Development And Preliminary Application Of The Disease Recurrence Perception Scale For Patients With Inflammatory Bowel Disease

Objective1.To develop the disease recurrence perception scale for inflammatory bowel disease(IBD)patients and test its reliability and validity.2.To investigate the current status of the disease recurrence perception of IBD patients in China and analyze the influencing factors.Methods1.Development of the disease recurrence perception scale for IBD patients(1)The initial development of the item pool of the scale was based on the common sense model of self-regulation,combining with literature review and face-to-face semistructured interviews.A total of 21 experts from 10 provinces and cities across the country were invited to complete two rounds of Delphi expert consultation to preliminarily screen the items and dimensions of the scale.Using convenient sampling method,30 IBD patients were selected for pre-survey to test the readability and operability of the scale,and a pretest scale was formed after pre-survey.(2)The convenient sampling method was used to select IBD patients as the research objects from eight grade A tertiary hospitals in Shandong Province,Zhejiang Province and other places.A total of 278 patients were selected to be given pretest scales for further screening based on Classical Testing Theory and Item Response Theory to form a formal scale;And a total of 345 patients were selected to be given formal scales for reliability and validity test using content validity,structural validity,convergent validity,discriminant validity,Cronbach’s α coefficient,split-half reliability,and retest reliability.2.Application of the disease recurrence perception scale for IBD patientsThe convenience sampling method was used to select 254 IBD patients from a top three hospitals in Qingdao as the research objects.The general information questionnaire and the disease recurrence perception scale for IBD patients were used as survey tools.Descriptive statistics,univariate analysis and regression analysis were used to explore the current status of the disease recurrence perception of IBD patients and its related influencing factors.Results1.Development of the disease recurrence perception scale for IBD patients(1)Based on the results of literature review and face-to-face semi-structured interviews,the item pool of 6 dimensions and 70 items was initially formed.A total of two rounds of expert consultation were conducted in this study,the recall rates were 92.0%and 91.3% respectively;The authority coefficients were 0.918 and 0.937 respectively;The coordination coefficients were 0.367 and 0.414 respectively.After two rounds of Delphi expert consultation,a total of 20 items were deleted,5 new items were added,11 items were merged into 4 items,and 17 items were modified.After the pre-survey,the pretested scale included 6 dimensions and 48 items was constructed.(2)Based on the Classical Testing Theory,11 items were suggested to be deleted after item analysis;Based on the Item Response Theory,7 items were suggested to be deleted after item analysis.According to the screening criteria,resulting in a total of 12 items were removed after discussion by the research group.Exploratory factor analysis combined with scree plot,finally extracting six common factors.The cumulative variance contribution rate was 62.623%.The results of the reliability and validity test showed that the scale content validity was 0.944 and the item content validity ranged from 0.889 to 1.000;The confirmatory factor analysis showed that except for GFI=0.846,NFI=0.855 and RMSEA=0.054,the rest of the fitting indicators met the ideal standard(χ2/df=1.999,IFI=0.922,TLI=0.910,CFI=0.921),indicating that the model fit of 6-factor was acceptable;The average variance extracted of each dimension ranged from 0.404 to 0.669,the composite reliability of each dimension ranged from 0.626 to 0.937,and the correlation coefficient among the six dimensions was 0.211 to 0.690;The total Cronbach’s α coefficient,split-half reliability,and retest reliability of the scale were 0.915,0.963,and 0.870 respectively.2.Application of the disease recurrence perception scale for IBD patientsThe results of preliminary application showed that the total score of disease recurrence perception of IBD patients was(145.42±16.38),the cause dimension had the lowest score(3.60±0.63)and the consequence dimension had the highest score(4.28±0.64);The results of univariate analysis showed that gender,age,permanent address,medical payment method,duration of disease,current disease status,history of intestinal surgery,comorbidity were affecting recurrence perception of IBD patients(P<0.05);Multiple linear regression analysis showed the factors affecting the recurrence perception of IBD patients were the gender,age,medical payment method,duration of disease,current disease status,history of intestinal surgery and co-morbidity.Conclusions1.The disease recurrence perception scale for IBD patients developed in this study included 6 dimensions and 36 items.This scale had good reliability and validity.It could be used as a tool to assess the level of disease recurrence perception of IBD patients.2.The perception of disease recurrence in patients with inflammatory bowel disease needs to be improved,especially in the causal dimension.The main factors affecting the disease recurrence perception level of IBD patients were the gender,age,medical payment method,duration of disease,current disease status,history of intestinal surgery and comorbidity.It is suggested that medical staff should fully consider the psychosocial factors of patients in clinical work,and carry out targeted nursing intervention according to the characteristics of patients to improve patients’ cognitive level of disease recurrence and reduce negative perception of the consequences and emotions of disease recurrence.