Development,Reliability And Validity Of The Self-Management Ability Scale For Atrial Fibrillation Patients

[Objective]In view of the lack of specific self-management ability assessment scale for patients with atrial fibrillation and the lack of scientific and effective assessment tools for the self-management ability of patients with atrial fibrillation,we should follow the standardized process of scale preparation and develop self-management of AF patients in line with Chinese cultural background.The reliability and validity of the scale were tested to provide a scientific measurement tool for clinical evaluation of self-management ability of patients with AF.[Methods](1)The theoretical framework of the scale was based on social cognitive theory,self-efficacy theory and self-management theory.(2)Based on the literature review of the self-management of AF at home and abroad,combined with semi-structured interviews with 10 AF patients and two rounds of Delphi expert correspondence with 16 experts,a pretest scale of selfmanagement ability of AF patients was developed.Nine patients of different ages(51-79 years old,average 63.00 ± 7.98 years old),educational level and occupation were selected from the outpatient department of atrial fibrillation and the ward of cardiovascular medicine.The content of the pre-test scale was adjusted according to the feedback results of the patients,so that the description of the scale was more clear,the content of the scale was more understandable,and the initial scale was formed.(3)The initial scale was used to investigate 160 patients with AF,and the statistical results were recorded into SPSS 23.0 statistical software for analysis.The extreme value method,correlation coefficient method and exploratory factor analysis method were used to analyze and screen the items of the scale to form a formal scale.Cronbach's ? coefficient and retest reliability were used to evaluate the reliability of the formal scale,and content validity and structure validity were used to evaluate the validity of the formal scale.[Results](1)The results of the scale construction: after literature research,the scale items pool with 3 dimensions and 20 items was initially formed;Through the semistructured interview of the target population,the content of the scale was supplemented and improved,and 4 items were added,forming the scale items pool with 3 dimensions and 24 items;After two rounds of expert consultation with 16 experts,4 scale items were added to form a pre-test scale for self-management ability of patients with atrial fibrillation containing 3 dimensions and 28 items.The effective recovery rate is 100%,the expert authority coefficients are 0.831 and 0.884,and the expert coordination coefficients are 0.168 and 0.216,respectively,and P<0.01 after chi-square test;Through the small sample pre-test of 9 patients with AF,the language description of individual items of the scale was adjusted to form the initial selfmanagement ability scale of patients with AF,which includes 3 dimensions and 28 items;Through the analysis and selection of the scale items by the research group,6 scale items were deleted in total,and the scale dimensions were modified into 5 dimensions,namely: compliance behavior management,bad habits management,emotion and social management,anticoagulant drug management,disease prevention and monitoring management.The final formal scale consisted of 5 dimensions and 22 scale items.(2)Reliability and validity test results: Cronbach's ? coefficient of the total scale is 0.811,and Cronbach's ? coefficient of the five dimensions is 0.756,0.884,0.683,0.810 and 0.621 respectively,which shows that the internal consistency of the scale is good.The retest reliability of the total scale is 0.927,and the retest reliability of the five dimensions are 0.823,0.934,0.895,0.838,and 0.872.The retest reliability of the total scale and each dimension of the scale was > 0.700,which was statistically significant(P<0.01).The content validity index(I-CVI)was 0.813-1.000,and the content validity index(S-CVI)was 0.926,which was good.Five common factors were extracted by exploratory factor analysis,and the cumulative variance contribution value was 56.49%.The load coefficient of each scale item on the corresponding factor was more than 0.400,and the load coefficient on other factors was very low,indicating that the structure validity was good.[Conclusions]This study follows the standardized process of the scale,and the self-management ability scale for patients with AF has good reliability and validity,which can be used to evaluate the self-management ability of patients with AF.