Validation evidence for Turkish adaptation of Champion's Health Belief Model Scales

Instruments using Health Belief Model constructs in breast cancer screening in previous studies were developed and tested by Champion for American women, and since then, these have been revised twice. Champion's Health Belief Model Scale (CHBMS) has been translated and tested in various studies in other countries and cultures. Also, the current study examined the validity and reliability of the Turkish adaptation of the CHBMS among Turkish women. The instrument was translated using a back-translation technique, which includes the use of a panel of experts and interpreters to translate the items from the source language to the target language and then back-translate them to the source language. The study was conducted in Ordu, a city in north Turkey. A total of 266 Turkish women aged 20 and older working as primary schoolteachers were included in the sample. Analyses included internal consistency, reliability, factor analysis, and known group techniques. After the analysis, 3 items from the Barriers domain, 1 from the Seriousness domain, and 2 from the Motivation domain were deleted from the original scale. So, the final Turkish version of the CHBMS (CHBMS-T) consisted of 36 items that were clustered into 6 subscales: susceptibility (3 items), seriousness (6 items), motivation (5 items), benefits of breast self-examination (BSE) (4 items), barriers to BSE (8 items), and confidence/self-efficacy of BSE (10 items). Internal consistency ranged from 0.69 to 0.83. Construct validity was supported by exploring the factor structure of the instrument using factor analysis and testing known-group techniques. Psychometric testing demonstrated satisfactory internal consistency and validity of the instrument for this group of women. It can be used in planning and testing interventions to improve BSE beliefs and practice.     

Adaptation of Champion's Health Belief Model Scale for Turkish women and evaluation of the selected variables associated with breast self-examination

The purpose of this study was to adapt Champion's Revised Health Belief Model Scale for Turkish women and to examine selected sociodemographic variables associated with breast self-examination (BSE). Data were collected from a total of 430 females who were living in one of the Health Center areas located in Izmir, a city in the west of Turkey. Champion's revised Health Belief Model Scale was translated into Turkish, validated by professional judges, translated back into English, and then tested. Factor analysis yielded 7 factors: susceptibility, seriousness, barrier 1, barrier 2, confidence, benefits, and health motivation. Significant correlations were found between 2 barriers. Therefore, 2 barriers were considered one barrier subscale. All the items on each factor were from the same construct. Cronbach alpha coefficients ranged from .58 to .89, and test-retest reliability coefficients ranged from .89 to .99 for the subscales. Women who received low scores on barriers reported greater frequency of BSE practice. Likewise, women having high scores on confidence, benefits, health motivation, susceptibility, and seriousness reported a greater frequency of BSE in the last year. The frequency of BSE practice was higher in high school and university graduates, women with a family history of breast cancer, and women with breast cancer and BSE training. The Turkish version of Champion's Revised Health Belief Model Scale was found to be a valid and reliable tool for use with Turkish women. It could be used to evaluate health beliefs about breast cancer and BSE among Turkish women.     

护理人员乳房自检实施及宣教情况的调查

目的了解护理人员乳房自检相关知识的掌握和实施情况,以及对周围人群的宣教情况。方法采用自制问卷对某医院140名护士进行调查,主要包括一般情况、乳房自我检查的相关知识、乳房自检的实施情况及对周围人群进行乳房自检相关知识的宣教情况。结果（1）被调查护士对乳房自检知识的平均掌握程度为59.1%;（2）51.4%的护士知道5个以上的乳腺癌高危因素;（3）50.7%的护士知道乳腺自检的频率和时间,36.4%的护士知道望诊的3~4个步骤,88.6%和61.4%的护士知道触诊手法和按压顺序;（4）仅5.7%的护士每月规律自检;（5）50%的护士曾接受过他人咨询,其中47.1%未给予咨询者指导。结论应加强护理人员乳房自检相关知识的培训,重点是乳腺癌高危因素、乳房自检频率和望诊方法等;同时,作为妇女健康的教育者和咨询者,护理人员应加强责任心,做好对周围人群乳房自检的宣传普及工作,积极维护自身及广大妇女的身心健康。     

乳腺增生症病人乳腺健康知识调查分析

目的 了解女性乳腺增生症病人乳腺健康知识及乳房自我检查的实施情况。方法 采用自行设计的问卷对850例女性乳腺增生症病人进行乳腺健康知识的调查及乳房自我检查实施情况的调查。结果 31．1％的乳腺增生症病人了解常见的乳腺疾病知识，58．5％的病人了解乳房自我检查知识，15．7％的病人掌握乳房自我检查的方法；不同职业、文化程度的乳腺增生症病人的乳房自我检查情况存在统计学差异（P〈0．01）。结论 加强妇女乳腺健康知识宣传，传授乳房自我检查的正确方法，有利于达到乳腺疾病早发现、早诊断、早治疗的目的。     

