conte HR, Weiner MB, Plutchik R. Measuring death anxiety:conceptual, psychometric,and factor-analytic aspects[J].J Pers Soc Psychol,1982, 43(4):775-785.
    [48]Wong P,Reker G,Gesser G. Death Attitude Profile-Revised:A multidimensional measure of attitude toward death,in book, Neimeyer RA,Death Anxiety Handbook, Washington DC.Taylor&Francis.1994:121-148.
    [49]Iranmanesh S,Savenstedt S,Abbaszadeh A.Student nurses' attitudes towards death and dying in south-east Iran[J].Int J Palliat Nurs,2008,14(5):214-219.
    [50]马国亮.护理学校学生死亡态度现状研究[J].中共郑州市委党校学报,2008,(3):110-111.
    [51]杨晶,刘玉春,杨萍.老年病房护士对死亡的态度与其个人经历的关系[J].现代护理,2006,12(1):91-92.
    [52]Abdel-Khalek AM.Why do we fear death? The construction and validation of the Reasons for Death Fear Scale[J]. Death Stud,2002,26(8):669-80.
    [53]唐庆,唐泽菁.死亡教育漫谈[J].外国中小学教育,2004,12:28-33.
    [54]尧必文,蒋九愚,张有闻.死亡教育探析[J].中国职业技术教育,2010,10:76-78.
    [55]王云岭,郑林娟,孙洪岩.从医护人员的职责看死亡教育[J].中国医学伦理学,2004,17(5):36-38.
    [56]陈雅雪,韩跃红.从临终关怀看死亡教育[J].昆明理工大学学报,2006,6(4):15-18.
    [57]沈霞.死亡教育—生物学教育的新课题[J].生物学教学,2006,31(4):10-11.
    [58]米光明,郭清秀,赖建强.1393名居民死亡态度与死亡教育调查分析[J].中国健康教育,1994,10(6):14-18.
    [59]刘月霞.来自生命末端的殷切呼唤—论死亡教育[J].中华护理杂志,1995,30(7):428-429.
    [60]郭巧红,任小红,周丽娟,等.对护生开展死亡教育的探讨[J].护理研究,2009,23(2B):453-455.
    [61]刘秀娜,罗羽,周娟.医学院校开设死亡教育选修课的尝试[J].护理研究,2007,21(9):2334.
    [62]张华萍,周晓敏,韦永凤,等.生死观教育对家居晚期癌症病人生死观及生活质量的影响[J].中华护理杂志,2006,41(6):514-516.
    [63]宋哗.一个亟待关注的课题—生死教育[J].理论经纬,2003,2:21-24.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700