上海市黄浦区成人基本医疗健康素养监测问卷编制及信效度分析

目的 通过自编问卷检验问卷测量性能,为了解黄浦区居民基本医疗健康素养水平提供测量工具。 方法 根据构建的黄浦区基本医疗健康素养评估指标体系设计初始评估问卷(57题),采用方便抽样方法抽取社区居民200人开展预测试;通过项目分析筛除冗余题项,形成基本医疗素养评估问卷(38题)。应用问卷对上述200位社区居民施测,并抽取50名两周后复测,分析问卷的信效度;方便抽取黄浦区某二级医院医护人员100人、社区慢性病患者50人施测,分析区分效度。应用SPSS 17.0进行项目难度、区分度分析及信效度分析。Cronbach’s α系数、Guttman分半系数和组内相关系数ICC值用以测量信度;利用内容效度、结构效度和区分效度分析检验效度。 结果 通过项目分析,共剔除22个条目,结合专家意见和专业知识,增加3条,最终38个条目进入指标体系终稿,形成“黄浦区成人基本医疗健康素养监测项目评估问卷”。全问卷的Cronbach’s α系数为0.709,重测信度为0.994;一级指标得分与总分的相关系数为0.728和0.643,2个一级指标间得分相关系数为0.213。 结论 本研究问卷针对城市居民基本医疗素养的测量而设计,是评估居民基本医疗素养的有效工具,丰富了国内基本医疗素养调查的内容,具有较好的信度、效度,对开展居民基本医疗素养的评估及干预措施有理论和实践上的指导意义。

Establishment and reliability and validity of a monitoring questionnaire on health literacy about adult basic medical care in Huangpu District of Shanghai Municipality

Objective To test the measurement performance of a monitoring questionnaire on health literacy regarding adult basic medical care by using a self-designed questionnaire so as to provide a measurement tool for investigating the level of health literacy concerning basic medical care among residents in Huangpu District.Methods An initial assessment questionnaire(including 57 questions)was designed according to the established assessment index system for health literacy about basic medical care in Huangpu District.A pre-test was conducted among 200 community residents selected by a convenient sampling method.The redundant items were screened out through item analysis,and the assessment questionnaire on basic medical literacy(including 38 questions)was formed.The questionnaire was used to survey the above-mentioned 200 community residents,and then 50 residents sampled were retested after two weeks.The reliability and validity of the questionnaire were analyzed.100 medical professionals from a secondary hospital and 50 community patients with chronic diseases in Huangpu District were selected by a convenient sampling method,and then the discriminatory validity was analyzed.SPSS17.0 software was employed for analyzing the project difficulty,discrimination,reliability and validity.The reliability was determined by means of Cronbach’s α coefficient,Guttman split-half coefficient and intraclass correlation coefficient(ICC).Content validity,structural validity and discriminant validity analyses were performed to test the validity.Results A total of 22 items were removed through the project analysis,and 3 items were added in combination with expert opinions and professional knowledge.Finally,38 items were included in the final draft of the indicator system,forming the evaluation questionnaire on monitoring project of health literacy about adult basic medical care in Huangpu District.The Cronbach’sαcoefficient of the questionnaire was 0.709,and the test-retest reliability was 0.994.The correlation coefficients of the first-level index score and the total score were 0.728 and 0.643,respectively,and the correlation coefficient of score of two first-level indexes was 0.213.Conclusions The questionnaire developed in the study is designed to measure the basic medical literacy of urban residents,and it is an effective tool to evaluate the residents’basic medical literacy.It enriches the content of domestic basic medical literacy survey,possesses good reliability and validity,and has theoretical and practical guiding significance for conducting evaluation and intervention measures of basic medical literacy in the residents.