健康信念模式指导下的健康教育对慢性阻塞性肺疾病急性发作期伴焦虑患者心理的影响

目的探讨健康信念模式指导下的健康教育对慢性阻塞性肺疾病急性发作期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)伴焦虑患者心理健康的影响。方法 2012年12月至2013年10月,便利抽样法选取在泰州市人民医院住院治疗的99例AECOPD伴焦虑患者为研究对象,按入院先后将其分为观察组(n=47)和对照组(n=52)。对照组患者接受常规健康教育,观察组在此基础上接受健康信念模式指导下的健康教育。入院时、出院时采用焦虑自评量表和症状自评量表评定两组患者的心理情况。结果出院时和入院时相比,对照组患者焦虑改善不明显,差异无统计学意义(P0.05);观察组患者焦虑改善显著,差异有统计学意义(P0.01)。出院时,两组患者SCL-90总分均下降,但观察组优于对照组,差异有统计学意义(P0.01)。结论健康信念模式指导下的健康教育能改善AECOPD伴焦虑患者的心理健康状况。     

Validity and reliability study of the Turkish version of Health Belief Model Scale in diabetic patients

BACKGROUND: Diabetes mellitus (DM) is an important health problem that leads to severe complications, is the cause of early death, and is showing an increase in frequency. The development of positive health behaviors is extremely important in the treatment of diabetic patients. There are various models that examine the health behaviors of individuals. One of these is the Health Belief Model. This model is very beneficial in explaining factors that affect patients' compliance with their disease. PURPOSE: This research was planned to measure the validity and reliability of the Health Belief Model Scale in diabetic patients in the Turkish population. DESIGN: Questionnaire Survey. SETTINGS: The research population was all of the diabetic patients (4,125) registered with the Turkish Diabetes Society, Denizli Province, Turkey. PARTICIPANTS: A convenience sample was composed of 352 patients with Type 2 DM. METHODS: The research data were collected with three tools, a "sociodemographic data form" related to the diabetic patients, the "Health Belief Model Scale in Diabetic Patients," and the "Diabetes Management Self-Efficacy Scale."For validity studies: language validity, content validity, concurrent validity and construct validity were examined. For reliability studies: the tool's internal consistency reliability, Cronbach alpha reliability coefficient, test-retest reliability were examined. RESULTS: The tool's internal consistency reliability subscales' Cronbach alpha coefficient values ranged from 0.73 to 0.86. For the total tool a Cronbach alpha value of 0.89 was found. In the tool's internal consistency reliability total item correlation the three items that were below 0.30 were removed and the 36 items were reduced to 33 items. The tool's test-retest reliability was 0.90. According to factor analysis the tool contains five subscales of perceived susceptibility, perceived severity, perceived benefits, perceived barriers and recommended healthy behaviors. CONCLUSION: The Health Belief Model Scale in diabetic patients was determined to be valid and reliable for use in the Turkish population.     

Using a community-based outreach program to improve breast health awareness among women in Hong Kong

OBJECTIVE: To evaluate the effectiveness of a community-based health education program via a mobile van to promote the awareness of breast cancer and breast self-examination (BSE) practice among women in Hong Kong. DESIGN: One group pretest/posttest design. SAMPLE AND MEASUREMENTS: Seven hundred and seventy-seven women in Hong Kong completed a self-administered questionnaire before and after a breast health education program from May 2002 to March 2003. RESULTS: About half were aware of breast health and breast diseases (53.7%) and breast screening methods (48.6%) before the intervention. It was found that women who had received instruction on BSE practice, and those who were aware of breast screening methods, breast health, and breast diseases were more likely to have had prior BSE practice. Most indicated their willingness to practice BSE regularly (93.3%) and to pass on the BSE knowledge to their relatives and friends (92%) in the posttest. CONCLUSIONS: The outreach health education program has successfully reached women living in the 18 districts in Hong Kong. It appears to be useful in raising the awareness of breast health and BSE practice among the women, but longer term follow-up is required to ascertain its sustainability.     

