Construction And Reliability And Validity Test Of Self-management Scale For Elderly Hemodialysis Patients

Research objective:1.Through literature research and combining social cognitive theory and self-efficacy theory,the item pool is formed,to provide a platform for the development of the scale items of elderly hemodialysis patients.2.Delphi method and pre-survey were used to screen the items of the scale,and the reliability and validity of the scale were tested by large sample survey.A scientific and rigorous self-management scale for elderly hemodialysis patients was developed,which provides a test tool for clinical patients' self-management abilityResearch method:1.A research group was set up to search the relevant content based on the research content and strictly in accordance with the literature research method.The members of the research group read the literature extensively and formed the item pool of the scale through discussion,modification and integration according to the existing relevant scale2.According to Delphi method,17 relevant medical and educational experts in the field of hemodialysis were invited to evaluate the items,and the items were screened based on the evaluation indicators of expert consultation(expert positive coefficient,expert authority coefficient,and the concentration of expert opinions,expert coordination coefficient).At the same time,the suggestions put forward by the experts were adopted after discussion and voting by the members of the research group,thus forming the self I manage the pre-trial version of the scale;then through convenient sampling method,198 elderly hemodialysis patients in two large-scale top three hospitals in Nanjing were selected for pre investigation.Through statistical analysis methods,such as frequency distribution method,dispersion degree method,t-test method,cronbach's alpha,factor analysis method,the items of the scale were screened again,and the common factors were obtained through principal component factor analysis So as to form the first version of self-management scale for elderly hemodialysis patients.3.Using convenient sampling method,240 elderly hemodialysis patients from three large-scale third class hospitals in Nanjing and Yancheng were selected,and a pre-trial version of elderly hemodialysis self-management scale was distributed to the patients.Under the guidance of the research team,the patients filled in the scale based on their actual situation,and then tested the reliability and validity of the scale with correct statistical methods,and finally formed elderly hemodialysis Patient self-management scale.Research result:1.Based on the results of literature analysis and the existing scale,the research team discussed the formation of 67 eligible items2.In the first round,the positive coefficient of expert correspondence was 88%,the coefficient of variation of 18 items was more than 0.3 or the mean of importance score was less than 3.5.The research group discussed the expert's opinions,agreed with the expert's suggestions,combined 6 items with similar semantics,and added 3 items.In the second round,the positive coefficient of expert correspondence was 93%,and the coefficient of variation of 5 items was more than 0.3 or the important If the average sex score is less than 3.5,delete it and add 3 items.Finally,47 items of self-management pre-trial scale for elderly hemodialysis patients were formed3.A total of 198 questionnaires were issued,186 were recovered and 161 were effective After the analysis of the relevant statistical methods,a total of 22 items were deleted.Five common factors were obtained by two rounds of factor analysis.The final cumulative variance contribution rate of the five common factors was 59.8%.They were named general daily life management,vascular access management,emotional management,safety management and cognitive management respectively.4.Large sample survey was used to test the reliability and validity of the scale.In terms of reliability,the total Cronbach-s a of the scale was 0.916,the Cronbach's a range of each dimension was 0.798-0.919,and the half reliability of the scale was 0.813.In terms of validity,the correlation coefficient range of each item and the total score of the scale was 0.27-0.72,the correlation coefficient range of each dimension and the total scale was 0.56-0.72,and the test was used The structure of the scale was verified by confirmatory factor analysis.RMSEA,CFI,IFI,TLI and RMR of the revised confirmatory factor analysis indexes met the fitting standards,CMIN/df,GFI and AGFI were close to the fitting standards,and the model was well fitted with the actual model after the revision,indicating that the scale had good reliability and validity.Research conclusion:1.The self-management scale of elderly hemodialysis patients includes 25 items and 5 dimensions.2.The self-management scale of elderly hemodialysis patients has good reliability and validity,which can provide a tool for the evaluation of clinical patients' self-management ability.