医院患者安全文化测评量表的构建

目的编制从医院整体层面测量、符合我国文化特色和医院实际情况的的患者安全文化测评量表,并检验其信效度,确保量表科学可行。方法通过文献法和专家咨询法形成量表初稿。使用量表初稿对四川省4家的412名医护人员、管理人员进行调查,采用相关分析、信度分析、因子分析统计方法对量表的信度与效度进行分析。结果患者安全文化测评正式量表包括共31个条目,分为6个因子、方差累计贡献率62.19%。6个因子分别为医院氛围及沟通、直接领导重视与支持、医院政策支持、负性事件的认识与处理、科室成员相互帮助、负性事件报告。整个量表的Cronbach'sα系数为0.909,各因子的α系数均大于0.79。量表折半信度系数为0.952,除因子四(折半系数为0.783)外,其他各因子的折半系数均大于0.8。结论量表具有较好的信度和效度,可以在医院中广泛使用。     

医院组织文化与医院变革关系的实证研究

目的:探讨医院组织文化和员工对医院变革态度之间关系.方法:以上海市某医院行政部门员工为研究对象,进行问卷调查.结果:性别、工龄和职务对组织文化和变革态度有显著影响;科层型、支持型文化与变革参与配合、管理运作效率存在显著正相关;支持型文化与变革顾虑存在显著负相关;科层型文化能正向预测变革参与配合、管理运作效率;支持型文化能负向预测变革顾虑.结论:医院管理者要塑造良好的组织文化,妥善做好变革管理,促进变革平稳推行.     

中国医院住院患者体验和满意监测量表的信效度评价

目的评价"中国医院住院患者体验和满意监测量表"的信度与效度,为改进量表、推广应用提供依据。方法采用邮寄方式对出院患者进行问卷调查,使用SPSS数据分析软件,分别对量表的内部一致性、折半信度、内容效度及结构效度进行评价。结果量表总体Cronbach’sα系数为0.956,所包含6个维度的Cronbach’sα系数均大于0.8。分半信度为0.971。各条目与量表总体的相关系数介于0.51~0.79之间。以所有条目为变量进行因子分析,共提取5个公因子,其累计贡献率为66.2%,各条目至少在其中一个公因子上负荷值大于0.4。结论量表具有良好的信度和效度,适用于中国医院住院患者满意度的测评。     

艾滋病母婴传播态度量表的效度和信度评价

目的评价艾滋病母婴传播态度量表。方法参考国内外文献设计出含16个条目的艾滋病母婴传播态度量表,用因子分析评价结构效度;区分效度通过对大学本科及以上和本科以下其他学历孕产妇的态度总分差异分析来进行评价;用Cronbach浕系数和折半信度来评价量表的内部信度;比较前后两次的得分差异和相关系数来评价重测信度。结果因子分析提取3个主成分解释总变异的52.21%,旋转后因子1定义为对艾滋病人及防控艾滋病母婴传播责任误解因子,因子2定义为不影响生育情况下对艾滋病母婴传播防控的认同因子,因子3定义为可能影响生育情况下对艾滋病母婴传播防控的认同因子;大学本科及以上的人得分高于本科以下学历的人。3个因子和全部条目的Cronbach浕系数分别为0.812,0.794,0.653和0.786,折半信度分别为0.759,0.799,0.569和0.728,重测（65人）相关系数分别为0.665,0.766,0.492,0.721,关联有显著性;两次调查的差异无显著性。结论量表具有较好的效度和信度,可以为国内类似调查提供参考。     

学习障碍儿童筛查量表区域性实施的信度与效度分析

目的对学习障碍儿童筛查量表（PRS）区域性实施的效度和信度进行分析,为学习障碍儿童筛查量表的广泛推广使用提供依据。方法采用分层整群随机抽样方法 ,抽取湛江市区4所小学1～6年级学生3991名,应用修订版《学习障碍儿童筛查量表》（PRS）进行调查,其后进行信度和效度检验。结果该量表除1个功能区的α信度系数为0.84外,其余4个功能区α信度系数均在0.90以上;言语型和非言语型部分α信度系数均在0.95以上;该量表用于筛检学习障碍儿童（LD）的灵敏度、特异度分别为70.2%和83.6%,ROC曲线下面积为0.821。因子分析从量表析出4个因子,即言语性因素、社会适应因素、时间方位因素和操作性因素。湛江市区学习障碍儿童的筛出率为10.3%,男童高于女童。结论 PRS量表区域性实施具有理想的信度和效度,适用于团体筛查LD儿童。     

