| Objective:To develop an empowerment scale for hypertensive patients in China,and test the reliability and validity of the scale to provide a measurement tool with acceptable reliability and validity for the the assessment of the empowerment of hypertensive patients and the development of nursing programs.Methods:Based on the theory of empowerment and the theory of internal strength,and through literature review,defining the concept of empowerment in patients with hypertension,establish 4 first-level indicators of inner experience,support resources,self-ability and behavioral practice,10 second-level indicators of self-perception,responsibility belief,professional support,etc.and 57 tertiary indicators.After 2 rounds of Delphi experts’ inquiries,the research team comprehensively considered the opinions of experts,constructed a pre-investigation scale of HPES-I for the assessment system of hypertension in patients with hypertension,including 4 first-level indicators,such as belief perception,social support,coping ability and behavioral practice,9 second-level indicators,such as self-perception,responsibility and belief,professional support,etc.and 41 tertiary indicators.Used the target sampling method,175 patients with hypertension who met the inclusion criteria were pre-surveyed with HPES-I,and 163 valid questionnaires were collected.Adopted discrete degree analysis method,correlation coefficient analysis method,and discrimination degree analysis method,and combined the patient’s comprehension ability and suggestion to modify the item in order to form the formal investigation version HPES-II of the empowerment evaluation system for hypertension patients.Used the target sampling method,500 patients with hypertension were formally investigated using HPES-II,and 472 questionnaires were effectively recovered.472 samples were randomly divided into 2 groups,236 in each group.One group was used for exploratory factor analysis and the other group was used for confirmatory factor analysis.Through the methods of discrete degree analysis,correlation coefficient analysis,discrimination analysis and factor analysis,the data were statistically analyzed for validity and reliability.Results:1.Validity of the scale(1)Content validity: After two rounds of Delphi expert inquiry,the Item-level Content Validity Index(I-CVI)of each item ranges from 0.800 to 1.000,and the Scale-level Content Validity Index(S-CVI)of the overall scale is 0.922.(2)Structural validity: Exploratory factor analysis use principal component method and 9factors are extracted,and the cumulative variance contribution rate is 73.806%.The confirmatory factor analysis fits the model structure of 9 factors.The results show that RMR=0.039,IFI=0.946,CFI=0.945,RMSEA=0.049,PGFI=0.689,2/df=1.565,indicating that the model fitting effect is good.(3)Convergence validity: The convergence validity of the first-level index ranges from0.578 to 0.648,and the convergence validity of the second-level indicator ranges from 0.439to 0.857.The convergence validity of the scale is good.(4)Differential validity: The differential validity of the first-level index ranges from0.760 to 0.805,and the differential validity of the second-level index ranges from 0.663 to0.926.The differential validity of the scale is good.(5)Internal correlation test: Pearson correlation coefficient between the first-level indicators ranged from 0.445 to 0.578,Pearson correlation coefficient between the first-level indicators and the aggregate table ranged from 0.738 to 0.845,Pearson correlation coefficient between the second-level indicators ranged from 0.134 to 0.658,Pearson correlation coefficient between the second-level indicators and the aggregate table ranged from 0.555 to0.825,and the internal correlation of the scale is good.2.Reliability of the scale(1)Cronbach’s alpha coefficient: Cronbach’s alpha of the total scale is 0.885,Cronbach’s alpha of the first index ranges from 0.649 to 0.867,and Cronbach’s alpha of the second index ranges from 0.488 to 0.904.(2)split-half reliability: the split-half reliability of total scaleis 0.805,the first-level index’s split-half reliability ranges from 0.595 to 0.641,and the second-level index’s split-half reliability ranges from 0.491 to 0.977.3.the Empowerment Scale of Hypertensive PatientsThis study finally constructed a formal version of the empowerment scale for hypertensive patients,which consisted of 4 first-level indicators: belief cognition,social support,coping ability and behavioral practice,9 second-level indicators such as self-perception,responsibility belief,professional support,etc.and a total of 31 third-level indicators.Conclusion:The empowerment scale of hypertensive patients has good reliability and validity,which can help medical staff to effectively evaluate the empowerment of hypertensive patients,and has certain guiding significance for the development of nursing work plan. |
PDF Full Text Request