广西医学

目的研发老年吞咽障碍患者照顾者自我效能量表并检验信效度。方法基于角色理论、自我效能理论及生物-心理-社会医学模式理论，采用文献研究、质性访谈构建初始条目池，经3轮专家函询修订形成量表预调查版。基于量表预调查版编制预调查问卷，采用便利抽样法选取成都市两所三级甲等医院30名老年吞咽障碍患者照顾者进行预调查，根据预调查结果调整量表后形成临床施测版。采用便利抽样法，于2024年5—11月选取上述两所医院收治的602例老年吞咽障碍患者照顾者进行正式调查，采用项目分析筛选量表条目，对量表进行信效度检验。结果老年吞咽障碍患者照顾者自我效能量表包括社交照顾信念、情绪照顾信念、治疗照顾信念、摄入照顾信念4个维度，共20个条目。探索性因子分析结果显示，累积方差贡献率为53.891%；验证性因子分析结果显示，模型整体拟合优秀；修正后模型指标χ2/df为1.891，近似误差均方根为0.054，拟合优度指数、增量拟合指数、非规范拟合指数、比较拟合指数均>0.9，量表的组合效度为0.751~0.827，平均方差抽取量（AVE）为0.388~0.461，不同维度间的相关系数均小于各对应维度的AVE平方根。条目层面的内容效度指数为0.883~1.000，量表层面的整体内容效度指数为0.800，量表层面的平均内容效度指数为0.967；效标关联效度为0.419（P<0.01），为中度正相关。量表总的Cronbach α系数为0.853，分半信度为0.736，重测信度为0.899。结论老年吞咽障碍患者照顾者自我效能量表具有较好的信效度，可以作为目标人群自我效能的有效测评工具。

Objective To develop a self‑efficacy scale for caregivers of elderly patients with dysphagia, and to test its reliability and validity. Methods Based on role theory, self‑efficacy theory, and the biopsychosocial medical model, an initial item pool was constructed through literature review and qualitative interviews. The preliminary version of the self‑efficacy scale for caregivers of elderly patients with dysphagia was formed after 3 rounds of expert consultation. Preliminary investigation inventory was designed based on preliminary version of the scale. Using the convenience sampling method, 30 caregivers of elderly patients with dysphagia from 2 Class⁃Ⅲ level⁃A hospitals in Chengdu were selected for a preliminary survey. Based on the results of the preliminary survey, the scale was adjusted to form the clinical test version. Using the convenience sampling method, 602 caregivers of elderly patients with dysphagia selected from May to November 2024 in 2 hospitals as above were formally surveyed. Item analysis was performed to screen items, and the reliability and validity of the scale were tested. Results The self⁃efficacy scale for caregivers of elderly patients with dysphagia consisted of 20 items across four dimensions: social care beliefs, emotional care beliefs, therapeutic care beliefs, and intake care beliefs. Exploratory factor analysis indicated a cumulative variance contribution rate of 53.891%. Confirmatory factor analysis demonstrated excellent overall model fit; the modified model indicator showed χ²/df =1.891, root mean squared error of approximation=0.054, and goodness⁃of⁃fit index, incremental fit index, Tucker⁃Lewis index, and comparative fit index all >0.9. The composite reliability for the scale ranged from 0.751 to 0.827, and the average variance extracted (AVE) ranged from 0.388 to 0.461, with all inter‑dimension correlation coefficients being smaller than the square roots of the corresponding AVE values. The item‑level content validity index ranged from 0.883 to 1.000; the scale‑level content validity index was 0.800, and the scale‑level average content validity index was 0.967. The criterion‑related validity was 0.419 (P<0.01), indicating a moderate positive correlation. The overall Cronbach's α coefficient of the scale was 0.853, the split‑half reliability was 0.736, and the test‑retest reliability was 0.899. Conclusion The self‑efficacy scale for caregivers of elderly patients with dysphagia demonstrates good reliability and validity and can serve as an effective assessment tool for measuring self‑efficacy in this target population.

ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref