基于中医理论的健康促进生活方式问卷的初步构建
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摘要
目的
充分挖掘中医理论中存在的对生活方式具有正向指导意义的理论,并以此为基础,借鉴国外和台湾地区生活方式的评价工具,采用系统量表开发技术,编制本问卷,为标准化评估中国国内人群的健康生活方式提供客观有效的依据。
方法：
1、采用文献研究法、头脑风暴法、专家咨询法编制基于中医理论的健康促进生活方式问卷条目池。
2、根据专业声誉及研究方向,选取相关领域15名专家,采用Delphi法对备选条目池进行2轮初筛,形成基于中医理论的健康促进生活方式问卷初版。
3、从信度、效度、反应度等方面对基于中医理论的健康促进生活方式问卷的初版进行考评。
4、选取广州市某一社区,随机抽取575例受试人群进行预调查,采用评价指标的应答率、因子分析法、评价条目与其维度的相关性分析等方法筛选条目,为下一步形成基于中医理论的健康促进生活方式问卷的修订版做准备。
结果：
1、基于中医理论的健康促进生活方式问卷条目池在充分挖掘中医理论对生活方式指导作用的基础上综合专家,中医临床医生以及中医院校学生对健康生活方式条目重要性评价结果,按预想结构归类成7个维度,73个条目构成的健康生活方式问卷条目池。
2、基于中医理论的健康促进生活方式问卷初稿
第一轮征询结果：
专家的积极系数为80%；12位专家对各条目评价的的均数在3.00-4.89之间,平均为4.03；专家对各条目重要性判断的总协调系数为0.32(X2=387.82),变异系数分别为0.16。按照重要性转换值均数大小排秩,结合专家对条目修改、合并及删除意见,得出7个维度,70个条目。.
第二轮征询结果：
专家的积极系数为100%；12位专家对各条目评价的的均数在2.83-5.00之间,平均为4.05；专家对各条目重要性判断的总协调系数为0.40(X2=255.96),变异系数分别为0.17。得出6个维度,54个条目的基于中医理论的健康促进生活方式问卷初稿。
3、基于中医理论的健康促进生活方式问卷初版的考评
①信度考评结果
基于中医理论的健康促进生活方式问卷6个维度和总的健康生活方式首次测试得分和间隔二周测试得分相关系数在0.542-0.875之间(p<0.001)；总的分半信度相关系数为0.61,各维度的分半信度在0.29-0.72之间；总的Cronbach'a系数为0.82,除运动维度的Cronbach'a系数为0.07,其他各维度的Cronbach'a系数在0.43-0.83之间。
②效度考评结果
问卷构成能够反映健康生活方式的真实情况,支持内容效度；采用因子分析评价结构效度,KMO统计量为0.73,Bartlett's球形检验卡方值为4776.15(p<000),适合于因子分析,经因子分析,得到19个公因子,其累计贡献率为64.66%。各因素与问卷的设计构想不同,结构效度较不理想,表明本问卷需要进一步对条目结构进行修订；各维度得分与问卷总分之间的相关系数均在0.42-0.74,除运动维度外,其余各维度的集合效度成功率均≥80%,说明各条目与维度之间有较好的相关性。
4、基于中医理论的健康促进生活方式问卷修订版
问卷回收有效率100%,经过因子分析法、删除条目后问卷的内部一致性信度分析、评价条目与其维度的相关性分析等方法对54个初选条目进行再筛选,筛选出6个维度,42个条目构成的基于中医理论的健康促进生活方式问卷修订版,并为下一步的研究做好准备。
结论：
1、本研究研制的基于中医理论的健康促进生活方式问卷包含饮食、睡眠、情志调养、运动、压力管理、环境及烟酒等6个维度,42个条目。
2、本问卷有较高的信度和一定的效度,可以作为测量普通人群健康生活方式的工具。
3、本问卷充分体现了中医理论对健康生活方式的指导意义,可以作为中医理论对广大人群进行健康指导的依据。
4、在本问卷的基础上可以进行进一步的研究,以不断优化研究结果,从而形成基于中医理论的健康促进生活方式问卷的终版。
Background
Lifestyle is life contents and methods of people everyday and it contains some unhealth customs that do harm to person's health besides individul all life behaviour. With the development of social economy and the improvement of the public health system and facilities, the diseases that resulting from lifestyle have become the chief criminals which can result in people's dealth. Now, lifestyle affecting individul's health has become the focus of the world and WHO points out that the sixty percent of individul's life and health is determinated by lifestyle.
