The Translation And Adaptation Of The Multimorbidity Treatment Burden Questionnaire And Its Preliminary Application In Chinese Community Elderly Patients

Objective1 To translate the Multimorbidity Treatment Burden Questionnaire(MTBQ)into Chinese,and evaluate the reliability and validity of Chinese version of the Multimorbidity Treatment Burden Questionnaire.2 To investigate and analyze the current status of the treatment burden for the eldely with multimorbidity in community,to provide a reference for the intervention research on the treatment burden of the elders in community with multimorbidity in China.MethodsThis study was divided into two parts:the first part is reliability and validity of Chinese version of the Multimorbidity Treatment Burden Questionnaire,the second part is to research the current status of the treatment burden and its influencing factors of the elders with multimorbidity in community.1.Reliability and Validity of Chinese Version of the Multimorbidity Treatment Burden Questionnaire.Firstly,achieving the authorization of the author of the Multimorbidity Treatment Burden Questionnaire,then using the translation,comprehensive,back-translation,cultural adaption,cognitive interview and preliminary investigation to translate the MTBQ into Chinese.Choosing 456 the elderly with multimorbidity in community to investigate,Use SPSS21.0 and Mplus 8.3 software to analyze the data.For item analysis,Answer distribution analysis and the correlation coefficient method are used.In terms of validity,content validity,structural validity and calibration validity are used.Among them,in terms of calibration validity,the Treatment Burden Questionnaire(TBQ)is used as the calibration standard.Level content validity index(I-CVI)and scale-level content validity index(S-CVI)evaluate the content validity of the questionnaire,and the structural validity includes Exploratory Factor Analysis(EFA)and Confirmatory Factor Analysis(CFA);using Cronbach's alpha to measure the internal consistency of the scale,using test-retest reliability to measure the stability of the questionnaire.2.The investigation of the current status:It is convenient to select 350 elderly patients with multimorbidity in the communities under two community health service centers in Zhengzhou as the target of investigation..The general information survey questionnaire,the Chinese version of MTBQ,Health Literacy Management Scale(HeLMS)and Social Support scale(SSS)were used to investigate the current status of treatment burden.SPSS 21.0 software was used for data analysis,Chi-square test were used for general data influencing factors analysis,Spearman correlation analysis was used to analyze the relationship between treatment burden with health literacy and social support,and ordered logistic regression was used for regression analysis.Results1.the Chinese version of the Multimorbidity Treatment Burden Questionnaire(MTBQ)suitable to Chinese cultural background was formd included 12 items and 3 dimensions,Medication and cost(5 items),Seeing doctors(4 items),lifestyle(3 items).The Cronbach's a coefficients for the overall scale was 0.803,and 0.624?0.740 for every dimension.Test-retest reliability was 0.947 for the overall questionnaire,and 0.761?0.907 for every dimension.Exploratory factor analysis load of each item is above 0.4.Analysis of content validity of the MTBQ indicated that I-CV1 was at least 0.83?1.00,S-CV1 was 0.97.The robust maximum likelihood method was used for confirmatory factor analysis.The results showed that the factor load of each item in this dimension was good.All the fitting indexes of the five dimensional structure model.Each fitting index has reached the reference standard.In terms of calibration validity,the correlation coefficient between the global MTBQ and the global TBQ was 0.889,and the correlation coefficient between the MTBQ dimensions and the TBQ was 0.315?0.744.2.The results showed that the total score of the Multimorbidity Treatment Burden Questionnaire was 18.8(12.50,27.08),and the scores for each dimension were as follows:medication and cost 2.0(1,4),seeing doctors 2.0(1,4),and lifestyle 4.0(3,6).In elderly patients with multimorbidity,no burden(score 0)is 1.1%,low burden(score<10)is 13.4%,medium burden(10?22)is 49.4%and high burden(?22)is 36.0%.The total score of health literacy for chronic diseases is(83.79±14.11),of which the information acquisition ability is(32.13±6.92),the willingness to financial support is(6.74±2.17),the communication and interaction ability is(30.54±5.73)and the desire to improve health is(14.37±2.59);The total score of the social support are(25.81±10.89),of which the subjective support dimension is(14.44 ± 5.87),the objective support dimension is(6.61±4.84),and the support utilization dimension is(4.83±2.40);The ordered logistic regression analysis shows that the per capita monthly household income(yuan),the type of medical insurance,the number of chronic diseases,multimorbidity severity,health literacy,and social support were the influencing factors of treatment burden on elderly with multimorbidity in community.Conclusions1.The Chinese version of the MTBQ was obtained.It can be used in the elderly patients with multimorbidity in community,and has good reliability and validity.2.The Chinese version of MTBQ was used to investigate the current status of treatment burden for the elderly with multimorbidity in community and analyze the influencing factors.The results showed that the family's per capita monthly income(yuan),and the type of medical insurance,number of chronic diseases,multimorbidity severity,health literacy,society support were the influencing factors of treatment burden on elderly with multimorbidity in community.