Development And Application Of Drug Self-management Scale For Patients With Inflammatory Bowel Disease

Objectives1.Develop a drug self-management assessment scale for patients with inflammatory bowel disease.Project analysis and reliability and validity tests were performed on this scale.To provide scientific and effective assessment tools for assessing the level of drug self-management in patients with inflammatory bowel disease.2.To understand the current situation of drug self-management in patients with inflammatory bowel disease by using the scale prepared in the previous period,and to explore the application effect of feedback method in drug self-management in patients with inflammatory bowel disease.MethodsThe study has four stages:The first step:According to the interview results,literature review methods and group discussion of patients with inflammatory bowel disease,the item pool of the scale was initially formed.Delphi expert consultation method was used for two rounds of expert correspondence,and the items were modified and pre investigated to form the initial scale.The second step:Patients with inflammatory bowel disease were selected for investigation,and items were further screened using item analysis;the validity of the scale was evaluated by structural validity and content validity;the reliability of the evaluation scale was evaluated using Cronbach’s α coefficient,split-half reliability,and retest reliability.The third step:64 patients with inflammatory bowel disease in a tertiary hospital were selected to investigate the current situation and analyze the influencing factors by using the drug self-management scale of inflammatory bowel disease patients.The fourth step:A total of 62 patients with inflammatory bowel disease in the first and second digestive departments of a third grade a hospital were selected as the experimental group and the control group.The control group was given regulareducation,the experimental group was given back education,statistical analysis of the drug self-management level of the two groups.Results1.Based on the results of interviews,literature review,and group discussion of patients with inflammatory bowel disease,a pool of items of the scale was initially formed,and then expert correspondence was conducted.The recovery rate of the first round of correspondences was 88.24%,the average number of entries was 3.6 to 4.7,the coefficient of variation of the entries was 0.09 to 0.13,and the degree of expert coordination was 0.228.The recovery rate was 100.00%,the average number of items was 3.8 to 4.8,the coefficient of variation of items was 0.09 to 0.12,the degree of expert coordination was 0.175,and the authoritative coefficient of experts in two rounds of consultation was 0.86.Combined with expert opinions and group discussion,3 items were modified,and the initial scale with 15 items was finally formed.2.After item analysis of the initial scale,the common values of item 1 and item3 are 0.13 and 0.18 respectively,and the factor load is 0.36 and 0.43 respectively,which are deleted;after exploratory factor analysis,item 8 and item 13 are both more than 0.4 in the two factor loads,but the difference is less than 0.15,which are deleted,and the formal scale finally contains 11 items.The total scale Cronbach’sαcoefficient is 0.87,the half-reliability is 0.77,and the retest reliability coefficient is 0.93.The content validity index of the items is 0.89 ~ 1.00;the content validity index of the consensus scale level is 0.81;the content validity index of the average scale level is0.97.3.The score of drug self-management level of 64 patients with inflammatory bowel disease was(15.88 ± 6.29).The level of drug self-management needs to be further improved.The age,education level and course of disease of patients with inflammatory bowel disease affect the level of drug self-management.4.After one month’s intervention on 62 patients with inflammatory bowel disease,the scores of drug self-management in the experimental group were significantly higher than those in the control group(P < 0.05);the scores of intestinalsymptoms and emotional functions in the experimental group were significantly higher than those in the control group(P < 0.05);however,there was no significant difference in the scores of social functions and systemic symptoms between the two groups(P>0.05).Conclusions1.After two rounds of expert consultation,the initial scale of drug self-management level of patients with inflammatory bowel disease was formed,with15 items in total,and the results were scientific and reliable.2.Four items were deleted by item analysis and exploratory factor analysis,and11 items of formal scale with good reliability and validity were formed by reliability and validity test.It can be used to evaluate the drug self-management level of patients with inflammatory bowel disease.3.The drug self-management level of patients with inflammatory bowel disease needs to be further improved.Nursing staff should consider the age,educational level and course of disease of patients when giving intervention measures.4.The feedback method can effectively improve the level of drug self-management in patients with inflammatory bowel disease and improve the intestinal symptoms and emotional function of patients.