Development And Reliability And Validity Test Of The Self-management Support Scale For Kidney Transplant Recipients

Objective:To develop the self-management support scale for kidney transplant recipients,test the reliability and validity of the self-management support scale for kidney transplant recipients,and provide targeted guidance for long-term self-management of kidney transplant recipients.Methods:This study included two parts:scale developing stage and scale testing stage.1.Scale developing stage:The theoretical basis of this study was derived from the chronic disease management model(CCM)and Jolanda et al.summarized patients ’ self-management support needs.The item pool of kidney transplantation self-management support scale was formed through literature review and interview with doctors and recipients.Combined with the domestic and foreign mature scale items related to the research topic of kidney transplantation self-management support,this research item pool was formed.According to the theoretical basis of this study,all items were screened,and the items related to the connotation of the theoretical basis were selected to form the preliminary draft of the self-management support questionnaire for renal transplant recipients.The expert consultation questionnaire was designed by ourselves.TheDelphi method was adopted to conduct 2 rounds of expert correspondence consultation with experts in related fields nationwide.The expert opinions reached a consensus,and the preliminary draft of the scale was revised based on the comprehensive expert opinions,finally forming the initial scale of self-management support for kidney transplant recipients.2.Scale testing stage:In this stage,a cross-sectional design and convenient sampling method were adopted to conduct a questionnaire survey on 323 patients who were followed up in the outpatient department of kidney transplantation of a third-grade hospital in Beijing from February to March in 2019.Thirty patients were selected for repeated investigation within two weeks after the survey.Survey tools included general information questionnaire,kidney transplant recipients self-management support initial scale,kidney transplant recipients self-management scale,IBM SPSS 22.0 software was used for data analysis.The discrete degree analysis,correlation analysis and degree of differentiation analysis were used to screen scale items.Exploratory factor analysis was used to screen the scale items and determine the scale structure.Cronbach’s alpha coefficient,split-half reliability and retest reliability were used to test the reliability of the scale,and content validity,structure validity and aggregation validity were used to analyze the scale validity.Results:1.Through integrating of the item pool,36 items were extracted.Two rounds of Delphi expert consultation expert positive coefficient were 96.7%and 100.0%respectively,and the coefficient of expert authority was 0.81 and 0.82 respectively,expert opinion Kendall coordination coefficient of 0.236 and 0.522 respectively(P<0.001).According to experts’suggestions,a total of 4 items were deleted and 8 items were added.Finally,the initial scale of self-management support for kidney transplant recipients was formed,including three dimensions of tool support,psychosocial support and relationship support,with a total of 40 items.2.After item selection and exploratory factor analysis,the kidney transplante recipients self-management support scale was finally determined,which contained 3 factors,22 items,9 items in the tool support dimension,9 items in the psychosocial support dimension,and 4 items in the relationship support dimension.The KMO value was 0.929,the Bartlett sphericity test chi-square value was 5205.176(P<0.001),the cumulative contribution rate of factorvariance was 66.0%,and the factor load of each item was 0.550～0.884.3.Reliability test:Cronbach’s alpha coefficient of the total scale was 0.944,and the Cronbach’s alpha coefficients of tool support,psychosocial support and relationship support were 0.921,0.915 and 0.908 respectively.The sub-half-coefficient of the totas scale was 0.717,the sub-half-coefficient of the three dimensions of tool support,psychosocial support and relationship support was 0.837,0.784 and 0.800 respectively,and the retest reliability coefficient was 0.729(P<0.001).4.Validity test:The content validity of the total scale was 0.967,and the correlation coefficient between the tool support dimension and each item within the dimension was 0.501～0.623,the correlation coefficient between the psychosocial support dimension and its internal items was 0.406～0.604,the correlation coefficient between the relationship support dimension and its internal items was 0.613～0.697,the correlation coefficient between each item and the total score of the scale was 0.398～0.596,the correlation coefficient between factors was 0.455～0.680,and the correlation coefficient between each factor and the total score of the scale was 0.664～0.900,all of which were significantly correlated at the level of P<0.01.The correlation coefficient between the total score of the kidney transplant recipient self-management support scale and the total score of the kidney transplant recipient self-management scale was 0.560(P<0.001).Conclusion:The self-management support scale for kidney transplant recipients developed in this study has good reliability and validity,and the statistical results meet the measurement standards,which can be used to evaluate the degree of self-management support of kidney transplant recipients in China.