Development And Preliminary Application Of Fluid Adherence Motivation Scale For Hemodialysis Patients Based On The Protection Motivation Theory

Objectives:(1)Based on the protection motivation theory,the theoretical framework and item pool of the fluid adherence motivation scale for hemodialysis patients were constructed.According to the expert consultation,project analysis and exploratory factor analysis,the item pool was selected to obtain the fluid adherence motivation scale of hemodialysis patients and test the reliability and validity of the scale,so as to provide a survey tool for the clinical evaluation of the fluid adherence motivation of hemodialysis patients(2)The scale was used for investigation to obtain the verification results of the scale and the status quo of fluid adherence motivation for hemodialysis patients as well as related influencing factors,so as to furnish consultation for subsequent studiesMethods:(1)Using the methods of literature review,theoretical analysis and patient interview,the research group discussed how to construct the item pool of the fluid adherence motivation scale for hemodialysis patients and determine the scoring method of the scale(2)Delphi method was adopted to invite experts in relevant fields to conduct expert consultation until the experts agree to stop consulting,and the entries were screened and improved by experts' score of importance and opinions(3)The preliminary survey was performed on 170 eligible hemodialysis patients with an initial scale.According to the results of project analysis and exploratory factor analysis,the scale entries and structure were optimized.Cronbach‘s a coefficient,half-reliability,and retest reliability were used for reliability detect.Content validity and structure validity were used to assess the validity of the scale(4)The formal survey was performed on 550 qualified hemodialysis patients with a formal scale.Using confirmatory factor analysis to verify the degree of fitting between the scale and the theoretical structure,and the motivation status and influencing factors of the fluid adherence motivation of hemodialysis patients were analyzedResults:(1)An entry pool with 7 dimensions and 33 items was initially established,and the items of the scale were judged according to Likert 5-level scoring method(2)After two rounds of expert consultation,the results tended to be consistent,the items were screened and improved,and the initial scale with 30 items was finally formed.The positive coefficients of the experts were 87%and 100%respectively.The authority coefficient(Cr)was 0.854 and 0.869 respectively.Kendall concordance coefficients were 0.165 and 0.145(3)162 valid questionnaires were collected from the preliminary survey.The results of the project analysis showed that 5 items were not satisfy three or more indicators at the same time,so we deleted them.Seven common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 75.949%.Three items that did not meet the standard were deleted,and 22 items were retained,among which 13 reverse items were scored in reverse.Cronbach's a coefficient of the scale was 0.923,spearman-brown coefficient was 0.858,and retest reliability coefficient was 0.899.The content validity index of the scale was 0.987 The correlation coefficient between the scores of each dimension of the scale was between 0.336?0.518,and the correlation coefficient between the scores of each dimension and the total score was between 0.683?0.767(4)517 valid questionnaires were collected from the formal survey.The confirmatory factor analysis results of the scale:?2/df=1.107,GFI=0.965,CFI=0.997,PGFI=0.717,RMSEA=0.014.The scores of the fluid adherence motivation scale for hemodialysis patients ranged from 41 to 96,and the differences in the scores of the scale were statistically significant in the level of education,years of dialysis,and annual family income.The absolute value of regression coefficient of cultural independent variable was the largest in multiple linear regression analysisConclusion:(1)In this study,the fluid adherence motivation scale for hemodialysis patients was developed,which contains 7 dimensions and 22 entries,among which 13 reverse entries were scored in reverse.Higher scores represented better motivation for compliance.Moreover,the scale has good reliability and validity,which can be used to assess the fluid adherence motivation of hemodialysis patients,and provides a measurement tool for the clinical evaluation of the fluid adherence motivation of hemodialysis patients(2)In this study,the confirmatory factor analysis model was fitted well,indicating that the scale structure could be in consistent with the theory of protection motivation.The fluid adherence motivation for hemodialysis patients in this survey was at a medium level,and education level,years of dialysis and annual family income were the influencing factors.Among them,education level had the greatest impact on the fluid adherence motivation of patients,which laid a theoretical foundation for further research on relevant interventions.