血液透析病患自我管理量表之

血液透析病患自我管理量表之建構與測試

自我管理對血液透析病患是一相當重要健康議題。成功的自我管理，能使患者在疾病治療與日常生活兩者間達至平衡。本研究目的旨在發展血液透析病患自我管理量表，並測試其信度與效度。研究分三階段進行。階段一：確立量表的構面，研究者依據自我管理概念分析之定義性特質與焦點團體的資料分析結果，形成血液透析病患自我管理量表之構面。階段二：發展量表題項，題項來源主要參考焦點團體中病人陳述，並輔以研究者多年的臨床經驗。階段三：量表信效度測試，量表之內容效度經八位專家審核確立後，以57位血液透析病患進行量表預測。爾後，於四家醫院血液透析室招募196位受試者，進行量表之信、效度測試。經探索性因素分析結果，共得4個因素，分別為與健康專業人員之伙伴關係、執行自我照顧活動、問題解決與情緒的處理，解釋總變異量達45.13%。血液透析自我管理總量表共20個題項，其Cronbach’s α為.87；四個次量表之Cronbach’s α介於.70與.78之間；兩週後再測信度相關係數為.86 ( p<.000)。結果顯示本量表具良好之信度與效度，可做為血液透析病患自我管理的評估工具。

關鍵字

血液透析；自我管理；量表建構

並列摘要

Successful self-management is crucial for hemodialysis(HD) patients to achieve a balance between disease control and daily life. The purpose of the study is to develop and psychometrically test a new instrument for measuring hemodialysis patients’ self-management behaviors. This study was divided three stages. Stage one: dimensions determination. The dimensions of the instrument were formed based on the attributes of a concept analysis of self-management and the findings from focus groups. Stage two：items generation. The items generated for the instrument were drawn from a previous focus group study conducted by the authors. Stage three: psychometrical testing. The instrument content was validated by eight experts. The hemodialysis self-management instrument (HD-SMI)was pilot tested with a sample 57 HD patients. To examine the psychometric properties of HD-SMI, data were collected from 196 subjects recruited from four hospitals’ HD centers. Four factors were extracted through exploratory factor analysis that explained 45.13 % of the total variance: partnership, self-care, problem-solving skills, and emotion management. Cronbach’s α coefficients of the HDSMI total scale was .87, and of four subscales ranged from .70 to .78. The two-week test-retest correlation was .86. The results indicated that the hemodialysis self-management instrument with good reliability and validity. The instrument can be used for measuring self-management in hemodialysis patients.