| ObjectiveTo develop a KAP scale for young and middle-aged hypertensive patients,and evaluate the reliability and validity of the scale.Then to verify the fitness between the theoretical framework and the actual survey results.The mean norm,percentage norm and standard partial norm of the scale were established.The KAP scale can provide a scientific tool for assessing the level of KAP among young and middle-aged hypertensive patients,and give reference for the management of young and middle-aged patients with hypertension.Methods1.Preparing the KAP scale for young and middle-aged patients with hypertension through the literature reading method,in-depth interview method,the pool of items was established,which including 3 theoretical dimensions and 52 items.Twenty-five experts were asked to give their advice through two rounds of Delphi expert to form a pre-test scale.2.Testing reliability and validity of the KAP scale.A total of 429 patients aged 18-60 years old were surveyed using a pre-test scale.Through project screening,homogeneity analysis,validity analysis,and reliability analysis,the items were screened and refined to form a formal scale.3.Confirmatory factor analysis of the scale.A total of 366 hypertension patients aged 18-60 years were surveyed using a formal scale.The structural equation model of the scale was established by modeling the latent variables,and the model was evaluated using model fitting index to understand the the fitness between theory and status.4.Establishing the norm of Hunan Province.The 14 cities in Hunan Province were divided into two levels according to the level of economic development.A total of 2,037 patients were asked to fill in the formal scale who were from the cities chosen by random sampling.The mean norm,the percentage norm and the standard norm of the scale were constructed by calculating the mean,standard deviation,percentile,and Z-score.Results1.Expert consultation results.This research successfully consulted 25 experts who were from Changsha,Wuhan,Xi'an,Beijing,Guangzhou,Shanghai,Chengdu,Hangzhou,and they were also 8 universities,5 tertiary hospitals,2 hypertension research institutes.There are 12 experts who are major in the field of cardiovascular medicine,3 people in psychology,and 10 people in chronic disease prevention and control.The positive coefficient and coordination degree are good,and the geographical representation and subject representative of experts are better.The pre-test KAP scale for young and middle-aged hypertensive patients was established after two rounds of expert consultation which included three dimensions(hypertension knowledge,attitudes and beliefs in hypertension treatment,and health-related behavior improvement in hypertension)and 38 items.2.Test of the reliability and validity of the pre-test scale.The total content validity index of the KAP scale(pre-test)for young and middle-aged hypertensive patients was 0.98,and the content validity index of each item was 0.75~1.00;the cumulative variance interpretation rate of the 3-factor model was 54.70%,and the factor load of each item all reached the recommended standard of 0.4.With the blood pressure value <140/90 mmHg as the dividing line,all subjects were divided into a better blood pressure control group and a poor blood pressure control group,and an independent sample t test was performed on the two groups of data,and the results showed there were differences in the group(P<0.01).The correlation coefficient between the effect scale and the blood pressure management attitude and belief dimension score of the scale was statistically significant(P<0.01),showing a significant positive correlation(r=0.547).The correlation with the healthy behavioral dimension was not statistically significant(P>0.05).The total Cronbach's ? coefficient of the scale was 0.89,and the Cronbach's ? coefficient of the three dimensions were 0.84,0.81,0.86 respectively.3.Confirmatory factor analysis of the official scale.Two models were constructed by confirmatory factor analysis.The fitting indexes of the two models showed that except for RMSEA(model 1 was 0.116 and model 2 was 0.103),the other fitting indexes met the recommended criteria(model 1 and model 2 results were respectively for WRMR: 0.915,0.808,CFI: 0.913,0.924,TLI: 0.902,0.917).The results of the Differtest test showed that the Model 2 is better than that of Model 1.Knowledge has a direct impact on attitudes and behaviors.The regression coefficients are 0.730 and 0.752 respectively.Attitude has a direct impact on behavior.The regression coefficient is 0.665.The total corrective reliability of the scale is 0.817.The reliability of dimensions were 0.808,0.813,and 0.816,respectively.4.The norm of Hunan Province.The norm in Hunan Province includes the mean norm,the percentage norm and the standard partial norm,and also the models of age and gender variables was established separately.The overall mean norm: 93 points for the general population,93 points for men and 92 points for women;94 points for 18 to 45 years old and 91 points for 46 to 60 years old.Percentage norm: Men get up to 50% when getting 90 points,and 89 points among women,and 90 points among general population.The standard norm: 76 points represent the "general" level for men,and 77 points for women,and 81 points for general population.Conclusion1.The KAP scale for young and middle-aged hypertensive patients based on the KAP theory showed excellent reliability and validity.The theoretical framework of the scale is consistent with the actual survey results,which has good stability and can be used as a tool to assess the level of KAP among young and middle-aged patients with hypertension.2.The construction process of the norm in Hunan Province is known to be a scientific and reasonable method for measuring the level of KAP for young and middle-aged hypertensive patients in Hunan Province and the other area which has same economic level. |
PDF Full Text Request