Study of the Knowledge-attitude-practice of TCM Treatment in Foreigners Questionnaire Developed Using the Delphi Method

doi:10.12114/j.issn.1007-9572.2020.00.159

Abstract

Abstract: Background　In 1996，China introduced the concept of ＂internationalization of traditional Chinese medicine＂，which aims to enable traditional Chinese medicine（TCM） to go global.But after more than 20 years of efforts to advance this，the process appears to have stalled.How to further promote the international development of TCM is what we need to study and discuss.Objective　To develop a knowledge-attitude-practice of TCM treatment in foreigners questionnaire，to provide a tool for investigating foreigners' perceptions of TCM treatment to promote the internationalization of TCM.Methods　Based on the theoretical framework of Knowledge-Attitude-Practice model，and literature review，group discussion and interviews with TCM experts，we formed an initial version of the questionnaire named as Knowledge-attitude-practice of TCM Treatment in Foreigners during February to June 2019.Then we conducted two rounds of email Delphi consultation with a panel of experts，and conducted statistical analysis of the response coefficient，authority coefficient，concentration degree and Kendall's W of experts.According to the results and expert suggestions，the items in questionnaire were modified，increased and decreased，then the Knowledge-attitude-practice of TCM Treatment in Foreigners questionnaire was finally determined and formed.Results　A total of 10 experts participated.The response coefficient of experts in both two rounds of consultation was 100.0%.The expert authority coefficient in two rounds of consultation was 0.87 and 0.88 respectively.The concentration degree of expert opinions in the knowledge，attitude，and practice dimensions of initial questionnaire was 3.80 to 4.70 points，3.70 to 4.50 points，3.60 to 4.40 points，respectively，during the first round of consultation，and was 4.30 to 4.80 points，4.10 to 4.60 points，and 4.00 to 4.50 points，respectively in the second round of consultation.The coefficient of variation of knowledge，attitude，and practice dimensions in the initial questionnaire was 0.10 to 0.32，0.16 to 0.29，and 0.19 to 0.35，respectively，in the first round of consultation，and was 0.09 to 0.19，0.15 to 0.25，and 0.16 to 0.31，respectively，in the second round of consultation.The Kendall's W of the first and second rounds of consultation was 0.657（χ2=218.620，P<0.001），0.671（χ2=181.181，P<0.001）.According to the statistical analysis results and 4 suggestions of the first round of consultation as well as our group discussion，2 of the 9 items in the knowledge dimension were deleted，1 of the 12 items in the attitude dimension was deleted，and 5 of the 11 items in the practice dimension were deleted but another 1 was added，then the remaining items were further modified and organized.No expert suggestions were put forward in the second round of consultation.And the final version of the questionnaire consists of 30 items，with 7 in the knowledge dimension，11 in the attitude dimension and 12 in the practice dimension.Conclusion　The Knowledge-attitude-practice of TCM Treatment in Foreigners questionnaire developed based on two rounds of reliable expert consultation with high positive coefficient，authority coefficient，concentration degree and coordination degree，includes three dimensions of knowledge，attitude and practice，with a total of 30 items，demonstrating high levels of scientificity and reliability，which can be used to investigate foreigners' perceptions of TCM treatment.

Key words: Traditional Chinese medicine；Internationalization of traditional Chinese medicine；Delphi technique；Health knowledge, attitudes, practices；“Knowledge-attitude-practice&rdquo, questionnaire

摘要： 背景　1996年，中国提出了“中医国际化”的概念，旨在使中医走向世界。但在致力于中医国际化发展的20多年后，这一进程缓慢。如何进一步促进中医药的国际发展，是需要研究和探讨的问题。目的　制定外籍人士对中医治疗的“知信行”问卷，为了解外籍人士对中医治疗认知情况提供调查工具，以推进中医国际化发展。方法　于2019年2—6月，以“知识-信念-行为”为理论模式，经查阅文献、小组讨论、中医专业专家访谈后形成初始“知信行”问卷。成立Delphi法专家函询小组，基于Delphi法进行2轮专家函询，对专家积极系数、权威系数、意见集中程度、意见协调程度进行统计分析，根据结果及专家意见对问卷中的条目进行修改和增减，最终确定并形成“知信行”问卷。结果　共10名专家参加本次专家函询，2轮函询的专家积极系数均为100%，专家权威系数分别为0.87、0.88。初始“知信行”问卷知识维度的专家意见集中程度2轮函询分别为3.80~4.70分、4.30~4.80分；信念维度的专家意见集中程度2轮函询分别为3.70~4.50分、4.10~4.60分；行为维度的专家意见集中程度2轮函询分别为3.60~4.40分、4.00~4.50分。初始“知信行”问卷知识维度的变异系数2轮函询分别为0.10~0.32、0.09~0.19；信念维度的变异系数2轮函询分别为0.16~0.29、0.15~0.25；行为维度的变异系数2轮函询分别为0.19~0.35、0.16~0.31。2轮函询专家意见的Kendall's W分别为0.657（χ2=218.620，P<0.001）、0.671（χ2=181.181，P<0.001）。第1轮函询结果显示专家共有4条建议，根据相关评价项目的统计分析结果及专家建议，经小组讨论在知识维度删除2个条目，剩余7个条目；信念维度删除1个条目，剩余11个条目；行为维度删除5个条目，增加1个条目，剩余12个条目；对保留条目进行修改和整理。第2轮函询结果显示专家未提供建议。最终确定并形成的“知信行”问卷共包括30个条目，分为知识（K1~K7）、信念（A1~11）、行为（P1~12）3个维度。结论　经过2轮专家函询，形成的“知信行”问卷包括知识、信念、行为3个维度，共30个条目。专家积极系数、权威系数、意见集中程度、协调程度均较高，专家函询结果可靠，最终形成的“知信行”问卷科学性、可信度高，可以用于外籍人士对中医治疗的认知调查。

关键词: 中医；中医国际化；德尔菲技术；健康知识, 态度, 实践；“知信行”问卷

LI Lusha,QIAO Qiaohua,WU Lihong, et al. Study of the Knowledge-attitude-practice of TCM Treatment in Foreigners Questionnaire Developed Using the Delphi Method　[J]. Chinese General Practice, 2020, 23(32): 4135-4140. DOI: 10.12114/j.issn.1007-9572.2020.00.159.
李璐莎,乔巧华,吴丽红等. 基于Delphi法的外籍人士对中医治疗“知信行”问卷研究[J]. 中国全科医学, 2020, 23(32): 4135-4140. DOI: 10.12114/j.issn.1007-9572.2020.00.159.

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