Ethnic differences in breast self-examination practice and health beliefs

Thirty-two African American nurses (AAN) and 78 Caucasian nurses (CN) were compared on breast self-examination (BSE) practice and health beliefs. Relationships between these variables were also examined. The Health Belief Model provided the framework for the study. The sample is a subset of 269 women from a larger study. AANs were recruited from a professional nurses' group. CNs were recruited from a list of female employees of a university medical centre. The results of t -tests revealed no significant group differences on BSE frequency ( P =0·06) or BSE proficiency ( P =0·10). Noted was that 42% of AANs compared to 20% of CNs examined their breasts 12 or more times during the year. AANs were more likely to consider BSE beneficial ( P =0·002) and to feel confident ( P =0·006) about doing BSE; CNs perceived more barriers ( P =0·001) to BSE. For AANs, BSE frequency and proficiency were positively related to confidence and inversely related to barriers; BSE frequency was also related to health motivation. For CNs, BSE frequency and proficiency were inversely related to seriousness. Implications include additional research to validate findings and to increase the knowledge base of all nurses regarding BSE.     

196例妊娠糖尿病患者健康信念现状及影响因素分析

目的 探讨妊娠糖尿病患者健康信念现状,分析其影响因素。方法 采用方便抽样法,2017年9月—2018 年3月抽取郑州市某三级甲等医院产科门诊就诊的妊娠糖尿病患者作为研究对象。采用一般资料调查表、妊娠糖尿病健康信念问卷、糖尿病知识理解情况自评表及糖尿病态度量表,对196例妊娠糖尿病患者进行调查。采用多元线性回归分析妊娠糖尿病患者健康信念的影响因素。结果 本组妊娠糖尿病患者健康信念总标准分为（63.10±3.11）分,糖尿病知识理解得分为（32.65±2.03）分,糖尿病积极态度得分（14.02±1.80）分,消极态度得分（16.64±1.44）分。多元线性回归分析结果显示,文化程度、职业、是否有妊娠糖尿病史、糖尿病知识理解、糖尿病积极态度进入回归方程（P<0.001）,可解释妊娠糖尿病患者健康信念总变异的73.6%。结论 本组妊娠糖尿病患者健康信念处于中等水平,文化程度、职业、妊娠糖尿病病史、糖尿病知识及糖尿病态度是健康信念的主要影响因素。建议产科门诊医护人员重视患者知识及态度对其健康信念的影响,重点关注文化水平较低及首次确诊妊娠糖尿病的患者,识别不同职业背景患者的需求,根据患者特点采用多形式教育模式,激发患者积极情绪,提高其信心与积极性,促进其形成良好的健康信念与行为。     

护士乳房自检知识掌握和实施状况分析

目的:了解护理人员乳房自检知识的掌握情况、实施情况以及影响实施的相关因素。方法:采用调查问卷对某医院140名护士进行资料收集。结果:①研究对象自检知识平均得分为61.1分;②不同文化程度和不同科室的护士知识得分有统计学差异;③5.7%的护士每月规律自检,74.3%的护士不定期自检;④60.0%的护士能按照正确的方法进行自检;⑤影响自检行为的因素包括知识得分(OR=1.029)和婚姻状态(OR=2.222)。结论:护理人员对乳房自检知识的掌握程度应进一步提高,自检实施情况欠佳,影响实施的因素需进一步深入研究。     

冠心病患者健康信念与健康行为的相关性研究

目的探讨冠心病患者的健康信念与健康行为的关系。方法用方便抽样的方法，调查了广州市3所三甲医院的103名冠心病患者，并以105名正常人作为对照。采用问卷调查法，用健康促进生活方式量表和冠心病健康信念问卷分别调查了研究对象的健康行为和健康信念，并使用SPSS11．0软件包进行统计分析。结果冠心病患者的健康信念总分与健康行为中健康责任和营养两个维度呈正相关（P〈0．05）；健康信念中维护健康动机与健康行为总分及其各维度均呈正相关（P〈0．05）；知觉到严重度与健康行为中运动和锻炼、自我实现两个维度呈负相关（P〈0．05）；知觉到益处与健康行为总分及其自我实现、压力应对和营养三个维度呈正相关（P〈0．05）。结论冠心病患者的健康信念可影响其健康行为，对维护其健康的愿望越强烈，就越有利于其健康行为的建立；越能意识到冠心病的严重性，就越能采取运动和锻炼、自我实现等健康行为；越能意识到采取健康行为所能带来的益处，就越能采取自我实现、正确积极地应对压力及合理的饮食等健康行为。     

Use of Giger and Davidhizar's Transcultural Assessment Model by Health Professions

Nursing science is increasingly gaining recognition. Witness the growing use by other disciplines of nursing's models and ideas. One example is the adoption of the Giger and Davidhizar Model of Transcultural Assessment by non-nursing disciplines to understand and address the needs of a pluralistic multicultural society. Below the authors describe a model to understand culturally diverse clients and show how health professions are using it to provide culturally competent care.