■受结核病影响的患者有多种未满足的支持性护理需求(SCN),这可能会严重影响他们的治疗依从性。准确评估患者SCN对于提供有效的以患者为中心的护理非常重要,但很少有仪器适合在临床实践中使用。因此,本研究的目的是开发结核病患者的SCN量表(SCN-TB),并评估其心理测量特性.
■基于SCN框架,SCN-TB是通过文献综述设计的,德尔菲咨询和试点研究。然后,采用便利抽样的方法,选取陕西省4所结核病专科医院550例患者,进一步检验SCN-TB的效度和信度。
■共有518名患者完成了调查。最终量表包含五个领域的25个项目:物理,实用,心理情感,社会,和信息。量表的内容效度为0.93,每个项目的效度范围为0.80至1.00。在探索性因子分析中确定了解释80.38%方差的五个因素。然后使用最大似然估计和自举进行验证性因子分析,确认了五因素模型。模型拟合指数为χ2/df=1.062(Bollen-Stineχ2=281.382,df=265,p<0.001),CFI=0.997,RMSEA=0.016,SRMR=0.053,NFI=0.951,GFI=0.929。所有因素均具有可接受的收敛效度和判别效度。克朗巴赫的α,半分,量表和重测信度系数分别为0.884、0.883和0.854。
■SCN-TB是一种有效且可靠的基于理论的评估结核病患者需求的工具,可应用于临床实践和研究。
UNASSIGNED: Patients affected by tuberculosis have diverse unmet supportive care needs (SCN) that may seriously affect their treatment adherence. Accurately assessing patients\' SCN is important for providing efficient patient-centred care, but few instruments are suitable for use in clinical practice. Therefore, the purpose of this study was to develop an SCN scale for patients with tuberculosis (SCN-TB) and to evaluate its psychometrical properties.
UNASSIGNED: Based on the SCN framework, the SCN-TB was designed via a literature review, Delphi consultation and pilot study. Then, 550 patients from four tuberculosis specialist hospitals in Shaanxi Province were enrolled by convenience sampling to further test the validity and reliability of the SCN-TB.
UNASSIGNED: A total of 518 patients completed the survey. The final scale encompasses 25 items in five domains: physical, practical, psycho-emotional, social, and informational. The content validity for the scale was 0.93, with that for each item ranging from 0.80 to 1.00. Five factors that explained 80.38% of the variance were identified in exploratory factor analysis. A five-factor model was then confirmed with confirmatory factor analysis using maximum likelihood estimation with bootstrapping. The model fit indices were χ 2/df=1.062 (Bollen-Stine χ 2=281.382, df=265, p<0.001), CFI=0.997, RMSEA=0.016, SRMR=0.053, NFI=0.951, and GFI=0.929. All factors had acceptable convergent and discriminant validity. The Cronbach\'s α, split-half, and test-retest reliability coefficients of the scale were 0.884, 0.883, and 0.854, respectively.
UNASSIGNED: The SCN-TB is a valid and reliable theory based tool for assessing the needs of patients with tuberculosis and can be applied in both clinical practice and research.