中文版血糖监测系统满意度调查量表信效度研究

doi:10.12114/j.issn.1007-9572.2019.00.809

摘要/Abstract

摘要： 背景　随着糖尿病人群的增加，血糖监测设备越来越多种多样，采用量化的方式来精准地评估患者对血糖监测设备的满意度对患者的血糖管理积极性具有重要意义。血糖监测系统满意度调查（GMSS）量表在美国、丹麦等国家均具有良好的信效度，但是否适用于中国，还未经检验。目的　本研究旨在检验中文版GMSS量表在糖尿病人群中应用的信度与效度。方法　本研究采用便利抽样法于2018年6—10月选取北京市一街坊社区、二街坊东社区、田村路街道社区符合要求的糖尿病患者475例为调查对象。采用一般资料调查问卷、中文版GMSS量表、幸福感指数量表（WHO-5）、血糖监测系统评分问卷（BGMSRQ）、糖尿病痛苦量表（DDS）进行问卷调查。在征得GMSS量表原作者同意后，由作者及两名双语学者分别对中文版及英文版量表进行翻译和回译，形成初步的中文版GMSS-1型糖尿病（T1DM）量表和GMSS-2型糖尿病（T2DM）量表。将初步汉化的量表及评分表发给8名糖尿病相关领域的专家，专家对量表的内容效度和跨文化调适做出评价并给予修改意见，并且对量表的每个问题与“血糖监测系统满意度”之间的相关性进行评分，将修改后的量表返回专家再次进行评分，计算内容效度后形成最终的中文版GMSS量表。分析患者的一般资料；对患者的中文版GMSS-T1DM量表、GMSS-T2DM量表总分和各维度得分分别与WHO-5、BGMSRQ、DDS得分进行Pearson相关分析，计算相关系数，反映中文版GMSS量表的校标效度；采用探索性因子分析评价中文版GMSS量表的结构效度；采用Cronbach'sα系数评价中文版GMSS量表的内部一致性信度；2周后按照各社区样本量所占比例随机选取30例糖尿病患者重新发放中文版GMSS量表，以计算量表的重测信度。结果　共发放问卷475份，回收有效问卷463份，问卷有效回收率为97.47%，其中T1DM患者256例，T2DM患者207例。经专家评定，中文版GMSS-T1DM量表平均内容效度指数（CVI）值为0.910，中文版GMSS-T2DM量表平均CVI值为0.925。中文版GMSS-T1DM量表总分、开放性维度得分、信任维度得分与WHO-5得分、BGMSRQ得分呈正相关，与DDS-T1DM得分呈负相关，情感负担维度得分、行为负担维度得分与WHO-5得分、BGMSRQ得分呈负相关，与DDS-T1DM得分呈正相关；中文版GMSS-T2DM量表总分、开放性维度得分与WHO-5得分、BGMSRQ得分呈正相关，与DDS-T2DM得分呈负相关，情感负担维度得分、行为负担维度得分与WHO-5得分、BGMSRQ得分呈负相关，与DDS-T2DM得分呈正相关，价值维度得分与WHO-5得分、BGMSRQ得分、DDS-T2DM得分均呈正相关（P<0.05）。探索性因子分析显示两版本中文版GMSS量表最终提取4个公因子，各条目因子负荷范围为0.612~0.913，中文版GMSS-T1DM累积方差贡献率为66.50%，中文版GMSS-T2DM累积方差贡献率为67.65%。中文版GMSS-T1DM量表内部一致性Cronbach's α系数为0.87，开放性、情感负担、行为负担、信任4个维度的Cronbach's α系数分别为0.82、0.83、0.81、0.83。中文版GMSS-T2DM量表内部一致性Cronbach'sα系数为0.90，开放性、情感负担、行为负担、价值4个维度的Cronbach's α系数分别为0.81、0.80、0.84、0.85。中文版GMSS-T1DM量表与GMSS-T2DM量表的重测信度为0.86、0.91，分半信度系数为0.89、0.90。结论　中文版GMSS量表两个版本的内容效度、效标效度、结构效度以及内部一致性信度均良好，可用于糖尿病患者的血糖监测系统满意度的评估。

