| Objective:(1)A scale of willingness to use appropriate techniques of traditional Chinese medicine in patients with type 2 diabetes was developed to provide an assessment tool for medical workers to understand the willingness to use appropriate techniques of traditional Chinese medicine in patients with T2 DM.(2)The scale was used to investigate the willingness to use appropriate techniques of TCM in patients with T2 DM and to analyze its influencing factors,so as to provide evidence for the subsequent formulation of targeted intervention measures to improve the willingness and utilization rate of appropriate techniques of TCM.Method:(1)Based on the integrated technology acceptance model and the health belief model,through literature review、semi-structured interview and using relevant questionnaires and scales for reference,A pool of items was constructed through group discussion to form the initial version of the scale;(2)By Delphi expert correspondence method,15 experts in this field were invited to conduct two rounds of evaluation.Based on expert opinions and suggestions,the research team adjusted,deleted or modified the scale items to form a revised scale;(3)A convenient sampling method was adopted to select30 patients with type 2 diabetes who met the inclusion and exclusion criteria in a third-class A hospital in Nanning in May 2022 for pre-investigation,and language debugging was conducted for each item.By the same method,256 patients with type 2 diabetes from three Grade A hospitals in Nanning City from June to August 2022 were selected for investigation.SPSS20.0 software was used for item analysis and reliability and validity test of the scale.Four methods were used for item analysis,including critical ratio method,correlation coefficient method,Cronbach’s α coefficient method and discrete trend method.Cronbach’s α coefficient method and split half reliability were used for reliability evaluation,and content validity and structure validity were used for validity evaluation.According to the results,the scale was adjusted and modified,and the official version of the Scale of Willingness to Use Appropriate Techniques in Traditional Chinese Medicine for Patients with Type 2 Diabetes was finally formed;(4)A total of 247 patients with type 2diabetes who met the inclusion and exclusion criteria from three Grade A hospitals in Nanning City from September to October 2022 were selected by convenience sampling method for confirmatory factor analysis.MannWhitney U test,Kruskal-Walis H test and multiple linear regression were used to analyze the influencing factors of general demographic data on the willingness to use appropriate techniques of traditional Chinese medicine in type 2 diabetes patients,and structural equation model was used to analyze the influencing factors of various dimension variables on the willingness to use appropriate techniques of traditional Chinese medicine in type 2 diabetes patients.Results:(1)The scale of willingness to use TCM appropriate technology for patients with type 2 diabetes was initially formed,including performance expectation(4 items),effort expectation(4 items),perceived disorders(7items),perceived threat(5 items),social influence(8 items),attitude to use(3items),willingness to use(5 items),a total of 7 dimensions,36 items;(2)The results of two rounds of Delphi expert correspondence showed that the recovery rates of the questionnaire were 100% and 94%,the authority coefficients of the experts were 0.88 and 0.91,the Kendall coordination coefficients were 0.192 and 0.208,the importance scores of the items were4.133 ~ 4.867,and the coefficient of variation was 1.867 ~ 1.870.Finally,4items were deleted,1 item was added,6 items were modified and adjusted,and 33 items in 7 dimensions were retained;(3)Item analysis and reliability and validity test: After item analysis by four methods,one item was deleted and a scale containing 32 items was obtained.Reliability test: the Cronbach,s a coefficient of the scale was 0.902,and the Cronbach,s a coefficient of each dimension was 0.813 ~ 0.935.The total broken half reliability is 0.741,and the broken half reliability of each dimension is 0.744 ~ 0.922.Validity test: 7factors were extracted from exploratory factor analysis,and the cumulative variance contribution rate was 72.525%.The content validity was 0.977,and the content validity at the item level was 0.875 ~ 1.000.The results of confirmatory factor analysis showed that the combination reliability was0.8483 ~ 0.9467,and the average variance extraction was 0.5366 ~ 0.8172.The square root of the average variance extraction of each dimension was greater than the correlation coefficient between this dimension and other dimensions,and the scale had good aggregation validity and discriminative validity.X2/df=1.987、RMSEA=0.063、RMR=0.064、TLI=0.917、IFI=0.926、CFI=0.925,the model fitting index reached the fit standard.It indicates that the scale has good reliability and validity;(4)The willingness to use appropriate techniques was(21.32±4.297)in patients with T2 DM.The other dimensions were performance expectation(15.98±3.288),effort expectation(18.03±3.691),perceived threat(16.09±3.243),perceived obstacle(13.74±4.321),social influence(28.81±4.139),and use attitude(12.74±2.351);(5)The results of structural equation model verification and multiple linear regression analysis showed that performance expectation,effort expectation,social influence,perceived threat and use attitude had positive effects on use intention,while perceived obstacles had negative effects on use intention.In terms of the influence effect,from the largest to the smallest,the influence was in the order of use attitude,social influence,performance expectation,effort expectation,perceived obstacle and perceived threat,and the influence effect coefficients were 0.514,0.246,0.137,0.114,-0.026 and 0.020,respectively.The results of multiple linear regression analysis showed that there were statistically significant differences in the level of willingness to use different genders and educational levels(p<0.05).Conclusion(s):(1)The reliability and validity of the Scale of Willingness to Use Appropriate Techniques in Traditional Chinese Medicine for patients with Type 2 diabetes designed in this study is good,which can be used as a reference for future relevant studies;(2)The willingness of patients with type 2diabetes to use TCM appropriate technology was relatively high;(3)Gender,education level,performance expectation,effort expectation,perceived threat,perceived barriers,social influence,and use attitude were the factors influencing the use intention of TCM appropriate technology in type 2diabetes patients. |
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