The Construction And Status Survey Of The Self-management Ability Scale For The Patients With Lower Extremity Arteriosclerosis Obliterans

ObjectiveConstruction of lower extremity arteriosclerosis obliterans patients selfmanagement ability scale(LEASOPSMAS),provide appropriate assessment tool for clinical workers.To investigate patients with LEASO current situation and influencing factors of self-management ability,in order to provide the theoretical basis for clinical medical staff to provide individualized health guidance for patients Methods1.Construct the item pool of LEASO patients’ self-management ability scale:through literature review,clear LEASO patient self-management ability theory and relevant content.Based on the theory of self-management and team members to the discussion of the content,form a LEASO patient interview outline.Adopte purposive sampling method,select 10 patients with LEASO semistructured interview,understand LEASO patients self-management deficiencies and needs through Colaizzi phenomenological research data analysis,summarized the content of qualitative research analysis,preliminary build LEASO patient self-management ability scale item pool.2.Expert consultation and reliability and validity test: by means of objective sampling,21 experts in clinical medicine,clinical nursing and nursing management in the field of vascular surgery were selected for two rounds of expert consultation to add,delete and merge the items of the scale,so as to form the self-management ability scale of LEASO patients.The preliminary self-management ability scale of LEASO patients was used to investigate 182 LEASO patients in three grade iii class a hospitals in nanchang,all of whom met the inclusion and exclusion criteria.The items of the scale were further screened through item analysis,and the reliability and validity of the scale were tested to form the self-management ability scale of LEASO patients。3.Investigation of LEASO patients’ self-management ability: using convenience sampling method,175 patients with LEASO were selected as subjects according to inclusion and exclusion criteria,and they were treated in outpatient and inpatient departments of three grade iii class a hospitals in nanchang city.The self-designed general information questionnaire and self-management ability scale of LEASO patients were used to investigate the patients and analyze the general demographic characteristics and disease-related factors affecting the self-management ability of LEASO patients.Results1.Construct the item pool of LEASO patients’ self-management ability scale: through literature review and qualitative study,the first round of expert consultation form of LEASO patients’ self-management ability scale was formed,which included 4 dimensions and 33 entries.Among them,there are 19 items in the disease symptom management dimension,7 items in the daily life management dimension,3 items in the emotion management dimension and 4 items in the information management dimension.2.Expert consultation and reliability and validity test:(1)Results of expert consultation: in the two rounds of expert letter consultation,the active coefficient of experts was 100%,and the proportion of experts who proposed modification was 80.95% and 9.52% respectively.The authority coefficients of experts were 0.86 and 0.902 respectively.Kendall’s W 0.079~0.158,the chi-square difference was statistically significant(P<0.05).In two rounds of expert consultation for delete three items,add three items,the modified reservation 7 items,split one item for two items,merging two items for one item,formed preliminary LEASO patient self-management ability scale,which has 4 first-level indicators,10 secondary indexes,33 tertiary indicators.(2)Results of reliability and validity test: the results showed that the total Cronbach’s coefficient of the scale was 0.949,and the total split-half reliability was 0.868.Cronbach’s coefficients of the four dimensions were 0.944,0.851,0.806 and 0.833,and the split-half reliability of the four dimensions were 0.928,0.814,0.802 and 0.841,respectively.The retest reliability of the scale was 0.983.The content validity of each item in the scale is 0.889~1.000,and the content validity of this scale is 0.946.Finally,the self-management ability scale for LEASO patients consists of 4 dimensions and 33 items,19 items in the disease symptom management dimension,8 items in the daily life management dimension,3 items in the emotion management dimension and 3 items in the information management dimension.3.Investigation of LEASO patients’ self-management ability: the total score of self-management ability of LEASO patients was(90.39±23.33).The dimension with the highest score was the information management dimension,and the average score of the items was(2.92±0.84).The dimension with the lowest score was the daily life management dimension,and the average score of the items was(2.69±0.75).Multiple linear stepwise regression analysis showed that the main factors affecting the selfmanagement ability of patients with arteriosclerosis obliterans were age,BMI,educational level,residence and marital status.ConclusionsThe self-management ability scale of LEASO patients has good reliability and validity,which can be used to evaluate the self-management ability of LEASO patients.Patients with LEASO have poor self-management ability,insufficient understanding of disease knowledge,poor control of risk factors,poor emotional relief,and blocked information channels.The main factors affecting the self-management ability of LEASO patients are: age,BMI,educational level,residence,marital status.Therefore,medical staff should strengthen the health publicity work of LEASO patients,enrich the forms of health publicity,and improve the health publicity effect,so as to improve the self-management ability of LEASO patients.