【摘要】：[目的]翻譯英文版MMAS-8為中文,并應用于2型糖尿病患者,評價其信效度,探討不同因素對患者服藥依從性的影響,為指導糖尿病患者治療及其糖尿病健康教育提供理論基礎。[方法]翻譯英文版MMAS-8為中文,對2014年7月至2015年1月期間就診于昆明醫(yī)科大學第一附屬醫(yī)院糖尿病科門診及其住院部的148例確診2型糖尿病患者進行中文版MMAS-8及中文版MMAS-4的調(diào)查,并收集患者的一般人口學信息及糖尿病相關信息,如性別、年齡、病程、職業(yè)、醫(yī)保類型、學歷、身高、體重、病程、并發(fā)癥、合并癥、降糖方案及糖化血紅蛋白。從納入者中隨機抽取20%左右,2周后進行電話回訪,完成中文版MMAS-8的重測。采用IBM SPSS 23(2)軟件進行數(shù)據(jù)分析,評價量表的信效度并探討不同因素對服藥依從性的影響。[結果](1)完成中文版MMAS-8的翻譯,并應用于148例(男性69例,女性79例)2型糖尿病患者中,其中30例患者完成2周后的中文版MMAS-8重測。(2)納入的148例2型糖尿病患者中文版MMAS-8得分為6.31±1.88,低中高依從性患者分別為42例(28.38%)、56例(37.84%)、50例(33.78%)。(3)中文版 MMAS-8 信度檢驗:Cronbach's α 系數(shù)為 0.776,ICC 為 0.854(P0.05);結構效度檢驗:采用因子分析法,共提取3個公因子,累積解釋變異量的67.28%,各條目在其主因子的因子載荷量均超過0.5;聚合效度檢驗:中文版MMAS-8評分與中文版MMAS-4評分的相關系數(shù)為0.878(P0.001);區(qū)分效度檢驗:血糖達標組(HbAlc7%)中文版MMAS-8得分大于血糖未達標組(HbAlc≥7%)[(7.20±1.039)(5.94±2.027),Z=-3.849,P=0.00],差異有統(tǒng)計學意義,兩組間低中高依從性分布比較差異有統(tǒng)計學意義(Χ2=14.554,P=0.01)。(4)各影響因素與服藥依從性間的關系分別進行單因素及多因素分析。單因素有序多分類logistic回歸分析提示:性別(wald Χ2=7.046,P=0.008),降糖方案(waldΧ2=6.158,P=0.013)對服藥依從性的影響有統(tǒng)計學意義;多因素有序多分類logistic回歸分析提示:性別、醫(yī)保類型、降糖方案對服藥依從性的影響有統(tǒng)計學意義,其中男性患者相對于女性患者服藥依從性低[OR=0.405,95%CI(0.197,0.829)],職工醫(yī)�；颊呦鄬ψ再M患者服藥依從性低[OR=0.130,95%CI(0.021,0.800)],單藥治療相對于聯(lián)合治療服藥依從性高[OR=2.970,95%CI(1.499,5.882)]。[結論](1)中文版MMAS-8具有良好的信度、效度;(2)中文版MMAS-8可應用于2型糖尿病患者,用于評估患者的服藥依從性情況,并指導臨床工作開展;(3)本組2型糖尿病患者服藥依從性整體欠佳;(4)本組2型糖尿病患者的服藥依從性與性別、醫(yī)保類型及降糖方案的復雜程度有關。
[Abstract]:[objective] to evaluate the reliability and validity of MMAS-8 in patients with type 2 diabetes mellitus, and to explore the effect of different factors on the compliance of patients with type 2 diabetes. To provide theoretical basis for diabetic treatment and diabetes health education. [methods] the English version of MMAS-8 was translated into Chinese, From July 2014 to January 2015, 148 patients with type 2 diabetes diagnosed in the Department of Diabetes, first affiliated Hospital of Kunming Medical University, were investigated with Chinese version of MMAS-8 and Chinese version of MMAS-4. General demographic information and diabetes related information were collected, such as sex, age, course of disease, occupation, type of medical insurance, education, height, weight, course of disease, complications, hypoglycemic regimen and glycosylated hemoglobin. About 20% of the participants were randomly selected, and 2 weeks later telephone interview was carried out to complete the retest of the Chinese version of MMAS-8. IBM SPSS 23 (2) software was used to analyze the data, to evaluate the reliability and validity of the scale and to explore the influence of different factors on drug compliance. [results] (1) the translation of the Chinese version of MMAS-8 was completed and applied to 148 patients with type 2 diabetes (69 males and 79 females). The Chinese version of MMAS-8 was retest in 30 patients after 2 weeks. (2) the score of Chinese version MMAS-8 was 6.31 鹵1.88 in 148 patients with type 2 diabetes mellitus and 42 cases (28.38%) with low, medium and high compliance, respectively. 56 cases (37.84%), 50 cases (33.78%). (3) Chinese version MMAS-8 reliability test: the Cronbach's 偽 coefficient was 0.776CICC was 0.854 (P0.05); Structural validity test: three common factors were extracted by factor analysis, 67.28% of the variation was interpreted, and the factor load of each item was more than 0.5 in its main factor. Aggregation validity test: the correlation coefficient between the Chinese version MMAS-8 score and the Chinese version MMAS-4 score was 0.878 (P0. 001). The Chinese version of MMAS-8 score of blood glucose standard group (HbAlc7%) was higher than that of blood glucose substandard group (HbAlc 鈮，

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