老年慢性病患者用药安全素养量表的编制和信效度评价

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【中图分类号】R95 【文献标识码】A

【Abstract】 Objective To develop and validate a medication safety literacy scale for elderly patients with chronic diseases，and to provide evaluation criteria for the safe use of medication. Methods The initial 42-item scale was developed based on semi-structured interviews， preliminary research，and expert evaluation. Using a quota sampling approach，elderly patients with chronic diseases from selected counties （districts） in Gansu Province were recruited as study participants.They were randomly assigned to Sample land Sample 2 in a ratio of 2：5.Sample1 was used for exploratory factor analysis （EFA）to refine the scale.Sample 2 was used for confirmatory factor analysis （CFA）and to assess the scale's reliabilityand validity.Results A total of 975 patients were included in the study， with 282 assigned to Sample1.A total of 838 questionnaires of Sample2 were distributed，and 693 valid questionnaires were collected （effectiveness rate of 82.7% ）. The EFA results from Sample 1 supported a 3-dimensional structure consisting of 7 factors： cognition （theory， practice; 9 items）， beliefs （concerns， necessity; 10 items），and behavior （medication selection，use，and storage; 13 items），yielding a final 32-item formal scale.Based on Sample 2，the CFA indicated satisfactory model fit for each dimension： χ2/ df ratios were 3.027，4.830，and 4.597; RMSEA values were 0.054，0.074，and 0.072，respectively; AGFI values were 0.957，0.925，and 0.912， respectively. The average variance extracted （AVE） >0.5 and composite reliability （CompR） >0.7 ，indicating good convergent validity of the scale; with each dimension being highly correlated with the overallscale，the correlation coeffcients were 0.46-0.68，where the correlation coeffcient for concern beliefs was -0.46 （P<0.01） ！ The absolute values of the correlation coeffcients between each itemand its corresponding domain （0.52-0.78） （号 （P<0.05） ，indicating good scale content validity index （I-CVI）.The Cronbach's α coefficients for factors and dimensions range from 0.71 to 0.87，andthe split-half reliabilityranges from 0.73 to 0.89，indicating good scale reliability. Conclusion The developed medication safety literacy scale for elderly patients with chronic diseases is a valid instrument to assess medication safety literacy in this population and can be promoted to use.

【Keywords】Medication safety literacy; Chronic diseases; Elderly patients; Reliability; Validity; Scale

第七次全国人口普查数据显示，我国60岁及以上人口达2.64亿人，占总人口的 18.7% ；其中患有慢性病的老年患者约1.9亿人，占老年人口总数的 72.0%[1] 。（剩余14004字）