关键词: 糖尿病, 满意度, 效度, 信度, 血糖监测系统满意度调查量表

Abstract: Background　To satisfy the needs of increased diabetic population，blood glucose monitoring equipments are becoming increasingly diverse.Accurately quantifying the level of diabetic patients' satisfaction with such equipments is of great significance in motivating their enthusiasm in glycemic management.The Glucose Monitoring Satisfaction Survey（GMSS），a scale has been proved to have good reliability and validity in countries such as the United States，Denmark and so on，but its applicability to China has not been tested.Objective　To test the reliability and validity of the Chinese version of GMSS in China's diabetic population.Methods　After obtaining the consent of the authors of the GMSS，we developed the initial Chinese version of the GMSS（consisting of GMSS-T1DM and GMSS-T2DM） on the basis of forward translation and back-translation with the help of two bilingual scholars，then developed the final version after two times of revision based on two rounds of 8 diabetes expertsd consultation（the first revision was performed according to the experts' evaluation of the content validity and cross-cultural adaptation of the initial version and corresponding suggestions，and their evaluation scores for the association of each item with the satisfaction with the monitoring system，and then this revised version was evaluated again by the experts，and the second revision was based on the experts' second evaluation scores） and calculating the content validity of the revised version.By use of convenience sampling，475 eligible patients with type 1 or type 2 diabetes were recruited from 3 communities in Beijing（Yijiefang Community，Erjiefangdong Community and Tiancunlu Subdistrict Community） from June to October 2018，and were surveyed with the General Data Questionnaire，Chinese version of GMSS，5-item World Health Organization Well-Being Index（WHO-5），Blood Glucose Monitoring System Rating Questionnaire（BGMSRQ），and Diabetes Distress Scale（DDS）.The general data of the patients were analyzed.Pearson correlation coefficients of the scale and subscale scores of the Chinese version of GMSS-T1DM and GMSS-T2DM with the scores of the WHO-5，BGMSRQ and DDS were calculated to evaluate the criterion validity of the Chinese version of GMSS.And the structural validity and internal consistency reliability of the Chinese version of GMSS were evaluated by using exploratory factor analysis and calculating the Cronbach's α coefficient，respectively.Two weeks later，the Chinese version of GMSS was retested for evaluating its test-retest reliability in 30 of the respondents of the first survey randomly selected in accordance with the proportion of sample size of each community.Results　Altogether，463（97.47%） responded effectively to the first survey，including 256 with T1DM，and 207 with T2DM.The average CVI values for the Chinese version of GMSS-T1DM and GMSS-T2DM were 0.910，0.925，respectively.The scale score of the Chinese version of GMSS-T1DM，and the scores of two subscales，openness and trust，were positively associated with the scale scores of WHO-5 and BGMSRQ，and negatively associated with the scale score of DDS-T1DM，while the scores of emotional burden and behavioral burden subscales were negatively associated with the scale scores of WHO-5 and BGMSRQ，and positively associated with the scale score of DDS-T1DM（P<0.05）.The scale score of the Chinese version of GMSS-T2DM，and the score of openness subscale were positively associated with the scale scores of WHO-5 and BGMSRQ，and negatively associated with the scale score of DDS-T2DM，the scores of emotional burden and behavioral burden subscales were negatively associated with the scale scores of WHO-5 and BGMSRQ，and positively associated with the scale score of DDS-T2DM，and the score of worthwhileness subscale was positively associated with the scale scores of WHO-5，BGMSRQ and DDS-T2DM（P<0.05）.By exploratory factor analysis，four common factors were extracted from each of the Chinese version of GMSS-T1DM and GMSS-T2DM，with loading ranged from 0.612 to 0.913，explaining 66.500% of the total variance of the former，and 67.650% of the total variance of the latter，respectively.The Cronbach's α coefficients for the Chinese version of GMSS-T1DM，and its openness，emotional burden，behavioral burden and trust subscales were 0.87，0.82，0.83，0.81 and 0.83，respectively.The Cronbach's α coefficients for the Chinese version of GMSS-T2DM，and its openness，emotional burden，behavioral burden，and worthwhileness subscales were 0.90，0.81，0.80，0.84 and 0.85，respectively.The test-retest reliability and split-half reliability were 0.86，0.89，respectively for the Chinese version of GMSS-T1DM，and were 0.91 and 0.90，respectively for the Chinese version of GMSS-T2DM.Conclusion　Both the Chinese version of GMSS-T1DM and GMSS-T2DM have good content validity，criterion validity，structural validity and internal consistency reliability，so they can be used for evaluating diabetic patients' satisfaction with the blood glucose monitoring system.

Key words: Diabetes, Satisfaction, Validity, Reliability, Glucose Monitoring Satisfaction Survey

芦慧雅,路晓琳,高宏凯,等. 中文版血糖监测系统满意度调查量表信效度研究[J]. 中国全科医学, 2020, 23(14): 1812-1818. DOI: 10.12114/j.issn.1007-9572.2019.00.809.
LU Huiya,LU Xiaolin,GAO Hongkai, et al. Reliability and Validity of the Chinese Version of the Glucose Monitoring Satisfaction Survey　[J]. Chinese General Practice, 2020, 23(14): 1812-1818. DOI: 10.12114/j.issn.1007-9572.2019.00.809.

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