围生期孕妇健康素养量表的编制及应用

发布时间：2019-06-08 13:32

【摘要】：目的:编制《围生期孕妇健康素养量表》,为围生期孕妇健康素养测量工具的进一步开发提供依据;探索重庆市某区围生期孕妇健康素养及其影响因素,为进一步开展围生期孕妇健康素养干预,提高围生期孕妇健康素养水平提供依据。方法:根据Nutbeam D教授提出的功能性、沟通性、批判性3大健康素养层次为理论支撑,通过大量查阅国内外文献,并经课题组多次讨论,以及对18位专家开展咨询调查,形成包含58个条目的围生期孕妇健康素养初始量表;然后于2016年3-5月在1所综合医院和2所妇幼保健院门诊选取477名围生期孕妇,采取7种条目筛选方法对初始量表进行条目筛选,形成包含51个条目的围生期孕妇健康素养正式测试量表,并对其可行性、信度和效度进行初步考评。采取整群抽样方法于2016年9-11月抽取1所综合医院和2所妇幼保健院门诊523名围生期孕妇,运用《围生期孕妇健康素养量表》进行现况调查,用Epidata3.1建立数据库,并用SPSS17.0进行围生期孕妇健康素养水平及其影响因素的分析。结果:专家咨询结果显示,专家积极系数为90%,平均权威系数为0.87。通过条目筛选和信效度检验,形成包含功能性健康素养、沟通性健康素养和批判性健康素养3个领域11个维度共51个条目组成的《围生期孕妇健康素养量表》。经考评,该量表回收率为95.4%,完成率为100%,完成时间都在20分钟内;总量表及三个领域的Cronbach'sα系数分别为0.909、0.879、0.848、0.843,分半信度系数分别为0.885、0.802、0.773、0.823;三个领域与总量表的相关系数在0.690-0.784之间,因子分析显示量表结构与理论构想基本相符。现况研究显示,功能性、沟通性、批判性、总健康素养具备率分别为35.8%、16.1%、7.1%、14.0%;乡镇、学历初中及以下、丈夫学历初中及以下、家庭月收入4000元及以下、不按时孕期体检、不愿意接受产前教育培训、性格内向、与公婆及配偶关系不好的围生期孕妇健康素养具备率较低(P均0.05)。多因素logistic回归分析表明,围生期孕妇的学历、是否按时孕期体检、是否愿意接受产前教育培训是功能性健康素养的影响因素;是否愿意接受产前教育培训、与公婆的关系是沟通性健康素养和总健康素养的影响因素;家庭月收入、与公婆的关系是批判性健康素养的影响因素。结论:《围生期孕妇健康素养量表》具有较好的可行性、信度、效度,可作为测评围生期孕妇健康素养的工具。围生期孕妇健康素养水平受多种因素影响,针对这些影响因素采取相应的干预措施是下一步工作的重点。
[Abstract]:Objective: to compile the Perinatal Maternal Health Nutrition scale (PHS), and to provide evidence for the further development of health literacy measurement tools for parturient pregnant women. To explore the health literacy of pregnant women in a district of Chongqing and its influencing factors, so as to provide the basis for further intervention of health literacy of pregnant women in the perioperative period and the improvement of the level of health literacy of pregnant women in the postpartum period. Methods: according to the theoretical support of functional, communicative and critical levels of health literacy put forward by Professor Nutbeam D, through a large number of references at home and abroad, and after many discussions by the research group, and 18 experts were consulted and investigated. The initial scale of health literacy of pregnant women in the postpartum period was formed, which included 58 items. Then, from March to May 2016, 477 pregnant women were selected from 1 general hospital and 2 maternal and child health centers, and seven kinds of item screening methods were used to screen the items of the initial scale. A formal test scale for maternal health literacy was formed, which included 51 items, and its feasibility, reliability and validity were evaluated. From September to November 2016, 523 postpartum pregnant women were selected from 1 general hospital and 2 maternal and child health centers by cluster sampling. The current situation was investigated by using the Perinatal Maternal Health element scale, and the database was established by Epidata3.1. SPSS17.0 was used to analyze the health literacy level and its influencing factors of postpartum pregnant women. Results: the results of expert consultation showed that the positive coefficient of experts was 90% and the average authority coefficient was 0.87. Through item screening and reliability and validity test, 51 items including functional health literacy, communicative health literacy and critical health literacy were formed, which included 51 items in three fields: functional health literacy, communicative health literacy and critical health literacy. The recovery rate of the scale was 95.4%, the completion rate was 100%, and the completion time was within 20 minutes. The Cronbach's 伪 coefficients of the total scale and the three fields were 0.909, 0.879, 0.848 and 0.843, respectively, and the split-half reliability coefficients were 0.885, 0.802, 0.773 and 0.823, respectively. The correlation coefficient between the three fields and the total scale is between 0.690 鈮，

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