中文版初产妇亲子关系量表的信度和效度研究

目的分析中文版初产妇亲子关系量表的信度和效度。方法采用Brislin翻译模型对母亲客体关系量表(MORS-SF)进行汉化,经专家组及与试验调试条目形成终版初产妇亲子关系,而后扩大样本量进行正式试验。采用项目分析、内容效度、结构效度、效标关联效度、反应度、内部一致性系数对量表的信、效度进行分析。结果中文版亲子关系量表共保留13个条目,因子分析提取3个公因子,累计贡献率达64.637%。调查问卷的Cronbach'sα系数为0.946,且各维度的Cronbach'sα系数均0.65。结论中文版初产妇亲子关系量表具有良好的信度和效度,适合中国初产妇母婴间亲子关系的测评。     

医院员工对医疗服务质量满意度影响因素的信度与效度评价

目的研究当前医院员工对医疗服务质量满意度影响因素的信度和效度的评价步骤、方法及应用,从众多的员工满意度调查中搜寻充分、有效的证据,为医院管理者提供管理决策和服务策划的依据。方法从内部服务质量、工作态度、部门协作、经营管理、科室文化和员工忠诚度6个维度选出30个项目构成指标体系初始内容,通过专家调查、预调查分析,筛选出18个项目形成正式调查量表。结果正式调查结果Cronbachα系数为0.923,经因子分析,因子负荷和结构与量表内容基本吻合,维度内相关性强于维度间相关性,支持该量表的有效性和广泛适用性。结论本研究项目医院员工对医疗服务质量满意度及其影响因素的信度和效度评价,是可信的和有效的。     

抑郁症病耻感量表的汉化及在社区人群中的信效度评价北大核心

目的 汉化抑郁症病耻感量表(DSS),并检验其在社区人群中的信效度。方法 通过翻译、回译、专家委员会评议、预调查,形成中文版抑郁症病耻感量表。对2000名社区居民进行抑郁症病耻感调查,采用临界比值法和Pearson相关分析对量表进行条目分析;Cronbach′s α系数和重测信度评价量表的信度;经专家测评评定量表的内容效度,因子分析评价量表的结构效度。结果 DSS量表各条目的内容效度指数(I-CVI)为0.778~1.000,量表水平的内容效度指数(S-CVI)为0.914。探索性因子分析提取两个公因子,各条目的因子归属情况与原量表保持一致。进一步验证性因子分析结果显示模型的契合度良好。个人病耻感维度、感知病耻感维度、量表总分的Cronbach′s α系数分别为0.710、0.810、0.812,P<0.001;重测信度分别为0.902、0.734、0.901,P<0.001。结论 中文版抑郁症病耻感量表经文化调适后在中国社区人群中具有良好的信效度,可用于社区居民对抑郁症患者的态度、抑郁症患者自身的病耻感水平的测评。     

远洋运输业海员群体安全文化测评量表的构建

目的在研究国内外文献的基础上根据中国国情制定远洋运输业海员安全文化测评量表,并对其信度、效度进行检验,确保科学可行。方法在查询国内外有关海员以及相关海员群体安全文化调查量表文献的基础上,筛选相关条目组成量表,然后通过专家咨询法,形成"海员安全文化"测评量表初稿。经过50人的预调查对量表进行进一步修订,之后使用量表对上海市某远洋运输业公司的400名海员进行正式调查,采用因子分析、信度分析等统计方法对量表的信度与效度进行分析。结果通过正式调查对量表的信度、效度检验最后形成了适用于我国海员群体安全文化测评的34条目量表,在问卷的结构效度方面,通过探索性因子分析得到了安全态度、安全政策、安全知识以及安全管理4个维度,共解释了总方差的66.008%;在问卷的内容效度方面,34个条目的条目内容效度指数(I-CVI)值均≥0.8,平均量表内容效度指数(S-CVI/Ave)的值为0.959;在信度检验中,量表4个维度以及总体的Cronbach'sα系数在0.828~0.969之间,Spearman-Brown系数在0.784~0.902之间。结论量表具有较好的信度、效度和良好的内容一致性,可为以后研究海员群体安全文化测评工具的工作提供依据。     

