Study On Reliability And Validity Of Chinese Version Of Facilitators Of And Barriers To Adherence To Hypertension Treatment Scale And Its Preliminary Application

BackgroundPrimary Hypertension(Hypertension)is the most common chronic noncommunicable diseases,and is the most important risk factor for cardiovascular and cerebrovascular diseases,such as stroke,coronary heart disease and heart failure,and advanced kidney diseases.As early as 2003,the World Health Organization(WHO)pointed out that poor compliance of patients with chronic diseases is a global problem,which is particularly important for patients with hypertension.The first step is how to accurately and effectively evaluate the compliance of patients.At present,there is no universally recognized evaluation scale for hypertension treatment compliance at home and abroad,including medication and lifestyle,and there is a lack of relevant evaluation tools in China.Therefore,foreign evaluation tools,Facilitators of and Barriers to Adherence to Hypertension Treatment Scale(FATS),were introduced,and their reliability and validity test was conducted.The scale was compiled by Marie n.Fongwa in 2015,and is currently used in the United States.No Chinese version of the scale and relevant reliability and validity test studies have been found in China.Objectives1.Verify the reliability and validity of the Chinese Facilitators of and Barriers to Adherence to Hypertension Treatment Scale(FATS),so as to evaluate the treatment compliance of hypertensive patients in China more comprehensively and accurately.2.Preliminarily apply the Chinese version of FATS scale and explore its clinical and community applicability in China.3.To understand the current status of treatment compliance of hypertension patients in China and explore its influencing factors.MethodsScale localization and test of reliability and validity:The FATS was translated into Chinese following the Brislin model and use the expert consultation to complete the cultural adjustment.From October to November,2017,200 patients with hypertension from the department of cardiovascular medicine of a top three hospital,a community hospital and a residential area in Guangzhou were selected by convenience sampling.The general information questionnaire,Chinese version of FATS and Treatment Adherence Scale of High blood pressure(TASHP)were used to test the the reliability and validity.The investigation and study:From October to November 2017,200 patients with hypertension from the department of cardiovascular medicine of a top three hospital,a community hospital and a residential area in Guangzhou were selected by convenience sampling.The general information questionnaire,Chinese version of FATS and Treatment Adherence Scale of High blood pressure(TASHP)were used to investigate.Using t test,single factor variance analysis,Spearman correlation analysis and multiple regression analysis to explore the influencing factors.ResultsScale localization and results of reliability and validity:The Chinese version of FATS consisted of 16 items.The exploratory factor analysis were extracted four factors,and the cumulative contribution rate was 63.63%.which was divided into four dimensions namely self-management and positive personal behavior(6 items),high blood pressure treatment adherence barriers(4 items),high blood pressure knowledge(4 items),social support(2 items);Likert4 grading method is used,which is"never,occasionally,often and always",with 1-4 points assigned,and 4-1 points(total 16?64 points)for reverse problems.Cronbach's ca of the scale was 0.832,of each dimension was 0.822,0.831,0.567 and 0.969.The test-retest reliability was 0.868 and the convergent validity was 0.685.The S-CVI/Ave was 0.970 and the range of 1-CVI of each item is 0.830?1.000.The survey results of treatment adherence to hypertension:Among the 200 subjects,the mean of sum scores of TASHP was 95.53±15.0 and of FATS was 43.08 ±8.51.There were 121 people(60.5%)whose sum scores of TASHP were greater than or equal to 95,79 people(39.5%)lower than 95,and there was a significant difference between the high score group and the low score group.There were a significant difference between sex,age and among culture,the method of medical payment and the classification of hypertension diagnosis(P<0.05).The treatment compliance of hypertension had a significant correlation with gender,age,cultural degree and self-management behaviors,knowledge of hypertension,and belief(P<0.05).Conclusion1,The Chinese version of FATS scale has a good internal consistency.In terms of the reliability and validity of the scale,it has a good content validity and convergent validity retest reliability,and also has a good sensitivity to evaluate the treatment compliance of patients with hypertension.2.The Chinese version of FATS scale can be further extended and expanded.3.Currently,the treatment compliance of hypertension patients is relatively good,but there is still a huge room for improvement,which needs to be further improved,especially in the aspect of blood pressure self-monitoring.The main influencing factors:include gender,age,education level,economic level,length of the course of disease and the patient's own attitude of knowing,believing and practicing hypertension.