健康素养管理量表(HeLMS)在大肠癌初筛阳性居民中的适用性评估

 目的   对健康素养管理量表(Health Literacy Management Scale,HeLMS)的信度和效度进行评价,探讨其在大肠癌初筛阳性居民中的适用性。方法   采用HeLMS量表对上海市嘉定区2015—2016年1 959名大肠癌初筛阳性的居民进行问卷调查,用因子分析法、Cronbach α系数、相关系数等考察量表的信度和效度。结果    量表的总Cronbach α系数为0.961,量表各维度的Cronbach α系数为0.834~0.929;量表每个条目与其所属维度间的相关系数为0.511~0.936,且均有统计学意义;肠镜检查组的健康素养量表得分为128.99±12.83,显著高于未进行肠镜检查组的126.98±15.66 (P=0.002)。对年龄、性别、初筛阳性特点等进行分层分析,发现年龄>70岁、女性、风险评估及大便隐血均阳性者在肠镜组和非肠镜检查组患者量表得分差异上有统计学意义(P<0.05)。分半信度的Cronbach α系数0.976;因子分析法得到的结果与量表结构大致相符,各维度得分与量表总得分的相关系数为0.517~0.916,均有统计学意义;量表得分的三分位组别(高分、中分和低分)在量表各维度的差异均有统计学意义,提示量表区分效度较好。结论    HeLMS量表在大肠癌初筛阳性居民中具有较好的信度和效度,可用于评价其健康素养水平。

Reliability and validity of the Health Literacy Management Scale (HeLMS) among positive residents at initial stage of colorectal cancer screening

Objective   To evaluate the reliability and validity of the Health Literacy Management Scale (HeLMS) and its utility in positive residents of colorectal cancer screening.Methods    A total of 1 959 residents with positive results at initial screening stage of colorectal cancer screening in Jiading District of Shanghai from 2015 to 2016 were investigated using HeLMS.Factor analysis,Cronbach coefficient and correlation coefficient were used to evaluate the reliability and validity of the scale.Results    The overall Cronbach α coefficient was 0.961,and the subscales varying from 0.834 to 0.929.The correlation coefficient between each item of the scale and its dimension varied from 0.511 to 0.936 and reached statistically significance.The HeLMS score was 128.99±12.83 in the subjects receiving colonoscopy test,significantly higher than those without having colonoscopy (126.98±15.66) (P=0.002).Stratified analysis was applied on the age,gender and positive characteristics in early screening,and it showed that the residents scale scores of those were above 70 years old,female,or positive in both risk assessment and fecal occult blood,had significant difference between colonoscopy and non colonoscopy cases (P<0.05).The split-reliability was as high as 0.976.Factor analysis showed that the results were consistent with the scheme of the scale.Significant correlations were observed between overall scores of the scale and score of each dimension,with correlation coefficients ranging from 0.517 to 0.917 (all P values<0.05).The tertile (high,middle and low) score groups in each dimension differed significantly,showing a good discriminatory accuracy of the scale.Conclusions    The HeLMS is of high reliability and validity in positive redsidents of early screening of colorectal cancer,and may be used to evaluate the level of health literacy in the population.