The Level And Influencing Factors Of Perceived Enactment Of Autonomy Among Elderly Patients

Objective:To establish a Simplified Chinese version of the PEA scale on the base of cross-cultural adaptation and evaluation of psychometric properties of the studied questionnaire;to investigate perceived enactment of autonomy among elderly patients,and comprehensively analyze and discuss its influencing factors by using a cross-sectional survey,aiming to help elderly patients hold and use their own autonomy,and then help them enhance self-care behaviors,shorten course of the disease,promote disease rehabilitation,reduce complication and recurrence rate and finally improve quality of life.Methods:There are two parts in the research,evaluation of reliability and validity of simplified Chinese version of the PEA scale and analysis of related factors.1.Reliability and validity test of Simplified Chinese version of the PEA scale The authorization under the premise of the original author Hwang HL and Lin HS,follow the current internationally accepted foreign scale introduction program.Finally the Simplified Chinese version of the PEA scale was determined.Using Cronbach' s alpha and1/2 scale reliability to evaluate the reliability of the scale,content validity and structure validity to test the validity of scale.2.To investigate the level of perceived enactment of autonomy among elderly patients and explore the influencing factors.A convenience sample of 400 respondents in 4 hospital in Taiyuan city,Shanxi Province were investigated by self-administered questionnaire which included the Simplified Chinese version of the PEA scale,Simplified Coping Style Questionnaire,LSIA and self-made general data questionnaire.To investigate the level of perceived enactment of autonomy among elderly patients.One-way analysis of variance,Pearson correlation and multiple linear regressions were used to test variables that were significantly correlated with the perceived enactment of autonomy.Results:1.Following the current internationally accepted foreign scale introduction program,finally confirmed the Simplified Chinese version of the PEA scale is composed of three dimensions of 21 entries.Freedom has 8 items,Individuality has 9 items.Independence has 4 items.2.The Cronbach's alpha coefficient of total table is 0.91,reliability coefficient of the subscales is 0.67~0.89;Split-half reliability of total table is 0.914,and Split-half reliability of the subscales is 0.584~0.865,showed that PEAS-CV has good reliability.Through cross-cultural adjustment and revision of the senior experts,all item content validity Index(I-CVI)of the PEAS-SCV ranged from 0.80~1.00.Scale-Level CVI(S-CVI)was 0.94,to ensure the content validity of the Simplified Chinese version of the scale.KMO and Bartlett's test show that suitable for factor analysis(KMO=0.89,2? =2146.11,P<0.001).Using exploratory factor analysis to examine the structure validity of scale.Using principal component analysis to extract the common factor,and to maximize the variation method of orthogonal rotation.Extracting the characteristic value of 1.0 or more factors get three common factors.The cumulative variance contribution rate is 53.85%,Each entry in the common factor load value is0.401 ~ 0.810.The above results show that good structure validity of the scale.3.The total score of PEAS-SCV was(61.33±8.51)points.The score of Freedom subscale was(22.63±4.55).The score of Individuality subscale was(27.15±3.92).The score of Independence subscale was(11.55±2.42).Among the three aspects of the perceived enactment of autonomy,the mean score of Individuality was(3.02±0.44),the mean score of Independence was(2.89±0.61),the mean score of Freedom was(2.83±0.57).4.Individuals' perceived enactment of autonomy were influenced by many factor.They are age,educational level,profession,economic sources,personal income medical care assurance,coping and life satisfaction.Conclusion:1.The Simplified Chinese version of the PEA scale can be applied in Chinese elderly patients since it had been tested as a reliable and valid tool in our study.2.The study of the influencing factors related to the perceived enactment of autonomy could facilitate researcher and nurse provider to investigate the level of perceived enactment of autonomy among elderly patients and make more individualized and operable interventions to help elderly patients hold and use their own autonomy,help them enhance self-care behaviors and finally improve quality of life.