作者：张伟，叶峰，朱丽丽，刘曦阳，魏佳慧，任丽，王慧

单位：

1.江苏大学京江学院2.江苏大学医学院3.江苏省泰州市第二人民医院护理部4.江苏大学附属人民医院护理部

Units：

1.Jiangsu University Jingjiang College, Zhenjiang 212000, China 2.School of Medicine, Jiangsu University, Zhenjiang 212000, China 3.Nursing Department, Taizhou Second People's Hospital, Taizhou 225300, China 4.Nursing Department, People's Hospital Affiliated to Jiangsu University, Zhenjiang 212000, China

关键词：

高血压; 健康信息素养; 量表; 信度; 效度;

Keywords：

Hypertension; Health information literacy; Scale; Reliability; Validity

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.052

Funds：

江苏省教育科学“十四五规划”2021年度课题（B/2021/01/25）； 江苏省高等教育学会“十四五”高等教育科学研究规划课题（YB012）； 江苏大学2021年度临床医学科技发展基金项目（JLY2021190）；

摘要：

目的 编制适合我国的高血压患者健康信息素养（HIL）量表并进行信效度检验。方法 2020年5月至2021年6月，通过文献研究及研究小组讨论形成初始条目池，经过两轮专家咨询形成初版高血压患者HIL量表（包含30个条目），采用方便抽样法，选取2021年3月江苏大学附属医院及江苏大学附属人民医院心内科门诊收治的高血压患者30例进行预调查，选取2021年4—5月在江苏大学附属医院及江苏大学附属人民医院心内科门诊或病房接受治疗的高血压患者400例进行正式调查，进行项目分析和量表信效度检验。结果 共发放问卷400份，回收有效问卷373份，问卷有效回收率为93.3%。临界比值法分析结果显示：除了条目16、20外，高分组与低分组其他条目评分比较，差异有统计学意义（P<0.05）。题总相关法分析结果显示：条目16、20评分与量表总分的r值分别为0.031、0.048，条目16、20校正评分与量表总分的r值分别为0.011、0.032；其他条目评分与量表总分的r值及其他条目校正评分与量表总分的r值均≥0.400(P<0.05)。同质性检验分析结果显示：初版高血压患者HIL量表的Cronbach’sα系数为0.928，删除条目16、20后其Cronbach’sα系数分别为0.930、0.929，条目16、20共同性<0.2且因素负荷量<0.45，考虑将其删除。最终通过项目分析，删除条目16、20，形成包含28个条目的高血压患者HIL量表。探索性因子分析结果显示：高血压患者HIL量表的KMO值为0.945,Bartlett’s球形检验的χ2=5 841.504,P<0.001。通过主成分分析法提取4个公因子，其累积方差贡献率为62.266%，分别命名为“健康信息认知”“健康信息获取”“健康信息评价”“健康信息应用”。高血压患者HIL量表的内容效度指数为0.821，各条目的内容效度指数为0.833～1.000。4个维度评分与量表总分的r值为0.556～0.868，各维度评分间的r值为0.175～0.448。高血压患者HIL量表的Cronbach’sα系数为0.932，各维度的Cronbach’sα系数为0.827～0.930，高血压患者HIL量表的折半信度为0.685、重测信度为0.863。结论 本研究编制的高血压患者HIL量表包含健康信息认知、健康信息获取、健康信息评价、健康信息应用4个维度共28个条目，其具有良好的信效度，可用于评估高血压患者的HIL水平。

Abstract：

Objective To develop a Hypertension Patients' Health Information Literacy (HIL) Scale in China and test its reliability and validity. Methods From May 2020 to June 2021, an initial item pool was formed by literature research and research group discussion, and a preliminary version of Hypertension Patients' HIL Scale (including 30 items) was formed after two rounds of expert correspondence. Using the convenient sampling method, 30 patients with hypertension in the Outpatient Department of Cardiology of the Affiliated Hospital of Jiangsu University and People's Hospital Affiliated to Jiangsu University in March 2021 were selected for pre-investigation, and 400 patients with hypertension treated in the Outpatient Department of Cardiology of the Affiliated Hospital of Jiangsu University and People's Hospital Affiliated to Jiangsu University from April to May in 2021 were selected for formal investigation, item analysis and reliability and validity test of the scale were conducted. Results Four hundred questionnaires were distributed and 373 valid questionnaires were recovered, with an effective recovery rate of 93.3%. The results of critical ratio method showed that the scores of other items in the high score group and the low score group were significantly different (P < 0.05) , except for items 16 and 20. The results of total-topic correlation method showed that the r values of score of items 16, 20 and the total score of scale were 0.031 and 0.048 respectively, and the r values of the corrected scores of items 16, 20 and the total score of scale were 0.011 and 0.032 respectively; the r values of the scores of other items and the total score of scale, and the r values of the corrected scores of other items and the total score of scale were ≥ 0.400 (P < 0.05) . The results of homogeneity test showed that the Cronbach's α coefficient of the preliminary version of Hypertension Patients' HIL Scale was 0.928, and the Cronbach's α coefficients were 0.930 and 0.929 after deleting items 16 and 20, respectively. The commonality of items 16 and 20 was < 0.2 and the factor loading was < 0.45, which should be be considered for deletion. Through item analysis, items 16 and 20 were deleted to form a 28-item Hypertension Patients' HIL Scale. The results of exploratory factor analysis showed that the KMO value of Hypertension Patients' HIL Scale was 0.945, χ2 of Bartlett's spherical test was 5 841.504, P < 0.001. Four common factors were extracted by principal component analysis, and their cumulative variance contribution rate was 62.266%, which were named as "health information awareness" "health information acquisition" "health information evaluation" and "health information application" . The content validity index of Hypertension Patients' HIL Scale was 0.821, and the content validity index of each item was 0.833-1.000. The r values of the four dimension scores and the total score of scale was 0.556-0.868, and the r values of the four dimension scores was 0.175-0.448. Cronbach's α coefficient of Hypertension Patients' HIL Scale was 0.932, Cronbach's α coefficients for each dimension was 0.827-0.930, the split-half reliability of Hypertension Patients' HIL Scale was 0.683, and the test-retest reliability of it was 0.863. Conclusion Hypertension Patients' HIL Scale developed in this study includes 4 dimensions of health information awareness, health information acquisition, health information evaluation, health information application and 28 items, and it has good reliability and validity, and can be applied to assess the level of HIL in hypertensive patients.

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