The Study Of Revision And Assessment In Chinese And Western Medicine Compliance Measurement Scale For Patients With Chronic Kidney Disease Based On Item Response Theory

ObjectiveBased on the item response theory,the Chinese and Western Medicine Compliance Scale(first edition)for CKD patients was revised to simplify the entry of the first edition of the scale,making it more suitable for clinical practice.The reliability,validity,difficulty,and discrimination of the revised edition scale were tested and compared to verify the quality of the revised scale.MethodsIn this study,the first version of the scale was analyzed using the Samejima Rank Response Model(GRM)in the item response theory model,and the discriminant parameters(a),difficulty parameters(b)and maximum information function peaks(Imax)of each item were calculated.According to the parameter interval and the actual situation,the items to be deleted are filtered to form a revised scale,and evaluated the internal consistency reliability,test-retest reliability,content validity,structural validity,and calibration-related validity of the revised scale.And again using the project response theory to analyze the revised scale,compare the discriminant degree,difficulty,and maximum information function peak of the scale before and after revision.Results(1)Revision of the scale:The first edition scale(26 entries)has a total of 16 items whose parameters do not meet the reference range after the project response theory analysis.However,in combination with the actual research situation,after the discussion and analysis,the research team deleted 11 items to form a revised version of 15 items.(2)Internal consistency reliability of the revised scale:The total Cronbach’ s a coefficient of the scale is 0.842,and the Cronbach’ s a coefficients of the three factors knowledge,belief,and behavior are 0.877,0.639,and 0.730,respectively.Most of the reliability coefficients are greater than 0.7,the internal consistency of the revised scale is good.(3)The test-retest reliability of the revised scale:the total test-retest reliability coefficient r is 0.909,and the test-retest reliability coefficients of the three factors are 0.905,0.828,and 0.796,respectively,and all the test-retest reliability coefficients are greater than 0.7.The scale has good stability.(4)The content validity of the revised scale:The revised scale covers the three dimensions of knowledge,belief,and behavior.There is no error in the language logic.The scale can achieve the research purpose,and the scale can be considered to have better content validity.(5)The structural validity of the revised scale:4 factors were obtained by exploratory factor analysis,the cumulative variance interpretation rate was 63.560%,and 4 factors were classified,and factor 1 and factor 2 were combined to obtain 3 factors:medication knowledge(items 1-9),medication behavior(items 13,14,15),medication beliefs(items 10,11,12),consistent with the structure of the revised scale,indicating that the revised scale has good structural validity.The degree of fit of the revised scale was evaluated by confirmatory factor analysis.Six of the nine fitted indices met the requirements for good fit.Overall,the revised scale had a good fit.(6)Correlation validity of the revised scale:The Pearson correlation coefficient of the revised scale and the morisky questionnaire is 0.349,P=0.00,the correlation between the two scales is low.(7)Theoretical analysis of the item response of the revised scale:the distinction and difficulty between the 2nd,4th,5th,6th,7th,9th,10th,11th,12th,14th and 15th items of the revised scale is significantly improved compared with the corresponding items in the first edition scale.The difficulty of items 1,3,and 13 of the revised scale is slightly lower than that of the first version of the scale.The difficulty and distinction of the 8th item of the revised scale have a significant increase compared with the first edition scale.Overall,the degree of discrimination and difficulty of the revised scale have been improved,and it is more moderate and reasonable compared with the first edition of the scale.ConclusionThis study revised the CKD patient’ s Chinese and Western Medicine Compliance Scale(first edition)through the item response theory,and formed a revised scale.The revised scale was reduced from 26 entries in the first edition to 15 entries.It was evaluated by classical measurement theory and item response theory,suggesting that the revised scale has good reliability,validity,discrimination and difficulty.The revised scale can be used for the evaluation of medication compliance of CKD patients.