The Psychometric Testing of the Diabetes Health Promotion Self-Care Scale

背景健康促進行為對促進及維持第2型糖尿病病人的健康是重要的，但少有量表測量糖尿病病人健康促進自我照顧行為。目的發展糖尿病健康促進自我照顧行為量表並檢測其信、效度。方法由高雄市四間醫院內分泌科門診選取489位第2型糖尿病病人，採用探索性及驗證性因素分析，評估健康促進自我照顧行為的建構效度，以健康促進自我照顧行為與糖尿病生活品質生活滿意度次量表、糖尿病賦權量表、及糖化血色素的相關性檢測同時效度，並以內在一致性及再測信度檢測量表的信度。結果以二階段驗證式因素分析結果顯示，以含七個次量表共26題的量表最契合收集的資料；七個次量表分別為：人際關係、飲食、自我監測血糖、個人責任、運動、遵循服藥及足部護理。量表總分與生活滿意度、糖尿病賦權呈顯著正相關。糖化血色素僅與健康責任次量表呈顯著正相關。總量表及各次量表Cronbach's α在.78至.94間；再測信度的組內相關係數值（intraclass correlation coefficient）在.76至.95間，顯示此量表具有良好的信度。結論／臨床應用糖尿病健康促進自我照顧行為量表具有良好的信、效度，健康專業人員可運用此量表評估糖尿病病人健康促進自我照顧行為，並依此提供適當的介入措施。

關鍵字

糖尿病健康促進自我照顧行為；量表發展；第2型糖尿病

並列摘要

Background: Health-promoting behavior is an important strategy to maintain and enhance health of patients with Type 2 diabetes. Few instruments have been developed to measure health promotion self-care behavior of patients with Type 2 diabetes. Purpose: Developing and psychometric testing of the Chinese version of the Diabetes Health Promotion Self-Care Scale (DHPSC) for patients with Type 2 diabetes. Methods: Four hundred and eighty-nine patients with Type 2 diabetes were recruited from endocrine clinics in four hospitals in Kaohsiung City in southern Taiwan. Exploratory and confirmatory factor analyses were used to assess the construct validity of the scale. Correlations between the DHPSC and the satisfaction subscale of Diabetes Quality of Life, Diabetes Empowerment Scale, and HbA1c were calculated to evaluate concurrent validity. Internal consistency and test-retest reliability were used to assess the reliability of the scale. The study was conducted in 2007 and 2008. Results: A proposed second-order factor model with seven subscales and 26 items fit the data well. The seven subscales were interpersonal relationships, diet, blood glucose self-monitoring, personal health responsibility, exercise, adherence to the recommended regimens, and foot care. The DHPSC statistically significantly correlated with the satisfaction subscale of Diabetes Quality of Life and the Diabetes Empowerment Scale. HbA1c only statistically significantly correlated with the subscale of health responsibility. Reliability was supported by acceptable Cronbach’s alpha (range, .78-.94) and testYretest reliability (range, .76-.95). Conclusions/Implications for Practice: The DHPSC has satisfactory reliability and validity. Healthcare providers can use the DHPSC to comprehensively assess the health promotion self-care behaviors of patients with Type 2 diabetes.

並列關鍵字

diabetes health promotion self-care ； instrument development ； Type 2 diabetes

參考文獻

Aikens, J. E.,Bingham, R.,Piette, J. D.(2005).Patient-provider communication and self-care behavior among Type 2 diabetes patients.The Diabetes Educator.31(5),681-690.

Google Scholar

American Diabetes Association. (2010). Diabetes statistics. Retrieved from http://www.diabetes.org/diabetes-basics/diabetesstatistics/

Google Scholar

Anthony, S.,Odgers, T.,Kelly, W.(2004).Health promotion and health education about diabetes mellitus.The Journal of the Royal Society for the Promotion of Health.124(2),70-73.