In Chinese medicine theory there is some description about healthy lifestyle and it covers many aspects such as food, sleep, psychology and so on. Thousands of years of China history indicates the traditional theory can help people eliminate disease and prolong life. Today, people pay more and more attention to chinese medicine health rehabilitation and chinese medicine health rehabilitation has resulted in a wave of research in academic circles. Currently, the research about Chinese medicine theory guiding lifestyle tend to study some Chinese medicine theory guiding some action in mainland, for example, the food nursing theory of chinese medicien can help people establis healthy lifestyle of food. Because the content is scattered and unsystematic there is no tool to evaluate the whole lifestyle. Because of the diversities of language and cultural background and lack of the basement of Chinese medicine theory some international evaluation tools are not appropriate in mainland. Therefor, besed on these, the present study attemped to quantify people's lifestyld in mainland and explore guilding significance of Chinese medicine theory on lifestyle.
Objectives
To provide an objective and standard tool to estimate Chinese people's lifestyle in mainland the study fully excavates the Chinese medicine theory that has positive guilding significance on lifestyle and adopts the tools on evaluating life styles in Taiwan region and abroad using the systematic technology of developing scale.
Methods
1、An item pool of HLQ based on Chinese medicine theory is to be complied by adopting literature reviews, brain storm and expert consultation and interview.
2、 Totally15experts based on their professional reputation and research domain were selected to form a panel and the2round Delphi method was adopted to form the primary editon of HLQ.
3、 The validity and the reliability of the primary edition of HLQ were worked out from the data of totally500subjects from the selected community in GuangZhou.
4、 Totally500subjects from one selected community in GuangZhou to investigate via questionnaire, factor analysis, response rate, correlation coefficient between item and domain were adopted to further screen the items for HLQ.
Results
1、The item pool of HLQ based on Chinese medicine theory
The item pool of HLQ is established that consists of7domains and73items based on sufficiently excavating guilding significance of Chinese medicine theory on lifestyle and synthesizing the results of item importance of HLQ from experts, doctors and students from Chinese medicine college.
2、 The preliminary edition of HLQ based on Chinese medicine theory
①Result of the first round consultation
The positive coefficient of experts is80%. The means concerning authority coefficient of each item evaluated by12experts range from3.00to4.89, and the average is4.03. The total coordination oefficient(Kendall'W coefficient) of each item evaluated by12experts is0.32. The coefficient variation is0.17. The70items falling into7domains were obtained according to the mean of transformed importance value and experts'updated suggestion on the items.
②Result of the second round consultation
The positive coefficient of experts is100%. The means concerning authority coefficient of each item evaluated by12experts range from2.83to5.00, and the average is4.05. The total coordination oefficient (Kendall' W coefficient)of each item evaluated by12experts is0.40.The coefficient variation is0.16. The54items are observed to belong to6domains.
3. The evaluation of the preliminary edition of HLQ based on Chinese medicine
③The appraisal result of reliability
Cronbach a of total score Was0.82and that of6domains were observed to rangefrom0.43to0.83except for the domain of sport. Retest reliability of total score is0.735and that of6domains is from0.542to.875(p<0.001). The correlation coefficient of Spearman-brown split-half was0.61and hat of7domains goes from0.29to0.72(p<0.001).
④the appraisal result of validity
The content validity was supported by prophase research, and the items of the HLQ can reflect the real present situation of healthy lifestyles of people in mainland. The construct validity in factor analysis did not go well with the structure of the HLQ. The KMO statistic of0.73and Bartlett's test of sphericity with X2=4,776.15(p<000) suggested that the factor analysis could be performcd appropriately. The Spearman correlation coefficient of the6domains ranging from0.42to0.74. The success rate of converage validity of all domains except for sport are above80%suggests there is better correlation between items and domains.
4、 The revised edition of HLQ based on Chinese medicine
Totally575, accounting for100%, valid questionnaires were used for data analyses in this study, and the revised editon of HLQ is composed of6domains and49items obtained from further screen by2methods.
Conclusion
1、 The HLQ based on Chinese medicine theory contains6domains which are food, sleep, psycholoy, sport, stress control, environment, smoking and drinking and49items.
2、 The HLQ based on Chinese medicine theory has high reliability and some validity to indicate that it can evaluate the lifestyle of common persons as a kind of tool.
3、 The HLQ based on Chinese medicine theory demonstrates the guilding significance of Chinese medicine on lifestyle. So, it can be testimony of Chinese medicine guilding lifestyle of persons.
4、 Further research will be developed based on the questionnair and in the end the final edition of HLQ based on Chinese medicine will be obtained.
