Development And Reliability And Validity Of Fear Of Physical Activity Scale For School-Age Children With Asthma

Objective:1.Based on the fear-avoidance model(Fear-avoidance model,FAM)to explore the psychological experience of fear of physical activity in obese school-age children with asthma and their parents’ feelings about fear of physical activity in children were investigated,in order to providing evidence for the development of fear of physical activity scale for school-age children with asthma.2.Based on the fear-avoidance model(FAM)and qualitative study results,though literature review,group discussion and Delphi expert consultation to developed and verified fear of physical activity scale for children with asthma,to providing evidence for exploring potential fear of physical activity children with asthma and subsequent investigation of influencing factors of fear of physical activity in children with asthma.Method:1.Qualitative research:Objective sampling method was adopted to select 13 pairs of obese asthmatic children and their parents who were treated in the pediatric asthma clinic of a third-class hospital in Yangzhou from October 2021 to January 2022 as research objects.Descriptive phenomenological research method was applied to collect relevant data through semi-structured interview,and Colaizzi 7-step analysis method was adopted to analyze the interview data.2.Scale compilation:Established a research group,based on the fear-avoidance model(FAM)and qualitative research results,through literature review,experts consultation and group discussion to preliminarily determine the item of the scale.Twenty pediatric clinical medical staff,nursing management,nursing pedagogy,psychology and kinesiology experts from Yangzhou,Jiangsu Province were selected by Delphi expert letter consultation method.Two rounds of expert letter consultation were conducted by sending emails or questionnaires on site.According to the importance of items,the mean value of items,the coefficient of variation of items and expert opinions,some items were added,deleted and modified.Twenty groups of children with asthma and their parents were pre-investigated to form the initial scale of fear of physical activity scale for school-age children with asthma.3.Scale measurement:According to the principle of convenient sampling method,197 school-age children with asthma and their parents who met the inclusion and exclusion criteria in a Grade A hospital in Yangzhou City from July 2022 to December 2022 were selected to investigate the initial fear of physical activity scale.The critical ratio method,correlation coefficient method,commonality and factor load were selected to determine the scale items.Exploratory factor analysis was used to determine the scale dimension and evaluate the scale validity.Kronbach coefficient,split half reliability and retest reliability were used to evaluate the reliability of the scale.Results:1.Qualitative study on fear of physical activity experience of school-age obese asthmatic children and their parentsAfter interviews with 13 groups of obese asthmatic children and their parents,the data reached saturation,and the data were analyzed,summarized and refined,and finally formed 3 themes and 7 sub-themes,that is,there are a variety of wrong perceptions of physical activity(think physical activity can induce a variety of discomfort symptoms;Confuse the symptoms of physiological discomfort after physical activity and the acute onset of asthma;Parents are over-alert to obesity in children and force children to physical activity);Negative response to fear of physical activity(children actively avoid physical activity;Parental movement restriction);Perceived adverse consequences of fear of physical activity(increased sedentary behavior,reduced physical activity endurance,further aggravating obesity and fear of physical activity;Children’s communication with peers is reduced,resulting in feelings of inferiority).2.Establishment of fear of physical activity scale for school-age children with asthmaBased on the results of qualitative research,literature collection and group discussion,the initial item pool was formed.After expert consultation with 20 pediatric clinical medical staff and experts in nursing management,nursing education,psychology and kinesiology,the fear of physical activity scale for school-age children with asthma(first draft)was formed.Based on expert opinions and results of group discussion,20 groups of school-age children with asthma and their parents were pre-investigated,and a three-dimension exercise fear scale for school-age children with asthma(test version)was formed with 19 parental items and 19 children items.3.Reliability and validity of fear of physical activity scale for school-age children with asthmaAfter the results of project analysis,20 items were deleted and 18 items were retained.After four rounds of exploratory factor analysis,5 items were deleted,and finally 13 items were left,3 factors were extracted,and the combined explanation variance was 60.745%.The correlation coefficients between the three factors and the total scale ranged from 0.724 to 0.758,all between 0.3 and 0.8,and P<0.05,which was statistically significant.The total Cronbach’s a coefficient of the scale was 0.819,and the Cronbach’s α coefficients of the three dimensions were 0.801,0.764 and 0.761,respectively.The split-half reliability of the total scale was 0.772,and the split-half reliability of the three dimensions was 0.704,0.821 and 0.771,respectively.The test-retest reliability of the total scale was 0.958,and the three dimensions were 0.940,0.880 and 0.941,respectively,indicating that the scale had good reliability and validity.Conclusion:1.The results of the qualitative study show that school-age obese asthmatic children and their parents have a variety of wrong perceptions of physical activity and often adopt avoidance coping methods,which further aggravate obesity and physical activity fear.Clinical medical staff should strengthen health education,assist children and parents to make physical activity plans and provide relevant support,so as to reduce their fear of physical activity and promote scientific physical activity of children.2.The results of the scale compilation showed that the fear of physical activity scale for school-age children with asthma and their parents was preliminatively developed,which included 38 items in three dimensions:"cognition of physical activity","coping style" and "adverse consequences of fear of physical activity".3.The results showed that the fear of physical activity scale for school-age children with asthma developed in this study has sound reliability and validity,and can be used as an objective tool to assess the fear of physical activity in school-age asthma children and their parents.