| Objectives:To developed the Chinese version of Advance Directives Knowledge,Attitude and Practice Scale among stroke patients,and evaluate the reliability and validity of the scale,and to investigate the status quo of knowledge cognition,belief attitude and behavioral intention of stroke patients,so as to provide Scientific Theoretical Foundation for the popularization and application of the scale in stroke patients.Methods:(1)By means of literature review,interview and questionnaire,an item pool was formed;(2)After two-round of Delphi consultation,15 experts identified the various items and model frameworks,and the original scale was formed;(3)Secondly,200 stroke patients were tested by convenient sampling method.Items of the original scale were screened with the Critical Ratio method,correlation coefficient method,Reliability Analysis method,Communalities method and factor loading method,and an initial scale was formed;(4)Furthermore,exploratory factor analysis and confirmatory factor analysis were performed on the questionnaire results of 200 and 250 patients with stroke patients to screen the items in the initial version of the scale and determine the formal scale;(5)Finally,through the statistical analysis of 319 valid scales,the content validity,expert validity,structural validity,Cronbach’s alpha coefficient,partial reliability and retest reliability of the scale were evaluated,a formal scale with 23 items was formed.Results:By means of literature review,interview and questionnaire,a pool with 3dimensions and 50 items was formed.After two rounds of Delphi expert letter consultation,initially formed the original questionnaire covering 30 items;.Secondly,the items of the original questionnaire were screened and reduced by means of the Critical Ratio method,correlation coefficient method,Reliability Analysis method,Communalities method,factor loading method,exploratory factor analysis and confirmatory factor analysis.Two rounds of Delphi expert letter consultation results and the survey results of 319 stroke patients showed that,the content validity of the scale was evaluated,Among them the item-level CVI(I-CVI)and scale-level CVI(S-CVI) was 0.867-1.000 and 0.982,and the expert validity was 0.82.Exploratory factor analysis finally extracted three common factors,and the contribution rate of cumulative variance was 74.004%.The confirmatory factor analysis showed that the overall fitting coefficient x~2/df=1.813,RMSEA=0.053,GFI=0.90,AFFI=0.87,NFI,IFI,and NNFI were 0.98,0.99,and 0.99,respectively.The factor loads of 22 items were between 0.70-0.93,the combination reliability was between 0.853-0.956,the convergence validity was between0.592-0.863,and the discriminant validity was between 0.769-0.929.The Cronbach’sαcoefficients for the scale and Subscales were 0.957 and between 0.927-0.954,and the split-half test reliability for the scale and Subscales were 0.883 and between0.932-0.955.Test-retest coefficients for the scale and subscales were 0.900 and between0.735-0.901.According to the statistical analysis of 319 effective scales,the cognitive score of patients with stroke on the knowledge of advance directives was(4.36±3.24),the score of belief attitude was(31.96±7.83),and the score of behavioral intention was(17.18±5.29).The results of one-way ANOVA showed that gender,age,educational level,occupation and personal monthly income affect their knowledge cognition,belief attitude and behavioral intention(p<0.05).Conclusion:The Chinese version of advance directives Knowledge,Attitude and Practice Scale for patients with stroke has a good reliability and validity,which can be used to evaluate the status quo of advance directives knowledge cognition,belief attitude and behavioral intention of stroke patients in China.In China patients with stroke have a low level of knowledge cognition of advance directives,but a medium level of belief attitude and behavioral intention.The affect factors about their knowledge cognition,belief attitude and behavioral intention were gender,age,educational level,occupation and personal monthly income. |
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