已婚育龄妇女生殖健康知识、态度及行为量表评价

目的评价已婚育龄妇女知识、态度及行为量表的信效度,为研究已婚育龄妇女生殖健康提供有效的测评工具。方法采用Cronbach'sα、分半信度系数分别评价量表的内部一致性信度、分半信度;采用Pearson相关系数评价量表的内容效度,探索性因子分析和结构方程模型结合评价量表的结构效度。结果态度、行为2个分量表的Cronbach'sα系数分别为0.874、0.638;分半信度系数分别为0.860、0.643;2个分量表与各自所含维度的Pearson相关系数分别为0.497~0.828、0.304~0.866,差异均有统计学意义(P0.05);经探索性因子分析和结构方程模型分析,多数模型适配度指标(χ~2/df=2.16,RMSEA=0.04,GFI=0.96,AGFI=0.96,CFI=0.9680.90,NFI=0.9420.90,IFI=0.9680.90)表明量表结构效度较为理想。结论该量表具有较好的信度、效度,可以作为已婚育龄妇女生殖健康知识、态度及行为评价工具。     

Assessing the reliability and validity of anti-tobacco attitudes/beliefs in the context of a campaign strategy

OBJECTIVES: To identify multi-item attitude/belief scales associated with the theoretical foundations of an anti-tobacco counter-marketing campaign and assess their reliability and validity. METHODS: The data analyzed are from two state-wide, random, cross-sectional telephone surveys [n(S1)=1,079, n(S2)=1,150]. Items forming attitude/belief scales are identified using factor analysis. Reliability is assessed with Chronbach's alpha. Relationships among scales are explored using Pearson correlation. Validity is assessed by testing associations derived from the Centers for Disease Control and Prevention's (CDC) logic model for tobacco control program development and evaluation linking media exposure to attitudes/beliefs, and attitudes/beliefs to smoking-related behaviors. Adjusted odds ratios are employed for these analyses. RESULTS: Three factors emerged: traditional attitudes/beliefs about tobacco and tobacco use, tobacco industry manipulation and anti-tobacco empowerment. Reliability coefficients are in the range of 0.70 and vary little between age groups. The factors are correlated with one-another as hypothesized. Associations between media exposure and the attitude/belief scales and between these scales and behaviors are consistent with the CDC logic model. CONCLUSIONS: Using reliable, valid multi-item scales is theoretically and methodologically more sound than employing single-item measures of attitudes/beliefs. Methodological, theoretical and practical implications are discussed.     

Assessing attitude: the case of health-enhancing physical activity

OBJECTIVES: The basic phases of constructing compact questionnaire scales for health-promotion interventions are demonstrated in the case of attitudes towards two modes of physical activity, outdoor aerobic exercise (OAE) and everyday commuting activity (ECA). The scales were to show good psychometric properties and to provide adequate indicators of attitude. METHODS: Behaviours and criteria were specified for both OAE and ECA. The items describing the emotional (affect) and cognitive (outcome-expectations) aspects of attitude towards OAE and ECA behaviours were selected on the basis of a pilot study. The scales under development were used in a Finnish population survey on health, personal resources and physical activity (n = 1,516). Item analyses were completed for purposes of refining the scale; principal component analyses and factor analyses were used to establish the dimensional structure of the scales. Evidence of discriminatory validity was provided by comparing the scale scores of the different groups of respondents with regular, with sub-criterion, and without any OAE and ECA behaviours, respectively. RESULTS: The purported psychometric properties were met in the case of the affective and, less obviously, the positive outcome-expectation scales. The negative expectation scales need to be reconstructed with additional items. CONCLUSIONS: The psychometric properties of the affective scales and the positive expectation scales allow conclusions to be drawn regarding group differences in attitudes towards OAE or ECA behaviours. These scales are ready to be cross-validated in a new sample. Test-retest reliability should also be established.     

