| Objective:1.The traditional Chinese medicine health literacy scale for puerperal women was developed to provide an effective tool for evaluating the level of traditional Chinese medicine health literacy of puerperal women.2.Using the scale,to know the status of puerperal women’s health literacy level of traditional Chinese medicine and analyze the influencing factors,so as to provide reference for formulating targeted intervention measures.Methods:1.Scale development stage: Based on the social cognitive theory and with the three levels of the Health Literacy of Chinese Citizens-Basic Knowledge and Skills(2015 Edition)as the basic framework,the dimensions and item pool of the scale were initially formed by referring to the existing scales and questionnaires through literature research,semi-structured interviews and thematic group discussions.By Delphi expert letter consultation method,15 medical and nursing experts in the field of obstetrics and gynecology of traditional Chinese medicine were invited to evaluate the dimensions and items of the scale through two rounds of letter consultation.The expert authority coefficient(Cr),familiarity coefficient(Cs),judgment basis coefficient(Ca),score mean of each item,coefficient of variation and full score ratio were used as evaluation indexes.The draft of the scale was formed by adding,subtracting,modifying or merging items in combination with expert opinions and thematic group discussions.Twenty puerperal women who gave birth in a third-class Hospital of Integrated Traditional Chinese and Western Medicine in Nanning,Guangxi and recovered at home 7days after discharge were selected for a small sample pre-survey to form the initial scale.2.Scale reliability and validity test stage: Objective sampling method was used to select 255 puerperal women who gave birth from April to August2022 in a Grade-A Hospital of Integrated Traditional Chinese and Western Medicine and a Grade-A Hospital of Traditional Chinese Medicine in Nanning,Guangxi and recovered at home 7 days after discharge for clinical investigation.Coefficient of variation method,critical ratio method,Cronbach’s α coefficient method and correlation coefficient method were used to analyze the scale items.Internal consistency coefficient and broken half reliability were used to test the scale reliability,and content validity,exploratory factor analysis and correlation analysis were used to test the scale validity to form a formal scale.3.Scale application stage: Objective Sampling method was used to investigate 159 puerperal women who gave birth in a 3A Hospital of Integrated Traditional Chinese and Western Medicine in Nanning City,Guangxi Province from September to December 2022 and recovered at home7 days after discharge.Through univariate analysis and multiple linear regression analysis,the status quo of puerperal women’s health literacy level of traditional Chinese medicine was learned and its influencing factors were discussed and analyzed.Results:1.Scale development stage: A scale item pool consisting of 38 items from 3 dimensions(basic knowledge,healthy lifestyle and basic skills)was initially formed.The results of Delphi expert correspondence showed that the positive coefficient of experts in the two rounds was 100%,the expert authority coefficient was 0.880 and 0.904,and the Kendall W coordination coefficient was 0.318 and 0.329,respectively,P<0.001,and the difference was statistically significant.A total of 5 items were deleted,5 items were modified,1 item was added,2 items were merged into 1 item,and the draft of the scale was formed.After a small sample survey,an initial scale with 33 items including 3 dimensions was formed.2.Scale reliability and validity test stage: 2 items were deleted in item analysis;Two exploratory factor analyses were carried out on the remaining items,three items were deleted and three common factors were extracted.The cumulative variance contribution rate was 61.173%,and a formal scale with28 items in 3 dimensions was obtained.The validity test results showed that the level content validity index I-CVI of the scale item was 0.800～1.000(>0.78),the content validity index was 0.960(>0.9),and the correlation coefficient between each dimension of the scale was 0.443～0.633,and the correlation coefficient between each dimension and the total score of the scale was 0.765 ～ 0.885.The prompt scale has good validity.Reliability test results showed that the Cronbach’s α coefficient of the scale was 0.950 for the total scale,and the Cronbach’s α coefficient of each dimension was 0.881～0.945,all greater than 0.7.The partial half-reliability of the total scale was 0.957,and the partial half-reliability of each dimension was 0.860～0.939,indicating that the scale had good reliability.3.Scale application stage: The overall average score of traditional Chinese medicine health literacy of 159 puerperal women was 97.00(93.00,109.00),and the scoring rate was 71.21%,which was at the medium level.The score rates of basic knowledge,healthy lifestyle and basic skills were72.65%,71.68% and 68.00%,respectively.The results of multiple linear regression analysis showed that residence,occupation,number of full-term births and number of attending school courses were the factors influencing the overall level of TCM health literacy of puerperal women(P<0.05).The place of residence was the factor affecting the dimension of basic knowledge(P<0.05).The factors influencing the dimension of healthy lifestyle include:residence,occupation;The factors affecting the basic skills were residence and the number of pregnant women attending school courses(P<0.05).Conclusions:1.The traditional Chinese medicine health literacy scale for puerperal women developed in this study consists of 28 items from 3 dimensions(basic knowledge of traditional Chinese medicine,healthy lifestyle and basic skills of traditional Chinese medicine),which has good reliability and validity and certain practicability,and can be used as an assessment tool for the level of traditional Chinese medicine health literacy for puerperal women.2.Puerperal women have a certain level of traditional Chinese medicine health literacy,but it still needs to be further improved.Residence,occupation,the number of full-term births and the number of pregnant women attending school courses were the main factors affecting the level of traditional Chinese medicine health literacy of puerperal women. |
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