連續可活動性腹膜透析自我效力量表之建立與測試

Developing and Testing of a CAPD Self-Efficacy Scale

林秋菊(Chiu-Chu Lin) ； 陸洛(Luo Lu) ； 王璟漩(Jing-Shiuan Wang) ； 賴永勳(Yung-Hsiung Lai)

《護理研究》 6卷4期 (1998/08) Pp. 315-326

https://doi.org/10.7081/NR.199808.0315

摘要

近年來，自我效力（self-efficacy）被認為是健康行為改變與維持的有力預測因子。本研究旨在建立並測試一研究工具，以評估連續可活動性腹膜透析（CAPD）病人的自我效力。此研究工具之發展係以Bandura自我效力理論及Orem自我照顧理論為概念基礎。研究分二階段進行，階段一：研究工具之發展（instrument development），本研究查證與自我效力及CAPD相關文獻、與 CAPD小組專家及CAPD病人討論、以及研究者臨床觀察來發展問卷項目（item）。問卷的內容效度由八位專家審閱確立之。階段二：本研究以內在一致性信度、三週間隔再測信度及因素分析來檢定CAPD自我效力量表心理計量。
本研究採量性研究法，立意取樣南部設有CAPD中心的五所教學醫院122位CAPD病人為研究對象。「CAPD自我效力量表」經由因素分析草取出四個因素，分別為：持守例行的治療計畫、調整生活型態、處理異常狀況、護理導管及導管出口處。此四個因素可解釋的總變異量為50.2％。而此四個因素頗能反映本研究設計所引用的Orem 自我照顧理論中「健康偏差的自我照顧需求」之概念。顯示本量表具有良好的建構效度。在信度方面，「CAPD自我效力量表」之四個因素的Cronbach's α與再測信度係數分別介於0.76－0.94與0.64－0.83。顯示本量表具有良好的內在一效性且具穩定性。本文亦就研究結果進行討論並提出對未來研究方向的建議。

關鍵字

連續可活動性腹膜透析 ； 自我效力 ； 自我照顧

並列摘要

Self-efficacy has recently been documented as a strong predictor in change and maintenance of health behavior. The aims of this study are to develop and test an instrument to measure self-efficacy in patients undergoing CAPD. With Bandura's self- efficacy theory and Orem's self-care theory serving as the conceptual basis for instrument development, the study was divided into two phases, an instrument development phase and a validity and reliability assessment phase. In phase one, we reviewed self-efficacy and CAPD literature as well as discussing with CAPD team members and CAPD patients serving as sources for item generation. Eight experts reviewed the instrument for content validity. In phase two, the following psychometric properties of the CAPD Self-Efficacy Scale were examined: internal consistency, reliability, three weeks test-retest reliability, and the dimensionality of the CAPD Self-Efficacy Scale revealed by factor analysis.
A quantitative research method was employed in this study. The purposively recruited sample for this study consisted of 122 CAPD patients at the CAPD centers of five teaching hospitals located in Southern Taiwan. Four factors of CAPD Self-Efficacy Scale were identified following factor analysis: Sticking with the routine therapeutic regimen, Adjusting life style, Managing abnormal conditions, Caring for the catheter exit site. These four factors explained 50.2% of the total variance in CAPD self-efficacy. The coefficients of Cronbach's α and retest reliability in these four factors of CAPD self- efficacy were 0.76 - 0.94 and 0.64 - 0.83 respectively. The results showed that the instrument had a satisfactory validity and reliability. Implications of these results for future research were discussed.

並列關鍵字

continuous ambulatory peritoneal dialysis (CAPD) ； self-efficacy ； self care