The Chinese Localization Of Living With Medicines Questionnaire And Application In Elderly Patients With Chronic Disease Using Multiple Medication At Home

Objectives1.To translate the English version of the Living with Medicines Questionnaire(LMQ),into Chinese and to evaluate the validity and reliability of the Chinese version of LMQ in chronic disease coexisting with multiple medication.2.To explore the current status of Polypharmacy medication burden of patients with chronic disease coexisting and related influencing factors.Methods1.The translation and reliability and validity test of the LMQ:We translated the LMQ following the Brislin's model from translation to back-translation.To facilitate the selection of 592 multi-medication elderly patients with chronic disease co-existing in the communities affiliated to the three health service centers of Zhengzhou City,and to conduct a questionnaire survey to evaluate the reliability and validity of the Chinese version of Living with Medicines Questionnaire(C-LMQ).Use IBM SPSS 21.0 and IBM AMOS 21.0 analysis software to analyze the data,use the Pearson correlation analysis of item-total score to judge the homogeneity of the C-LMQ,use the decision value(CR)to test the discrimination between items,Content validity and structure validity were used to evaluate the validity of C-LMQ,Cronbach's a,half reliability and test-retest reliability were used to evaluate the reliability of C-LMQ.2.The investigation of the current status:The convenience sampling method was used from September 2019 to January 2020 in 3 community health service centers in Zhengzhou High-tech Zone,Nanyang Road,and Linshanzhai to select elderly patients with coexisting chronic diseases as research objects.The survey tools include general information questionnaire,Chinese version of medication life questionnaire,social support assessment scale,and analyze the influencing factors of polypharmacy burden of elderly patients with chronic disease in their house.IBM SPSS 21.0 was used to analyze the relevant data.Descriptive analysis,t-test or one-way ANOVA and multiple linear regression were used to analyze the data.Results1.Finally,a Chinese version of LMQ that is suitable for China's cultural and has good reliability and validity has 8 dimensions:medication attitude(7 items),practical difficulties(6 items),doctor-patient relationship(5 items),medication Effects(5 items),interference with daily life(6 items),side effects(4 items),medication behavior(3 items),financial burden(3 items).The C-LMQ item analyzed the correlation coefficient between each item and the total score of the questionnaire from 0.317 to 0.658(P<0.01).The CR of each item was calculated to be 3.0,showing statistical significance(P<0.01).The degree index is 0.949,and the content validity index of each item is 0.86?1.00.There are 39 items in the C-LMQ.Exploratory factor analysis extracts 8 common factors.The C-LMQ of cumulative variance contribution rate is 76.780%.This version uses a life questionnaire for confirmatory factor analysis.?2/df=1.575;GFI=0.865,NFI=0.915,IFI=0.967,TLI=0.963,CFI=0.967,RMSEA=0.041.The Cronbach's a of C-LMQ is 0.892,the total test-retest reliability and the half confidence is 0.904 and 0.817.2.The scores of multiple medication burdens of elderly patients with chronic coexisting chronic diseases at home were scored as:attitude to medication(18.57±3.31),difficulty in practice(20.36±2.85),doctor-patient relationship(13.58 ± 3.36),and effect of medication(13.34 ± 2.58),Interfering with daily life(17.36±2.61)points,side effects(11.89 ±1.98)points,medication behavior(8.45± 2.15)points,economic burden(9.38±2.26)points;The total score of social support is(34.00±8.19)points,where the subjective support dimension score is(18.44± 3.64)points,the objective support dimension score is(8.08±3.05)points,and the social support utilization dimension score is(7.47±2.23).Regression analysis showed that age,education,number of medications per month,monthly drug payment,and subjective support are factors that affect the burden of multiple medications in elderly patients with chronic disease coexisting at home,explaining the multiple medication burdens together The total variability was 40.0%.Conclusions1.The Chinese version of the the Living with Medicines Questionnaire had good reliability and validity,and can be used to measure the multi-medication burden of elderly patients with chronic disease coexisting at home in China.2.The C-LMQ was used to evaluate the multiple medication burden level of the elderly patients with chronic disease at home.The results showed that the multiple medication burden level of the elderly patients was relatively heavy,among which age,education level,per capita income level and type of medication each time,daily medication frequency,monthly self payment and subjective support were the main factors affecting the multiple medication burden.