| ObjectivesObjective to establish a health level assessment table for patients with gestational diabetes mellitus in China(GDM),and verify the reliability and validity of this assessment table.It provides reference basis for evaluating the health literacy level of GDM patients,enacting a reformed improvement route,and verifying the relevant intervention effect.Methods1.This study uses the hierarchical model of health literacy and the health empowerment theory as the theoretical framework.By referring to the relevant guidelines of gestational diabetes and existing health literacy scale,the item pool of GDM patients’ health literacy scale was formed through literature review,semi-structured interview and group discussion.2.Invited 19 domestic experts in the field of GDM treatment and nursing to consult the Delphi method on two occasions and selected items,drew up the draft of health literacy evaluation table of GDM patients and made preliminary investigation.3.A convenient sampling method was employed to conduct a field survey on 299 GDM patients from the first general hospital of Qingdao with the preliminary test figure table for the health knowledge of GDM patients.Critical proportion method,correlation coefficient,cronbach’s α coefficients in table item analysis and factor scores screening GDM patients health literacy form again for official tools.4.By using a convenient sampling method,a field survey was conducted on 395 GDM patients from the first general hospital of Qingdao using the health information table of GDM patients.Retest reliability,split-half reliability and Cronbach’s α coefficient were used to evaluate the reliability of the scale.Content validity,structural validity,convergence validity,discriminative validity,intrinsic correlation test and criterion correlation validity were used to evaluate the validity of the scale.Results1.The results of comprehensive literature analysis,semi-structured interviews and project group discussions formed a pool of GDM patient health literacy scale items with 8dimensions and 61 items.2.The effective questionnaire recovery rates of the two rounds of expert consultation were 100% and 94.74%,respectively,and the rate of expert opinion submission was57.89% and 27.78%.The mean value of the authority coefficient(Cr)were 0.924 and0.942,respectively.The expert coordination coefficients(Kendall’s W)of dimensions were 0.154 and 0.332,and the Kendall’s W of entries were 0.123 and 0.325,indicating statistical significance(P <0.05).The presurvey did not modify the scale to form the health literacy pretest scale for GDM patients with 6 dimensions and 49 items.3.The first field investigation(item selection): A total of 300 questionnaires were sent out,and 299 effective questionnaires were received,with effective recovery of99.67%.A total of 15 entries were deleted using four methods.The formal health literacy Scale for patients with GDM contained 6 dimensions and 34 items.4.The second field investigation(reliability and validity test): The Cronbach’s αcoefficient,split-half reliability,retest reliability of the scale is 0.927,0.785,0.967;I-CVI was 0.889～1.000,and S-CVI was 0.947.The results of confirmatory factor analysis showed that the model matched well with the scale.The convergence validity and discrimination validity were good,the factor load values of each item ranged from 0.621 to 0.843,the combination reliability(C.R)ranged from 0.853 to 0.912,and the average variance extraction(AVE)of each dimension ranged from 0.558 to 0.593.Through the internal correlation test,the correlation coefficient between each dimension and the total table ranges from 0.565 to 0.851,which is at a medium-high level.The correlation coefficient between the total score of this scale and the Chinese version of diabetes health literacy scale was 0.545(P<0.001).ConclusionThe GDM patients’ health literacy scale include 34 items and 6 dimensions: medical knowledge,nutrition knowledge,sports knowledge,health decision and behavior ability,psychosocial coping ability,and information literacy.The scale has good reliability and validity,and can be used as a measurement tool to evaluate the health literacy level of GDM patients. |
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