痛风患者健康教育知识知晓度测量问卷的研制及临床应用

目的: 编制痛风患者健康教育知识知晓度测量问卷并检测其信效度，调查痛风患者健康教育知识知晓度。方法: 选择2019年1—6月入住中南大学湘雅二医院风湿免疫科的痛风患者150例，根据文献回顾及痛风患者健康教育需求调查初步形成健康教育知识体系框架，通过2轮的德尔菲(Delphi)专家函询得到预试问卷，对150名痛风患者进行测量，问卷项目的分析与筛选采用变异系数法、决断值分析、条目与总分的相关系数法、探索性因素分析法。信度采用内部一致性信度、分半信度进行评价。效度检验主要包括内容效度、建构效度。另选择2019年6—12月中南大学湘雅二医院住院及门诊痛风患者150例调查痛风患者健康教育知识知晓情况。结果: 问卷一级指标的指标重要性为3.83~5.00，二级指标的指标重要性为3.00~4.83，各条目的变异系数为0.31~1.23，问卷各条目决断值(critical ratio, CR)为3.168~8.333。研究各条目与总分的Pearson相关系数为0.319~0.544。经探索性因素分析后，4个维度均有题目删除，最后问卷共有16个条目。问卷的Cronbach’ s α系数为0.715，分半信度Spearman-Brown系数为0.785。问卷各因素与总问卷之间的相关系数为0.300~0.701，问卷各条目与各因素之间的相关系数为0.402~0.732，结果具有统计学意义(P均＜0.05)。经问卷调查，痛风患者健康教育知识知晓度测量问卷总得分为(6.85±3.22)分，痛风相关知识得分为(2.03±1.24)分，饮食指导得分为(1.53±1.06)分，运动指导得分为(2.19±1.24)分，药物指导得分为(1.24±1.22)分。结论: 痛风患者健康教育知识知晓度测量问卷对于测量相关内容方面具有较好的信度及效度，编制过程较科学，涉及内容较全面，可进一步应用于临床。痛风患者健康教育知识知晓度较低，对痛风药物相关知识尤为缺乏。

Development and clinical application of the health education knowledge assessment questionnaire for gout

Objective: To develop and test the health education knowledge assessment questionnaire for gout and to investigate the understanding degree of health education knowledge in patients with gout. Methods: From June 2019 to June 2019, 150 cases of gout patients were enrolled.According to the literature review and the healthy education requirements of gout patients, the framework of education knowledge system was preliminarily formed.The pre-test questionnaire was obtained through two rounds of he Delphi technique.A survey of 150 patients with gout was carried out.The analysis and selection of the questionnaire were based on the coefficient of variation, the analysis of determination value, the correlation coefficient of the items and the total scores, and the exploratory factor analysis.In this study, we evaluated the reliability of internal consistency, semi-reliability.Validity test mainly included content validity and construct validity.In addition, a total of 150 patients with gout in our hospital and outpatient gout were selected to investigate the understanding degree of health education knowledge from June 2019 to December 2019. Results: The significance of the first level index of the questionnaire was 3.83-5.00, the secondary index was 3.00-4.83, and the variation coefficient of each item was 0.31-1.23, and the critical ratio(CR) value of each item in this questionnaire was 3.168-8.333.The Pearson correlation coefficient of each item and the total score of this study was 0.319-0.544.After exploratory factor analysis, some topics were deleted in four dimensions, and there were 16 entries in the final questionnaire.Cronbach' s α coefficient of this questionnaire was 0.715, split-half reliability Spearman-Brown coefficient was 0.785, and retest reliability coefficient was 0.729. The correlation coefficient between each factor of this questionnaire and the total questionnaire was 0.300-0.701, and the correlation coefficient between each item of the questionnaire and each factor was 0.402-0.732, all P < 0.05. The results were statistically significant. By questionnaire investigation, the total score of questionnaire was (6.85±3.22), the score of disease-related knowledge was (2.03±1.24), the score of dietary guidance was (1.53± 1.06), the score of exercise guidance was (2.19±1.24), the score of medication guide was (1.24±1.22). Conclusion: The Health Education Knowledge Assessment Questionnaire For Gout has a good reliability and validity for measuring related content, the compilation process is scientific and the content is comprehensive, which can be further applied in clinic.The understanding degree of health education knowledge is low in Chinese patients with gout, and knowledge of gout medicine is lacking especially.