Chinese version of chronic disease health literacy questionnaire in Chinese population and its reliability and validity test in stroke patients

Abstract

Abstract: Objective To introduce and sinicize the Health literacy questionnaire for chronic disease patients in China，explore its applicability in stroke patients. Methods From January to July 2019，539 stroke patients were selected by convenience sampling method in four grade-A tertiary hospitals in Shanghai，and were investigated by the simplified Chinese version of health literacy questionnaire for chronic disease patients in China. The simplified Chinese version questionnaire was formed by the item analysis，total-sub reliability，retest reliability，structural validity，aggregation and differentiation validity，and calibration correlation validity verification，and was verified in stroke patients. Results There were statistically significant differences in 13 items in the simplified Chinese questionnaire between high and low groups（all P<0.05）. The total-sub correlation coefficients were 0.317-0.442 （all P<0.01），and the Pearson correlation coefficient（PCCs） was 0.746（P<0.01）.The PCCs of retest reliability was >0.8. The kaiser-meyer-olkin measure of sampling adequacy（KMO） was 0.914，the exploratory factors were extracted，the chi-square of minimum discrepancy/degree of freedom（CMIN/DF）=1.544，root of the mean square residual（RMR）=0.024，comparative fit index（CFI）=0.969，normed fit index（NFI）=0.918，incremental fit index（IFI）=0.969，goodness-of-fit index（GFI）=0.804，root-mean-square error of approximation（RMSEA）=0.066. The standardized load values range was 0.702-0.991. The combination reliability of four dimensions was 0.980，0.868，0.918 and 0.936，respectively. The average variance extracted（AVE） amount of four dimensions was 0.803，0.623，0.742 and 0.787，respectively. The square root of AVE of the four dimensions in discriminant validity was 0.896， 0.789，0.861 and 0.887，respectively. The average score of health literacy level of stroke patients was （31.51±1.35）points，which was <36 points. Conclusion Health literacy questionnaire for chronic disease patients in China is suitable for stroke patients，and the health literacy of stroke patients is in the middle level.

Key words: Stroke, Health literacy, Sinicization, Revise

CLC Number:

R181.2

SUN Hui-jun, LIANG Qi-wen, ZHANG Jie. Chinese version of chronic disease health literacy questionnaire in Chinese population and its reliability and validity test in stroke patients. [J]OCCUPATION AND HEALTH, 2023, 39(3): 339-345.

References

[1] DOMBROWSKI S U,FORD G A,MORGENSTERN L B,et al.Differences between us and uk adults in stroke preparedness:Evidence from parallel population-based community surveys[J].Stroke,2015,46(11):3220-3225.
[2] SIERRA C,COCA A,SCHIFFRIN E L.Vascular mechanisms in the pathogenesis of stroke[J].Curr Hypertens Rep,2011,13(3):200-207.
[3] QUAH J L J,YAP S,CHEAH S O,et al.Knowledge of signs and symptoms of heart attack and stroke among singapore residents[J].Biomed Res Int,2014,2014(15):572425-572432.
[4] GACHE K,LELEU H,NITENBERG G,et al.Main barriers to effective implementation of stroke care pathways in france:A qualitative study[J].Bmc Health Serv Res,2014,14(95):1-10.
[5] 陈竺.全国第三次死因回顾抽样调查报告[M].北京:中国协和医科大学出版社,2008:8.
[6] 宇传华,罗丽莎,李梅,等.从全球视角看中国脑卒中疾病负担的严峻性[J].公共卫生与预防医学,2016,27(1):5.
[7] BONITA R,MENDIS S,TRUELSEN T,et al.The global stroke initiative[J].Lancet neurol,2004,3(7):391-393.
[8] 张润华,刘改芬,潘岳松.世界卒中流行趋势概况[J].中国卒中杂志,2014,9(9):767-773.
[9] 曾新颖,李镒冲,刘江美,等.危险因素控制对2030年中国慢性病死亡、期望寿命和劳动力损失的影响估计[J].中华预防医学杂志,2017,51(12):7.
[10] 王陇德.《中国脑卒中防治报告2020》概要[J].中国脑血管病杂志,2022,19(2):9.
[11] SIMONDS S K.Health education as social policy[J].Health Education Monographs,1974,2(1):1-10.
[12] PLEASANT A.Advancing health literacy measurement:A pathway to better health and health system performance[J].Int J E-health Med C,2014,19(12):1481-1496.
[13] MONSEN K A,CHATTERJEE S B,TIMM J E,et al.Factors explaining variability in health literacy outcomes of public health nursing clients[J].Public Health Nurs,2015,32(2):94-100.
[14] World Health Organization,Division of health promotion,education and communications health education and health promotion unit.Health promotion glossary[M].Geneva:World Health Organization,1998:21.
[15] SERVICES D H H,STATES U.Healthy people 2010:Understanding and improving health[J].2000:73.
[16] SANDERS K,SCHNEPEL L,SMOTHERMAN C,et al.Peer reviewed:Assessing the impact of health literacy on education retention of stroke patients[J].Prev Chronic Dis,2014,11(4):E55.
[17] BENJAMIN R.Health literacy improvement as a national priority[J].Int J E-Health Med C,2010,15(Suppl 2):1-3.
[18] 黄悦勤.医学科研中随机误差控制和样本量确定[J].中国心理卫生杂志,2015,29(11):7.
[19] 曾立晗.构筑我国卒中防治“钢铁长城”——2017中国脑卒中大会暨第七届全国心脑血管病论坛成功召开[J].中华医学信息导报,2017,32(11):1.
[20] BRISLIN R W.Back-translation for cross cultural research[J].J Cross Cult Psychol,1970,1(3):185-216.
[21] 吴清,叶旭春,巫雅萍,等.全面健康素养测量量表的汉化及信效度分析[J].中国全科医学,2017,20(10):5.
[22] 周晓宏,郭文静.探索性因子分析与验证性因子分析异同比较[J].科技和产业,2008,8(9):3.
[23] 秦颖.卡尔森循证式疼痛管理先决条件量表的翻译与初步应用[D].长沙:中南大学,2012.
[24] 张士玉.问卷调查数据分析实务[M].北京,首都经济贸易大学出版社,2015:62.
[25] 李灿,辛玲.调查问卷的信度与效度的评价方法研究[J].中国卫生统计,2008,25(5):541-544.