脑卒中高危筛查意向量表的编制与信效度检验研究

背景 我国正在大力开展社区脑卒中高危筛查项目，居民的参与意向是影响项目成效的重要因素。但是目前缺乏可靠的社区居民脑卒中高危筛查意向量表。 目的 编制脑卒中高危筛查意向量表并评价其信效度，为评估居民脑卒中高危筛查意向提供可靠的工具。 方法 基于计划行为理论，通过文献回顾、实地走访和头脑风暴，形成量表条目池。2021年7—8月，遴选5名脑卒中相关研究或精通量表编制的专家，进行2轮专家评价，形成初始版脑卒中高危筛查意向量表（包含3个维度，28个条目）。2021年8—9月，采用便利抽样法，选取湖北省襄阳市、武汉市、荆门市，广东省广州市、惠州市、深圳市的社区居民为研究对象，对初始版脑卒中高危筛查意向量表进行信效度检验。 结果 共发放问卷535份，有效问卷524份，有效回收率为98%。最终形成4个维度25个条目的量表，分为积极态度、消极态度、主观规范、知觉行为控制。总量表Cronbach's α系数为0.904，重测信度的组内相关系数（ICC）为0.810。各条目内容效度（I-CVI）为0.8~1.0，量表的全体一致内容效度（S-CVI/UA）为0.93，平均内容效度（S-CVI/Ave）为0.99。探索性因子分析显示，因子累积方差贡献率为61.945%，各条目因子载荷量为0.482~0.828。验证性因子显示拟合优度χ2=361.040，df=267，χ2/df=1.352，近似误差均方根（RMSEA）=0.038，拟合优度指数（GFI）=0.897，比较拟合指数（CFI）=0.958，调整拟合优度指数（AGFI）=0.875，增值拟合指数（IFI）=0.959，非规准适配指数（TLI）=0.953，规范拟合指数（NFI）=0.859。 结论 脑卒中高危筛查意向量表具有较好的信效度，可作为测量居民脑卒中高危筛查意向的工具。

Development,Validity and Reliability of High-risk People's Intention to Use Stroke Screening Scale

Background The program of screening for stroke in high-risk populations is being carried out vigorously in Chinese communities,the implementation effectiveness of which is closely associated with residents'intention to use the program.However,there is no reliable scale for measuring high-risk residents'intention to use stroke screening.Objective To develop a scale for measuring high-risk people's intention to use stroke screening,and to assess its reliability and validity,providing a reliable tool for assessing high-risk residents'intention to use stroke screening.Methods The Theory of Planned Behavior,literature review,field survey and brainstorming were used to develop the item pool of the scale.Then the items were used to form an initial version of High-risk People's Intention to Use Stroke Screening Scale(three domains covering 28 items)after being revised in accordance with the assessment results of two rounds of expert survey with five experts(four stroke researchers and one with a good command of developing a scale)from July to August 2021.After that,the reliability and validity of the initial version of the scale was tested in August to September 2021 with a convenience sample of community residents from Hubei's Xiangyang,Wuhan,Jingmen,and Guangdong's Guangzhou,Huizhou,Shenzhen.Results Altogether,535 residents attended the survey for testing the reliability and validity of the initial version of the scale,and 524 of them(98%)returned responsive questionnaires.The final revised version consists of four domains(positive attitude,negative attitude,subjective norms,perceived behavioral control)with 25 items.The Cronbach'sαof the scale was 0.904.And its ICC for test-retest reliability was 0.810.The content validity index of each item(I-CVI)ranged from 0.80 to 1.00.The scale-level CVI/universal agreement(S-CVI/UA)and average scale-level CVI(S-CVI/Ave)were 0.93 and 0.99,respectively.By exploratory factor analysis,four common factors were extracted,and they explained 61.945%of the total variance.The loading for each factor was 0.482-0.828.Confirmatory factor analysis showed that the scale's fit indices were:χ²=361.040,df=267,χ²/df=1.352,RMSEA=0.038,GFI=0.897,CFI=0.958,AGFI=0.875,IFI=0.959,TLI=0.953,NFI=0.859.Conclusion The scale has proven to be highly reliable and valid,which could be used as a tool for measuring high-risk community-dwelling residents'intention to use stroke screening.