老年患者自主性感知现状及影响因素研究

发布时间：2018-08-14 10:38

【摘要】：目的:引进台湾中文版知觉自主性量表,完成量表中文简版的心理测量学检验,为同类研究提供有效、科学、可信的测评工具;并采用横断面调查的研究设计分析老年患者的自主性感知现状,探讨影响老年患者自主性感知水平的相关因素,并提出相应干预对策。本课题将为指导老年患者更好的保护和利用其自主性、增强其自我护理行为、缩短病程、加快康复、减少并发症、降低复发率、提高生活质量提供一个新的干预视角。方法:本研究分为两部分,第一部分为自主性感知量表的引进及信效度检验,第二部分为老年患者自主性感知水平现状及其影响因素分析。1.知觉自主性量表的引进及信效度检验获得原作者台湾学者黄慧莉和林惠贤教授授权,遵循目前国际通行的量表引进程序,最终形成中文简版自主性感知量表,并通过内容效度和结构效度对量表的效度进行评价,通过Cronbach’sα系数和分半信度来对量表的信度进行评价。2.老年患者自主性感知水平现状及其影响因素分析采用方便抽样的方法,选取山西省太原市4所三级甲等综合医院的老年患者共400例作为研究对象进行问卷调查。问卷内容包括一般人口学资料、中文简版自主性感知量表、老年人生活满意度量表和简易应对方法问卷。调查老年患者自主性感知水平现状及以自主性感知的3个维度和总体自主性感知水平作为应变量,通过单因素方差分析、相关分析以及多元逐步回归方法分别分析其相应的影响因素。结果:1.遵循量表引进程序,最终确定中文简版自主性感知量表由3个维度21个条目组成,分别为自主性8个条目、个体性9个条目以及独立性4个条目。2.总量表的Cronbach’sα系数为0.91,3个维度的Cronbach’sα系数为:0.67~0.89;总量表的分半信度为0.914,三个维度的分半信度为0.584~0.865,说明中文简版自主性感知量表具有较好的信度。通过严格的跨文化调适及资深专家的修订,总量表的内容效度指数(S-CVI)为0.94,各条目的内容效度指数(I-CVI)在0.8~1.0,保证了中文简版量表的内容效度。经KMO适应性检验和Bartlett球形检验,结果显示KMO值为0.89、Bartlett球形检验值为2146.11,P0.001,说明适合进行因子分析。采用主成分分析法,经方差最大正交旋转法后提取到3个公因子(各公因子特征值均1),累计解释方差贡献率为53.85%。每个条目在公共因子负荷值为0.401~0.810,证明量表的结构效度较好。3.老年患者自由性感知总体得分为(61.33±8.51)分,各分量表得分分别为自由性(22.63±4.55)分、个体性(27.15±3.92)分、独立性(11.55±2.42)分。各维度条目均分,由高到低依次是个体性为(3.02±0.44)分,独立性为(2.89±0.61)分,自由性为(2.83±0.57)分。4.自主性感知的3个维度不同程度受年龄、学历、职业、经济来源、个人收入、医疗费用支付方式、积极应对、消极应对和生活满意度等影响。结论:1.中文简版自主性感知量表结构合理、信效度良好,适合中国文化背景下对老年患者的自主性感知水平进行测量。2.老年患者的自主性感知的相关因素可帮助研究者和医护工作者评估老年患者自主性感知水平,并制定针对性的干预方案,为指导老年患者更好的保护和利用其自主性、增强其自我护理行为、提高生活质量提供一个新的干预视角。
[Abstract]:Objective: To introduce the Chinese version of the Taiwan Perceptual Autonomy Scale and complete the psychometric test of the Chinese version of the scale, so as to provide an effective, scientific and reliable assessment tool for similar studies. This study will provide a new perspective of intervention to guide elderly patients to better protect and utilize their autonomy, enhance their self-care behavior, shorten the course of disease, accelerate rehabilitation, reduce complications, reduce recurrence rate and improve the quality of life. The introduction and reliability and validity test of the questionnaire, the second part is the status quo of elderly patients'autonomy perception and its influencing factors. 1. The introduction and reliability and validity test of the scale were authorized by Taiwan scholars Professor Huang Huili and Professor Lin Huixian. Following the current international standard scale introduction procedure, the Chinese version of the scale was finally formed. The validity of the scale was evaluated by content validity and structure validity. The reliability of the scale was evaluated by Cronbach's alpha coefficient and split-half reliability. 2. The status quo of elderly patients'autonomous perception and its influencing factors were analyzed by convenience sampling method. Four third-class A comprehensive schools in Taiyuan, Shanxi Province were selected. A total of 400 elderly patients in the hospital were investigated with questionnaires. The contents of the questionnaire included general demographic data, Chinese version of self-determination scale, elderly life satisfaction scale and simple coping method questionnaire. Results: 1. Following the introduction procedure of the scale, the Chinese version of the self-determination scale was finally determined to consist of three dimensions and 21 items, namely, 8 items of autonomy, 9 items of individuality and independence. The Cronbach's alpha coefficient of the total scale was 0.91, the Cronbach's alpha coefficient of the three dimensions was 0.67-0.89, the split-half reliability of the total scale was 0.914, and the split-half reliability of the three dimensions was 0.584-0.865, indicating that the Chinese version of the scale had good reliability. The content validity index (S-CVI) of the total scale was 0.94 and the content validity index (I-CVI) of each item was 0.8-1.0, which ensured the content validity of the simplified Chinese version of the scale. By the analysis method, three common factors (the eigenvalues of each common factor were 1) were extracted by the orthogonal rotation method, and the cumulative explanatory variance contribution rate was 53.85%. The scores of freedom, individuality and independence were 22.63 (+ 4.55), 27.15 (+ 3.92) and 11.55 (+ 2.42) respectively. The items of each dimension were divided equally. From high to low, the individuality was (3.02 + 0.44), the independence was (2.89 +0.61) and the freedom was (2.83 +0.57). 4. The three dimensions of self-determination were affected by age, educational background, occupation, economic source, and personal income to varying degrees. Conclusion: 1. The Chinese version of the self-determination scale has a reasonable structure and good reliability and validity. It is suitable for measuring the level of self-determination of elderly patients in the context of Chinese culture. 2. The related factors of self-determination of elderly patients can help researchers and researchers. Medical workers evaluate the level of autonomy perception of elderly patients and formulate targeted intervention programs, which provide a new perspective for guiding elderly patients to better protect and utilize their autonomy, enhance their self-care behavior and improve the quality of life.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R47

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