| Objectives 1 To develop the knowledge-attitude-practice(KAP)questionnaire of insulin injection site rotation for diabetic patients,and test the reliability and validity of KAP questionnaire.2 Application the questionnaire to investigate the KAP status of insulin injection site rotation in diabetic patients and explore its influencing factors,to provide reference for the formulation of targeted interventions.Methods 1 Based on the framework of KAP theory,with referenced to the ‘Chinese Technical Guide for Diabetes Injection(2016 Edition)’ and related literature to construct item pool.Through two rounds of expert consultation,the items and contents of the questionnaire were screened and revised,and through the pre-survey adjust the sentences of the questionnaire to form the initial questionnaire.By convenience sampling method,a total of 149 diabetes patients who treated with insulin injection were investigated in a tertiary hospital in Beijing,to test the initial KAP questionnaire.The questionnaire’s items were screened by correlation analysis and t test method.The reliability of the questionnaire was tested by using Cronbach’s alpha coefficient and test-retest reliability,content validity and contract validity were used to test the validity of the questionnaire,and finally a formal questionnaire was formed.2 A total of 579 diabetes patients who treated with insulin injection were investigated in a tertiary hospital during December 2019 to November 2020 in Beijing,using the formal KAP questionnaire,general information questionnaire,the self-efficacy of diabetes scale and psychological insulin resistance scale.Discussing the influencing factors of insulin injection site rotation knowledge,attitude and behavior level in diabetic patients through t test,ANOVA,correlation analysis and regression analysis methods.Results 1 In the two rounds of expert consultation,the positive coefficient of experts were both 100%,the authority coefficient of whole experts were 0.89 and 0.90,respectively.After two rounds of expert consultation,7 items were deleted,4 items were modified,and 23 items were formed in the initial KAP questionnaire,including knowledge dimension(10 items),attitude dimension(4 items),behavior dimension(9 items);the total score range of questionnaire was 13～72 points.The higher the score of each dimension and questionnaire,the better the knowledge,attitude and behavior of insulin injection site rotation.Results of the reliability and validity tests: The Cronbach’s alpha coefficient of the total questionnaire was 0.901,and each dimension’s Cronbach’s alpha coefficient were0.851～0.898.The retest reliability of the total questionnaire was 0.919(P<0.01),and the retest reliability of each dimension were between 0.786 to 0.905(P<0.01).The questionnaire’s S-CVI was 0.975 and the I-CVI were 0.857～1.The correlation coefficient between each dimension of the questionnaire were 0.270～0.519(P<0.01),the correlation coefficient between each dimension and the total questionnaire were 0.713～0.828(P<0.01).By factor analysis,four common factors were extracted with the cumulative variance contribution rate was 64.193%.It can be used as a formal questionnaire.2 The total score of the KAP questionnaire were 30～68,the average score was(46.54±6.20),among them,4.5% were in high score group,67.2% in middle score group and 28.3% in low score group.Knowledge dimension’s average score was(8.02±2.72),attitude dimension’s average score was(13.18±2.82)and average score of behavioral dimension was(25.34±3.03).The results of multiple linear regression analysis showed that self-efficacy,participate in health education activities regularly,the number of daily insulin injections,occupational state,psychological insulin resistance,the duration of insulin therapy and educational level were the main factors affecting the level of rotation of insulin injection sites in diabetic patients.Seven factors could explain 45.3% of the total variation.Conclusions 1 The KAP questionnaire of insulin injection site rotation for diabetic patients was preliminary completed in this study.The KAP questionnaire meets the basic requirements of measuring tools,which can be used to evaluated the level of knowledge,attitude and behavior on rotation of insulin injection site of diabetic patients.2 The KAP in rotation of insulin injection site of diabetes patients was at moderate to low level.The main influencing factors were self-efficacy,participate in health education activities regularly,the number of daily insulin injections,occupational status,psychological insulin resistance,the duration of insulin therapy and educational level.It is recommended that health education be carried out on the theme of insulin injection site rotation,and the KAP level of insulin injection site rotation in diabetic patients be evaluated regularly and given continuous support and guidance.Help patients to formulate a simple and easy to follow individualized injection site rotation scheme,so as to promote regular and standardized insulin injection rotation behavior.Figure 1;Table 22;Reference 140... |
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