运用组织文化引导员工价值观

通过问卷调查发现医院的组织文化问题,提出了4个方面的建议,重塑医务人员新形象、引导员工价值取向、提升组织凝聚力和建立共同的价值信念。只有多措并举,逐步将员工的奋斗方向引导到达成组织发展的目标上来,用共同目标、共同价值观统领职工思想,才能有效地构建幸福和谐的医院,推动医院全面健康发展。     

军人亚健康症状测评量表编制

目的：研制军人亚健康症状测评量表。测定亚健康症状评定量表与世界卫生组织生存质量测定量表简表（WHOQOL-BREF下同）相关性、效度和信度关系。方法：采用同一人回答二份量表方式,同时调查了270例军人生存质量与亚健康症状携带状况,通过研究WHOQOL-BREF与自制亚健康症状评定量表同质性,调查与测评以证明后者有效性。结果：亚健康症状评定量表具有与WHOQOL-BREF同等的信度与效度。为中国军人人亚健康症状评定的可靠工具。     

Evaluation of the viability and validity of an instrument to measure community activation

OBJECTIVE: This study examines psychometric properties of a community activation assessment scale used for the evaluation of the Quebec project within the Federal Provincial Heart Health Initiative. The scale is composed of three sub scales, one for each of the intervention target risk factors. METHODS: Data were collected by telephone interviews conducted with 199 key informants from the 24 communities of the project. Reliability was studied using Cronbach's alpha coefficients and intraclass correlations. Validity was explored with factor analysis techniques. RESULTS: Subscales' internal consistency were very good, ranging from 0.71 to 0.83, but intraclass correlations between informants from the same communities were low. Factor analyses indicated a unidimensional structure for each scale. INTERPRETATION: These results show that the scale seems to provide reasonable assessments of the opinion of key informants regarding activation in their community. However, ranking communities based on the aggregated scores from local key informants may lead to classification problems.     

Assessing the reliability of a stage of change scale

The purpose of this study was to assess the test-retest reliability of a scale measuring Prochaska's stages of change. Although structured questionnaire items are being increasingly used to segment target audiences according to Prochaska and DiClemente's stages of change, we could find only one report in the literature assessing the reliability of such scales. The unreliability of single-item or algorithm questionnaire scales might be why a number of studies show only minimal differences on some variables between individuals in different stages of change. A survey of the Perth metropolitan general population aged 16-69 years (N = 2629) was completed in August-September 1992 as part of a 3 year evaluation of the Western Australian Health Promotion Foundation. The consistency of respondents' responses was assessed across two questions measuring stages of change for the behaviours quitting smoking (n = 404), reducing alcohol consumption (n = 57) and doing more exercise (n = 704). Given the immediacy of the test-retest situation, the reliability results are moderately encouraging: kappa = 0.72, 0.73 and 0.52 for quitting smoking, reducing alcohol and doing more exercise, respectively. Health researchers should be aware of the probable moderate level of reliability if using the type of scale assessed in this study, when interpreting differences between individuals in different stages. In practice, several questionnaire items for classification purposes should be used so that internal reliability measures can be calculated. It is recommended that research be undertaken to devise more reliable scales for stages of change for the various health behaviours. It is noted that the attitude literature with respect to context and time specific intentions could be helpful in devising such scales.     

Rethinking how to measure organizational culture in the hospital setting. The Hospital Culture Scale

Like all organizations, health care delivery systems must be concerned with understanding the implicit beliefs, values, and assumptions extant within the organization that ubiquitously motivate and shape the behavior of participating members. The Hospital Culture Scale (HCS) was designed as a way to assess the unique culture of hospital organizations. The HCS demonstrated high discriminant validity and reliability when applied to all members (patients, nurses, and physicians) of this particular organization. Data provided from different hospital organizations indicated that the HCS could differentiate between a variety of hospitals. Physicians, nurses, and patients were also compared. Although there was agreement between nurses and patients on how scale items are used, there were disagreements when these organizational members were compared to physicians. Differences between hospital members on the overall perception of hospital culture were found. The implications and utility of the HCS are discussed.     