充分挖掘中医理论中存在的对生活方式具有正向指导意义的理论,并以此为基础,借鉴国外和台湾地区生活方式的评价工具,采用系统量表开发技术,编制本问卷,为标准化评估中国国内人群的健康生活方式提供客观有效的依据。
方法：
1、采用文献研究法、头脑风暴法、专家咨询法编制基于中医理论的健康促进生活方式问卷条目池。
2、根据专业声誉及研究方向,选取相关领域15名专家,采用Delphi法对备选条目池进行2轮初筛,形成基于中医理论的健康促进生活方式问卷初版。
3、从信度、效度、反应度等方面对基于中医理论的健康促进生活方式问卷的初版进行考评。
4、选取广州市某一社区,随机抽取575例受试人群进行预调查,采用评价指标的应答率、因子分析法、评价条目与其维度的相关性分析等方法筛选条目,为下一步形成基于中医理论的健康促进生活方式问卷的修订版做准备。
结果：
1、基于中医理论的健康促进生活方式问卷条目池在充分挖掘中医理论对生活方式指导作用的基础上综合专家,中医临床医生以及中医院校学生对健康生活方式条目重要性评价结果,按预想结构归类成7个维度,73个条目构成的健康生活方式问卷条目池。
2、基于中医理论的健康促进生活方式问卷初稿
第一轮征询结果：
专家的积极系数为80%；12位专家对各条目评价的的均数在3.00-4.89之间,平均为4.03；专家对各条目重要性判断的总协调系数为0.32(X2=387.82),变异系数分别为0.16。按照重要性转换值均数大小排秩,结合专家对条目修改、合并及删除意见,得出7个维度,70个条目。.
第二轮征询结果：
专家的积极系数为100%；12位专家对各条目评价的的均数在2.83-5.00之间,平均为4.05；专家对各条目重要性判断的总协调系数为0.40(X2=255.96),变异系数分别为0.17。得出6个维度,54个条目的基于中医理论的健康促进生活方式问卷初稿。
3、基于中医理论的健康促进生活方式问卷初版的考评
①信度考评结果
基于中医理论的健康促进生活方式问卷6个维度和总的健康生活方式首次测试得分和间隔二周测试得分相关系数在0.542-0.875之间(p<0.001)；总的分半信度相关系数为0.61,各维度的分半信度在0.29-0.72之间；总的Cronbach'a系数为0.82,除运动维度的Cronbach'a系数为0.07,其他各维度的Cronbach'a系数在0.43-0.83之间。
②效度考评结果
问卷构成能够反映健康生活方式的真实情况,支持内容效度；采用因子分析评价结构效度,KMO统计量为0.73,Bartlett's球形检验卡方值为4776.15(p<000),适合于因子分析,经因子分析,得到19个公因子,其累计贡献率为64.66%。各因素与问卷的设计构想不同,结构效度较不理想,表明本问卷需要进一步对条目结构进行修订；各维度得分与问卷总分之间的相关系数均在0.42-0.74,除运动维度外,其余各维度的集合效度成功率均≥80%,说明各条目与维度之间有较好的相关性。
4、基于中医理论的健康促进生活方式问卷修订版
问卷回收有效率100%,经过因子分析法、删除条目后问卷的内部一致性信度分析、评价条目与其维度的相关性分析等方法对54个初选条目进行再筛选,筛选出6个维度,42个条目构成的基于中医理论的健康促进生活方式问卷修订版,并为下一步的研究做好准备。
结论：
1、本研究研制的基于中医理论的健康促进生活方式问卷包含饮食、睡眠、情志调养、运动、压力管理、环境及烟酒等6个维度,42个条目。
2、本问卷有较高的信度和一定的效度,可以作为测量普通人群健康生活方式的工具。
3、本问卷充分体现了中医理论对健康生活方式的指导意义,可以作为中医理论对广大人群进行健康指导的依据。
4、在本问卷的基础上可以进行进一步的研究,以不断优化研究结果,从而形成基于中医理论的健康促进生活方式问卷的终版。
Background
Lifestyle is life contents and methods of people everyday and it contains some unhealth customs that do harm to person's health besides individul all life behaviour. With the development of social economy and the improvement of the public health system and facilities, the diseases that resulting from lifestyle have become the chief criminals which can result in people's dealth. Now, lifestyle affecting individul's health has become the focus of the world and WHO points out that the sixty percent of individul's life and health is determinated by lifestyle.
