Development And Reliability And Validity Of Chinese Adult Diabetic Foot Risk Assessment Scale

Objective: Based on the literature review results of diabetic foot risk assessment and expert letter consultation,a foot risk assessment tool suitable for adult diabetic patients in China were constructed,and item analysis and reliability and validity test of the scale were conducted.Methods: First step,through literature review,the existing diagnostic criteria for diabetic foot,risk assessment tools for diabetic foot,risk factors for diabetic foot and prevention and management data were collected,and the initial item pool was formulated.In the second step,25 experts from the field of diabetic foot were consulted by two rounds of letters to evaluate their participation enthusiasm,authority and consistency,and the threshold method was used as the screening evaluation index.The research group deleted and modified the items based on the comprehensive evaluation indicators and expert opinions to form the preliminary scale.Third,Cluster sampling was used to investigate 390 diabetic patients in endocrinology department of a grade A hospital in Changsha city,Hunan Province.SPSS26.0 software was used to delete and modify items and determine dimensions through discrete degree method,correlation coefficient method,factor analysis method and distinction analysis method,and then reliability and validity analysis of the scale was conducted.Results:(1)The positive coefficients of the two rounds of expert letter consultation were 89.29% and 88.00% respectively,and the expert authority coefficient was 0.89.After two rounds of correspondence consultation,the Kendall coordination coefficient of the first-level index was 0.474,and the second-level index was 0.431,both > 0.4(P < 0.05).According to experts’ opinions and the results of boundary method,9 items were adjusted to form the preliminary scale of 19 items.(2)According to the project analysis results,items C8 and E13 do not meet the standard in the dispersion degree method,and items F17,F18 and F19 do not meet the standard of the correlation coefficient method.However,according to the project analysis,items that do not meet two of the four analysis methods will be deleted,and 19 items will be retained eventually.(3)The total retest reliability of the scale was 0.958,and the retest reliability of each dimension was 0.670～0.758.The Cronbach’s α coefficient of the total scale was 0.770,and the retest reliability of each dimension was 0.714～0.845,and the rater reliability was 0.858,indicating that the scale had good reliability.(4)The content validity index of each item level was0.857～1.000,indicating good content validity.In exploratory factor analysis,six common factors were extracted,and the cumulative contribution rate of variance was 74.139%.The factor load of all items was >0.4,indicating that the scale had good structural validity.(5)Criterion Validity: there was a positive correlation between the scale and the simplified 60-second diabetic foot screening tool,the correlation coefficient was 0.492,P<0.01.Conclusion: This research compiled by Chinese adult risk of diabetic foot quick screening scale is composed of 19 items,is divided into six dimensions: history,the change of the skin and nails,foot deformity,peripheral artery disease,peripheral neuropathy,diabetic foot selfmanagement behaviors.The scale has good reliability,validity and stable structure,which can be used for early diabetic foot risk screening in diabetic patients,and can also be used as an assessment tool and basis for the formulation of diabetic foot risk grading management.It contains 3 pictures,20 tables and 85 references in the thesis.