儿童发育障碍性疾病知识问卷的编制及应用研究

Development and application of the knowledge assessment questionnaire for childhood developmental disorders

摘要

目的：编制儿童发育障碍性疾病知识问卷，检验其信度和效度，并探讨其在发育障碍性疾病患儿照顾者中的应用价值。方法：在参考专家共识及相关指南的基础上，通过两轮专家咨询及预测试形成问卷；采用分层抽样选取湖南省不同经济发展水平地区的6家儿童康复机构作为研究现场，共征募到252名发育障碍性疾病患儿的主要照顾者参加调查；应用该知识问卷及求医行为问卷收集资料，以检验问卷的信度和效度。采用中位数分组法，将照顾者分为知识水平高分组和低分组，比较两组在就诊及康复行为上的差异，并以此确定问卷的参考临界值。结果：最终形成的知识问卷包含4个维度，共18个条目。条目水平内容效度指数（item-level content validity index，I-CVI）为0.93～1.00，量表水平内容效度指数（scale-level content validity index，S-CVI）为0.98；验证性因子分析结果显示模型拟合良好〔比较拟合指数（comparative fit index，CFI）=0.898，近似误差均方根（root mean square error of approximation，RMSEA）=0.069〕。问卷总体 Cronbach's α 系数为 0.798，各维度的 McDonald's ω 系数和Cronbach's α系数均大于0.7。以问卷总分中位数（15分）为界，知识水平低分组（得分≤15分）的照顾者更易出现诊治延误，且对康复治疗的依从性更差。因此，建议将15分作为本问卷的参考临界值，即问卷得分≤15分的照顾者可视为知识水平不足，需重点加强健康教育。结论：本研究编制的儿童发育障碍性疾病知识问卷具有良好的信度和效度，区分度较好，可用于儿童发育障碍性疾病诊治和康复相关的科学研究及临床健康教育实践。

Abstract

Objective: To develop a knowledge assessment questionnaire for childhood developmental disorders, to test its reliability and validity, and to explore its application value among caregivers of children with developmental disorders. Methods: Based on expert consensus and relevant guidelines, two rounds of expert consultation and a pre-test were conducted to form the questionnaire. Stratified sampling was employed to select six children's rehabilitation institutions across regions with varying levels of economic development in Hunan Province as the study sites, and a total of 252 primary caregivers of children with developmental disorders were recruited for the investigation. The knowledge assessment questionnaire and medical-seeking behavior questionnaire were used to collect data for further testing the reliability and validity of the developed questionnaire. By using the median grouping method, the caregivers were divided into a high-knowledge group and a low-knowledge group. The differences in medical treatment and rehabilitation behaviors were compared between the two groups, and the reference cut-off value of the questionnaire was determined accordingly. Results: The finally developed knowledge questionnaire consisted of 4 dimensions and 18 items. The item-level content validity index (I-CVI) ranged from 0.93 to 1.00, and the scale-level content validity index (S-CVI) was 0.98. Confirmatory factor analysis results revealed that the model fitted well [comparative fitted index (CFI)=0.898, root mean square error of approximation (RMSEA)=0.069]. The overall Cronbach's αcoefficient of the questionnaire was 0.798, and both McDonald's ωcoefficients and Cronbach's αcoefficient of each dimension were all greater than 0.7. Based on the median total scores of the questionnaire (15 points), caregivers in the low-knowledge group (scores≤15 points) were more likely to experience delayed diagnosis and treatment, and showed poorer compliance with rehabilitation treatment. Therefore, it was suggested that 15 points be taken as the reference cut-off value of the questionnaire. Caregivers with scores≤15 points were considered to have inadequate knowledge and require targeted health education. Conclusion: The knowledge assessment questionnaire for childhood developmental disorders has good reliability, validity and discrimination ability. It can be applied to scientific research and clinical health education practice related to the diagnosis, treatment, and rehabilitation of childhood developmental disorders.

关键词

儿童发育障碍 / 评估工具 / 信度 / 效度 / 照顾者 / 知晓率 / 求医行为 / 治疗依从性

Key words

childhood developmental disorders / assessment tools / reliability / validity / caregivers / knowledge rate / medical-seeking behavior / treatment compliance

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基金资助

芙蓉实验室科技攻关项目(2024PT5111)

湖南省出生缺陷协同防治科技重大专项子项(2019SK1011)