上海市闸北区2型糖尿病患者生存质量及影响因素研究

目的找出影响糖尿病患者生存质量的可能因素,为今后改善社区卫生服务,提高患者生存质量提供依据。方法从上海市闸北区的3个社区卫生服务中心的糖尿病患者管理库中用单纯随机抽样法共抽取300人。通过患者自填或调查员面对面询问的方式进行问卷调查,生存质量调查用SF-36量表。采用多因素非条件Logistic回归进行影响因素分析。结果生存质量的促进因素主要包括：良好的家庭支持与交流情况,对生存质量6个维度有促进作用,OR值在总体健康感维度的1．662到精神健康维度的2．677之间;运动对6个维度有促进作用,OR值在总体健康感维度的1．481到躯体功能维度的1．956之间。生存质量的负面因素主要包括：患的其他慢性病数量,对4个维度有负面作用,OR值在躯体角色维度的0．638到躯体疼痛维度的0．712之间;单纯使用胰岛素对社会功能（OR=0．246）和情绪角色（OR=0．306）两个维度有负面作用。结论欲使糖尿病患者获得更好的生存质量,需要采取综合干预措施,重点应包括预防和积极治疗糖尿病的并发症,增进家庭支持与疾病交流,帮助患者改善运动习惯和正确认识胰岛素等。     

Psychosocial factors and dietary habits associated with vegetable consumption

OBJECTIVE: We assessed scales of psychosocial factors and dietary habits related to vegetable consumption and examined associations of these scales with vegetable intake. METHODS: Data are from 838 adults who participated in a 1997 to 1998 Washington State random digital-dial survey designed to monitor attitudes and behavior related to cancer risk and prevention. Information was collected on psychosocial factors related to vegetable consumption, vegetable-related dietary habits, demographic (participant) characteristics, and vegetable intake. Factor analyses were used to identify the underlying dimensions in the psychosocial and dietary habits scales. Analyses of variance, linear regression, and Pearson's correlations examined associations among participant characteristics, psychosocial factors, dietary habits, and vegetable consumption. RESULTS: Factor analyses of the psychosocial scale suggested four coherent dimensions or subscales--importance of eating vegetables, health benefits, convenience and taste of raw vegetables, and taste of cooked vegetables--with good internal consistency reliability (Cronbach's alpha = 0.67-0.77). There were four subscales within the dietary habits scale--add vegetables to mixed dishes, include vegetables at lunch and dinner, eat raw vegetables, and eat salads--with fair internal consistency reliability (Cronbach's alpha = 0.37-0.61). The psychosocial factors and dietary habits were strongly correlated (summary scales Pearson's r = 0.55), and after adjustment for participant characteristics, both scales were significantly and positively associated with vegetable intake (Pearson's r = 0.45 and 0.54, respectively, for summary scales; all Ps < 0.001). Further, the scales explained between 14% and 23% of the variance in vegetable intake. CONCLUSIONS: These scales of psychosocial factors and dietary habits related to vegetable consumption could be used to target intervention messages and evaluate intervention effects.     

抑郁症病耻感量表中文版在北京市15—24岁人群中的应用

目的探讨抑郁症病耻感量表（DSS）中文版在北京市15～24岁人群的适用性及效度和信度检验。方法由课题组专家对原量表进行翻译、审校和回译,确定DSS中文版符合量表原意。采用方便抽样抽取北京市某中学、两所综合大学学生和工作人员共830名15—24岁人群施测,分析了DSS的得分情况、效度、信度和区分度。结果调查对象个人DSS得分（17．43±3．86）低于感知DSS得分（19．48±4．18）（P〈0．05）;结构效度分析中,个人DSS提取了4个因子,其累积方差贡献率为60．29％;感知DSS提取了3个因子,其累积方差贡献率为56．6％;个人、感知及总DSS的Cronbach’s a．系数分别为0．45、0．67和0．70;区分度良好。结论DSS的效度和信度适中,区分度较好,可用于中国15～24岁人群抑郁症病耻感方面的研究。