The Study Of Compilation And Assessment In Chinese And Western Medicine Compliance Measurement Scale For Patients With Chronic Kidney Disease

ObjectivePatients with chronic kidney disease(CKD)have multiple dosage forms and require long-term uninterrupted use.In addition,Chinese CKD patients often use Chinese and Western medicines concurrently.The low compliance rate among patients with CKD is widespread.The self-reported scale is the most commonly used clinical method to assess patient compliance.However,there is still a lack of TCM and Western medicines drug compliance assessment scales for CKD patients.It is impossible to accurately assess patient compliance and analyze underlying causes.Based on the current situation of patients with CKD in China,this study makes a comparative study on the compliance of TCM and Western medicines in patients with CKD,and provides a reliable measuring tool for evaluating the compliance of patients with CKD in clinical research.MethodsIn the first stage,the study first developed a preliminary scale of 36 scales based on knowledge-belief-behavior(KABP model)under full literature study and research group discussion.Delphi method was used to conduct 3 rounds of expert consultations for 23 experts in the field of kidney disease.Comprehensive experts and research group’s opinions revised the first draft of the scale to form a preliminary draft of the prediction scale.In the second stage,20 predictors of CKD were adjusted through language adjustment and entry to form a predictive scale.This predictive scale was used to conduct a clinical investigation of 222 patients with CKD.Item analysis was performed using item analysis including critical ratio,item correlation analysis,internal consistency analysis,and principal component analysis to form a measurement scale.In the third stage,the reliability and validity of the measurement scale were evaluated,such as content validity,criterion-related validity,construct validity,Cronbach alpha coefficient,and retest reliability.Results(1)Delphi’s expert survey results:The expert authority score of three rounds is 0.784,0.80,0.78.The coefficient of variation of the index of item importance is 0.22,0.21,0.16,and all the item experts’ approval degree is greater than 30%.By using the demarcation method for the patient’s understanding of the degree of difficulty of the item,eight items are needed to determine language adjustment.By using the demarcation statistics on the index of the importance of items,10 items were deleted.Through the adjustment of the language and deletion of entries,a preliminary draft of the 34-item prediction scale was obtained.(2)Patient pre-survey:A preliminary survey was conducted on 20 CKD patients.After discussion,4 items were deleted,1 item was added,and language items were adjusted again for scale items and options to form a 31-item predictive scale.(3)Item analysis results:Statistics of 31 items of the predictive scale were used for statistical methods,such as critical ratio,item correlation analysis,internal consistency analysis,and principal component analysis.A total of 5 items were deleted,and finally,a formal scale containing 26 items and 3 dimensions is formed.(4)Testing of validity①Construct validity:Seven factors were obtained through exploratory factor analysis.The cumulative variance explained rate was 68.855%,which was basically consistent with the theoretical construction and had a good structural validity.According to the results of the exploratory factor analysis and the summary of the contents of the items,the scale is divided into five dimensions:taking basic medicine knowledge,boiling Chinese medicine knowledge,Chinese medicine medicine knowledge,medication beliefs,and medication behavior.②Content validity:Experts believe that scale items can clearly reflect the adherence of Chinese and Western medicine in CKD patients,the language is clear and easy to understand,there is no logic confusion,and the scale can be considered as having good content validity.③Criterion-related validity:The Pearson correlation coefficient between the scale score and the Morisky questionnaire score was 0.426,P<0.01.(5)Testing of reliabilityThe internal consistency coefficient of the total scale is 0.915;the internal consistency coefficients of each dimension are:0.831,0.930,0.835,0.439,0.732.The retest reliability of the total scale was 0.753;the retest reliability of all dimensions were 0.711,0.780,0.667,0.472,and 0.578,both statistically significant,P<0.01.ConclusionThis study completed the preparation of the Western Medicine Pharmacy Compliance Scale for CKD patients by using the Delphi method and classical measurement theory.After the scale of the project analysis,reliability and validity evaluation,factor analysis and other tests,the reliability and validity of the scale is better.It can be used as a tool for assessing the compliance of Chinese and Western medicines for CKD patients.