In Chinese medicine theory there is some description about healthy lifestyle and it covers many aspects such as food, sleep, psychology and so on. Thousands of years of China history indicates the traditional theory can help people eliminate disease and prolong life. Today, people pay more and more attention to chinese medicine health rehabilitation and chinese medicine health rehabilitation has resulted in a wave of research in academic circles. Currently, the research about Chinese medicine theory guiding lifestyle tend to study some Chinese medicine theory guiding some action in mainland, for example, the food nursing theory of chinese medicien can help people establis healthy lifestyle of food. Because the content is scattered and unsystematic there is no tool to evaluate the whole lifestyle. Because of the diversities of language and cultural background and lack of the basement of Chinese medicine theory some international evaluation tools are not appropriate in mainland. Therefor, besed on these, the present study attemped to quantify people's lifestyld in mainland and explore guilding significance of Chinese medicine theory on lifestyle.
Objectives
To provide an objective and standard tool to estimate Chinese people's lifestyle in mainland the study fully excavates the Chinese medicine theory that has positive guilding significance on lifestyle and adopts the tools on evaluating life styles in Taiwan region and abroad using the systematic technology of developing scale.
Methods
1、An item pool of HLQ based on Chinese medicine theory is to be complied by adopting literature reviews, brain storm and expert consultation and interview.
2、 Totally15experts based on their professional reputation and research domain were selected to form a panel and the2round Delphi method was adopted to form the primary editon of HLQ.
3、 The validity and the reliability of the primary edition of HLQ were worked out from the data of totally500subjects from the selected community in GuangZhou.
4、 Totally500subjects from one selected community in GuangZhou to investigate via questionnaire, factor analysis, response rate, correlation coefficient between item and domain were adopted to further screen the items for HLQ.
Results
1、The item pool of HLQ based on Chinese medicine theory
The item pool of HLQ is established that consists of7domains and73items based on sufficiently excavating guilding significance of Chinese medicine theory on lifestyle and synthesizing the results of item importance of HLQ from experts, doctors and students from Chinese medicine college.
2、 The preliminary edition of HLQ based on Chinese medicine theory
①Result of the first round consultation
The positive coefficient of experts is80%. The means concerning authority coefficient of each item evaluated by12experts range from3.00to4.89, and the average is4.03. The total coordination oefficient(Kendall'W coefficient) of each item evaluated by12experts is0.32. The coefficient variation is0.17. The70items falling into7domains were obtained according to the mean of transformed importance value and experts'updated suggestion on the items.
②Result of the second round consultation
The positive coefficient of experts is100%. The means concerning authority coefficient of each item evaluated by12experts range from2.83to5.00, and the average is4.05. The total coordination oefficient (Kendall' W coefficient)of each item evaluated by12experts is0.40.The coefficient variation is0.16. The54items are observed to belong to6domains.
3. The evaluation of the preliminary edition of HLQ based on Chinese medicine
③The appraisal result of reliability
Cronbach a of total score Was0.82and that of6domains were observed to rangefrom0.43to0.83except for the domain of sport. Retest reliability of total score is0.735and that of6domains is from0.542to.875(p<0.001). The correlation coefficient of Spearman-brown split-half was0.61and hat of7domains goes from0.29to0.72(p<0.001).
④the appraisal result of validity
The content validity was supported by prophase research, and the items of the HLQ can reflect the real present situation of healthy lifestyles of people in mainland. The construct validity in factor analysis did not go well with the structure of the HLQ. The KMO statistic of0.73and Bartlett's test of sphericity with X2=4,776.15(p<000) suggested that the factor analysis could be performcd appropriately. The Spearman correlation coefficient of the6domains ranging from0.42to0.74. The success rate of converage validity of all domains except for sport are above80%suggests there is better correlation between items and domains.
4、 The revised edition of HLQ based on Chinese medicine
Totally575, accounting for100%, valid questionnaires were used for data analyses in this study, and the revised editon of HLQ is composed of6domains and49items obtained from further screen by2methods.
Conclusion
1、 The HLQ based on Chinese medicine theory contains6domains which are food, sleep, psycholoy, sport, stress control, environment, smoking and drinking and49items.
2、 The HLQ based on Chinese medicine theory has high reliability and some validity to indicate that it can evaluate the lifestyle of common persons as a kind of tool.
3、 The HLQ based on Chinese medicine theory demonstrates the guilding significance of Chinese medicine on lifestyle. So, it can be testimony of Chinese medicine guilding lifestyle of persons.
4、 Further research will be developed based on the questionnair and in the end the final edition of HLQ based on Chinese medicine will be obtained.
引文
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