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老年患者自主性感知現(xiàn)狀及影響因素研究

發(fā)布時間:2018-08-14 10:38
【摘要】:目的:引進臺灣中文版知覺自主性量表,完成量表中文簡版的心理測量學檢驗,為同類研究提供有效、科學、可信的測評工具;并采用橫斷面調(diào)查的研究設(shè)計分析老年患者的自主性感知現(xiàn)狀,探討影響老年患者自主性感知水平的相關(guān)因素,并提出相應(yīng)干預(yù)對策。本課題將為指導老年患者更好的保護和利用其自主性、增強其自我護理行為、縮短病程、加快康復(fù)、減少并發(fā)癥、降低復(fù)發(fā)率、提高生活質(zhì)量提供一個新的干預(yù)視角。方法:本研究分為兩部分,第一部分為自主性感知量表的引進及信效度檢驗,第二部分為老年患者自主性感知水平現(xiàn)狀及其影響因素分析。1.知覺自主性量表的引進及信效度檢驗獲得原作者臺灣學者黃慧莉和林惠賢教授授權(quán),遵循目前國際通行的量表引進程序,最終形成中文簡版自主性感知量表,并通過內(nèi)容效度和結(jié)構(gòu)效度對量表的效度進行評價,通過Cronbach’sα系數(shù)和分半信度來對量表的信度進行評價。2.老年患者自主性感知水平現(xiàn)狀及其影響因素分析采用方便抽樣的方法,選取山西省太原市4所三級甲等綜合醫(yī)院的老年患者共400例作為研究對象進行問卷調(diào)查。問卷內(nèi)容包括一般人口學資料、中文簡版自主性感知量表、老年人生活滿意度量表和簡易應(yīng)對方法問卷。調(diào)查老年患者自主性感知水平現(xiàn)狀及以自主性感知的3個維度和總體自主性感知水平作為應(yīng)變量,通過單因素方差分析、相關(guān)分析以及多元逐步回歸方法分別分析其相應(yīng)的影響因素。結(jié)果:1.遵循量表引進程序,最終確定中文簡版自主性感知量表由3個維度21個條目組成,分別為自主性8個條目、個體性9個條目以及獨立性4個條目。2.總量表的Cronbach’sα系數(shù)為0.91,3個維度的Cronbach’sα系數(shù)為:0.67~0.89;總量表的分半信度為0.914,三個維度的分半信度為0.584~0.865,說明中文簡版自主性感知量表具有較好的信度。通過嚴格的跨文化調(diào)適及資深專家的修訂,總量表的內(nèi)容效度指數(shù)(S-CVI)為0.94,各條目的內(nèi)容效度指數(shù)(I-CVI)在0.8~1.0,保證了中文簡版量表的內(nèi)容效度。經(jīng)KMO適應(yīng)性檢驗和Bartlett球形檢驗,結(jié)果顯示KMO值為0.89、Bartlett球形檢驗值為2146.11,P0.001,說明適合進行因子分析。采用主成分分析法,經(jīng)方差最大正交旋轉(zhuǎn)法后提取到3個公因子(各公因子特征值均1),累計解釋方差貢獻率為53.85%。每個條目在公共因子負荷值為0.401~0.810,證明量表的結(jié)構(gòu)效度較好。3.老年患者自由性感知總體得分為(61.33±8.51)分,各分量表得分分別為自由性(22.63±4.55)分、個體性(27.15±3.92)分、獨立性(11.55±2.42)分。各維度條目均分,由高到低依次是個體性為(3.02±0.44)分,獨立性為(2.89±0.61)分,自由性為(2.83±0.57)分。4.自主性感知的3個維度不同程度受年齡、學歷、職業(yè)、經(jīng)濟來源、個人收入、醫(yī)療費用支付方式、積極應(yīng)對、消極應(yīng)對和生活滿意度等影響。結(jié)論:1.中文簡版自主性感知量表結(jié)構(gòu)合理、信效度良好,適合中國文化背景下對老年患者的自主性感知水平進行測量。2.老年患者的自主性感知的相關(guān)因素可幫助研究者和醫(yī)護工作者評估老年患者自主性感知水平,并制定針對性的干預(yù)方案,為指導老年患者更好的保護和利用其自主性、增強其自我護理行為、提高生活質(zhì)量提供一個新的干預(yù)視角。
[Abstract]:Objective: To introduce the Chinese version of the Taiwan Perceptual Autonomy Scale and complete the psychometric test of the Chinese version of the scale, so as to provide an effective, scientific and reliable assessment tool for similar studies. This study will provide a new perspective of intervention to guide elderly patients to better protect and utilize their autonomy, enhance their self-care behavior, shorten the course of disease, accelerate rehabilitation, reduce complications, reduce recurrence rate and improve the quality of life. The introduction and reliability and validity test of the questionnaire, the second part is the status quo of elderly patients'autonomy perception and its influencing factors. 1. The introduction and reliability and validity test of the scale were authorized by Taiwan scholars Professor Huang Huili and Professor Lin Huixian. Following the current international standard scale introduction procedure, the Chinese version of the scale was finally formed. The validity of the scale was evaluated by content validity and structure validity. The reliability of the scale was evaluated by Cronbach's alpha coefficient and split-half reliability. 2. The status quo of elderly patients'autonomous perception and its influencing factors were analyzed by convenience sampling method. Four third-class A comprehensive schools in Taiyuan, Shanxi Province were selected. A total of 400 elderly patients in the hospital were investigated with questionnaires. The contents of the questionnaire included general demographic data, Chinese version of self-determination scale, elderly life satisfaction scale and simple coping method questionnaire. Results: 1. Following the introduction procedure of the scale, the Chinese version of the self-determination scale was finally determined to consist of three dimensions and 21 items, namely, 8 items of autonomy, 9 items of individuality and independence. The Cronbach's alpha coefficient of the total scale was 0.91, the Cronbach's alpha coefficient of the three dimensions was 0.67-0.89, the split-half reliability of the total scale was 0.914, and the split-half reliability of the three dimensions was 0.584-0.865, indicating that the Chinese version of the scale had good reliability. The content validity index (S-CVI) of the total scale was 0.94 and the content validity index (I-CVI) of each item was 0.8-1.0, which ensured the content validity of the simplified Chinese version of the scale. By the analysis method, three common factors (the eigenvalues of each common factor were 1) were extracted by the orthogonal rotation method, and the cumulative explanatory variance contribution rate was 53.85%. The scores of freedom, individuality and independence were 22.63 (+ 4.55), 27.15 (+ 3.92) and 11.55 (+ 2.42) respectively. The items of each dimension were divided equally. From high to low, the individuality was (3.02 + 0.44), the independence was (2.89 +0.61) and the freedom was (2.83 +0.57). 4. The three dimensions of self-determination were affected by age, educational background, occupation, economic source, and personal income to varying degrees. Conclusion: 1. The Chinese version of the self-determination scale has a reasonable structure and good reliability and validity. It is suitable for measuring the level of self-determination of elderly patients in the context of Chinese culture. 2. The related factors of self-determination of elderly patients can help researchers and researchers. Medical workers evaluate the level of autonomy perception of elderly patients and formulate targeted intervention programs, which provide a new perspective for guiding elderly patients to better protect and utilize their autonomy, enhance their self-care behavior and improve the quality of life.
【學位授予單位】:山西醫(yī)科大學
【學位級別】:碩士
【學位授予年份】:2017
【分類號】:R47

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