中文版MMAS-8在T2DM患者中的信效度评价及应用研究

发布时间：2018-12-13 09:38

【摘要】：[目的]翻译英文版MMAS-8为中文,并应用于2型糖尿病患者,评价其信效度,探讨不同因素对患者服药依从性的影响,为指导糖尿病患者治疗及其糖尿病健康教育提供理论基础。[方法]翻译英文版MMAS-8为中文,对2014年7月至2015年1月期间就诊于昆明医科大学第一附属医院糖尿病科门诊及其住院部的148例确诊2型糖尿病患者进行中文版MMAS-8及中文版MMAS-4的调查,并收集患者的一般人口学信息及糖尿病相关信息,如性别、年龄、病程、职业、医保类型、学历、身高、体重、病程、并发症、合并症、降糖方案及糖化血红蛋白。从纳入者中随机抽取20%左右,2周后进行电话回访,完成中文版MMAS-8的重测。采用IBM SPSS 23(2)软件进行数据分析,评价量表的信效度并探讨不同因素对服药依从性的影响。[结果](1)完成中文版MMAS-8的翻译,并应用于148例(男性69例,女性79例)2型糖尿病患者中,其中30例患者完成2周后的中文版MMAS-8重测。(2)纳入的148例2型糖尿病患者中文版MMAS-8得分为6.31±1.88,低中高依从性患者分别为42例(28.38%)、56例(37.84%)、50例(33.78%)。(3)中文版 MMAS-8 信度检验:Cronbach's α 系数为 0.776,ICC 为 0.854(P0.05);结构效度检验:采用因子分析法,共提取3个公因子,累积解释变异量的67.28%,各条目在其主因子的因子载荷量均超过0.5;聚合效度检验:中文版MMAS-8评分与中文版MMAS-4评分的相关系数为0.878(P0.001);区分效度检验:血糖达标组(HbAlc7%)中文版MMAS-8得分大于血糖未达标组(HbAlc≥7%)[(7.20±1.039)(5.94±2.027),Z=-3.849,P=0.00],差异有统计学意义,两组间低中高依从性分布比较差异有统计学意义(Χ2=14.554,P=0.01)。(4)各影响因素与服药依从性间的关系分别进行单因素及多因素分析。单因素有序多分类logistic回归分析提示:性别(wald Χ2=7.046,P=0.008),降糖方案(waldΧ2=6.158,P=0.013)对服药依从性的影响有统计学意义;多因素有序多分类logistic回归分析提示:性别、医保类型、降糖方案对服药依从性的影响有统计学意义,其中男性患者相对于女性患者服药依从性低[OR=0.405,95%CI(0.197,0.829)],职工医保患者相对自费患者服药依从性低[OR=0.130,95%CI(0.021,0.800)],单药治疗相对于联合治疗服药依从性高[OR=2.970,95%CI(1.499,5.882)]。[结论](1)中文版MMAS-8具有良好的信度、效度;(2)中文版MMAS-8可应用于2型糖尿病患者,用于评估患者的服药依从性情况,并指导临床工作开展;(3)本组2型糖尿病患者服药依从性整体欠佳;(4)本组2型糖尿病患者的服药依从性与性别、医保类型及降糖方案的复杂程度有关。
[Abstract]:[objective] to evaluate the reliability and validity of MMAS-8 in patients with type 2 diabetes mellitus, and to explore the effect of different factors on the compliance of patients with type 2 diabetes. To provide theoretical basis for diabetic treatment and diabetes health education. [methods] the English version of MMAS-8 was translated into Chinese, From July 2014 to January 2015, 148 patients with type 2 diabetes diagnosed in the Department of Diabetes, first affiliated Hospital of Kunming Medical University, were investigated with Chinese version of MMAS-8 and Chinese version of MMAS-4. General demographic information and diabetes related information were collected, such as sex, age, course of disease, occupation, type of medical insurance, education, height, weight, course of disease, complications, hypoglycemic regimen and glycosylated hemoglobin. About 20% of the participants were randomly selected, and 2 weeks later telephone interview was carried out to complete the retest of the Chinese version of MMAS-8. IBM SPSS 23 (2) software was used to analyze the data, to evaluate the reliability and validity of the scale and to explore the influence of different factors on drug compliance. [results] (1) the translation of the Chinese version of MMAS-8 was completed and applied to 148 patients with type 2 diabetes (69 males and 79 females). The Chinese version of MMAS-8 was retest in 30 patients after 2 weeks. (2) the score of Chinese version MMAS-8 was 6.31 卤1.88 in 148 patients with type 2 diabetes mellitus and 42 cases (28.38%) with low, medium and high compliance, respectively. 56 cases (37.84%), 50 cases (33.78%). (3) Chinese version MMAS-8 reliability test: the Cronbach's 伪 coefficient was 0.776CICC was 0.854 (P0.05); Structural validity test: three common factors were extracted by factor analysis, 67.28% of the variation was interpreted, and the factor load of each item was more than 0.5 in its main factor. Aggregation validity test: the correlation coefficient between the Chinese version MMAS-8 score and the Chinese version MMAS-4 score was 0.878 (P0. 001). The Chinese version of MMAS-8 score of blood glucose standard group (HbAlc7%) was higher than that of blood glucose substandard group (HbAlc 鈮，

本文编号：2376327