【作者】 罗阳；

【导师】 何国平；

【作者基本信息】 中南大学 ， 护理学， 2011， 博士

【摘要】 目的：1.编制女性生殖道感染知识、信念、行为量表；对所编量表进行信、效度检验。2.通过编制的量表调查女性生殖道感染认知、信念、行为现状,分析相关的影响因素,为制定有效的预防生殖道感染的健康教育策略提供科学的、定量的评价工具。方法：1.以知信行理论和健康信念模式作为本量表编制的理论指导。在广泛查阅文献并参考国内外已经开发的相关问卷或量表的基础上,通过专家咨询,面对面访谈形成初选条目池。2.采用横断面调查研究设计。于2009年6月至2009年7月对100名女性进行了预调查,以t检验法、相关系数法、因子分析法三种方法进行条目筛选,保留条目形成女性生殖道感染知信行量表。于2009年8月至2009年10月采取分层整群抽样方法,采用一般人口学资料问卷和编制的量表,分别对长沙市一、二、三级共5家医院符合入选标准的842名妇女进行调查,并对量表进行考评。选用Cronbach’sα系数、分半相关和重测信度检验量表的信度；选用内容效度、结构效度和区分效度检验量表的效度。3.所有数据采用SPSS13.0和Amoss7.0统计软件包进行统计处理。统计方法包括：统计描述,两独立样本t检验,相关分析,探索性因子分析,验证性因子分析,单因素方差分析和多元线性回归分析。结果：1.共发放问卷842份,回收有效问卷800份,有效回收率为95.01%。长沙市育龄女性生殖道感染率为72.3%,其中慢性宫颈炎占58.82%。2.编制了包含51个条目的女性生殖道感染知信行量表,包括知识、信念、行为三个分量表。3.信度检验结果：各分量表的Cronbach’s a系数介于0.851～0.878之间,总量表的Cronbach’s a系数为0.908；各分量表的分半信度系数介于0.613-0.730之间(P<0.01),总量表分半信度系数为0.894(P<0.01)；一周后重复测量各个分量表得分的pearson相关系数介于0.703-0.783之间(P<0.01),总量表的重测信度系数为0.751 (P<0.01)。4.效度检验结果：内容效度指数达到0.91；探索性因子分析符合逻辑关系,各分量表累积方差贡献率介于53.023%～69.954%之间；所有因素间相关系数为0.211-0.441,各因素与总分间的相关系数为0.631-0.873,且相关均具有统计学意义(P<0.01)；验证性因子分析显示各拟合指标均达到或接近参考值；不同年龄段、文化程度、职业、婚姻状况以及丈夫不同文化程度与职业的研究对象在量表的某些维度上得分存在显著性的差异(P<0.01)。5.育龄女性生殖道感染知信行量表得分在中等及以下水平者占66.2%；单因素方差分析结果显示年龄、文化程度、职业、丈夫的文化程度和职业、婚姻状况、户口所在地是影响育龄女性生殖道感染知识、信念和行为的因素(P<0.01)；多元线性回归分析显示文化程度、职业、家庭收入、婚姻状况是育龄女性生殖道感染知识、态度信念和行为的主要影响因素(P<0.01),复相关系数R=0.445,决定系数R2=0.198。结论：1.本研究完成了女性生殖道感染知信行量表的初步编制。2.信度研究表明,该量表同质信度、重测信度和分半信度较好,达到心理测量学要求。效度研究表明,该量表内容效度、结构效度和区分效度较好,达到量表编制的基本要求。3.生育年龄妇女生殖道感染知信行状况不容乐观,文化程度、职业、家庭收入、婚姻状况是其主要影响因素。4.针对育龄女性不同年龄,不同文化程度,不同家庭收入以及不同户口所在地,有计划有重点地开展健康教育,在提高全人群生殖道感染相关知信行水平的基础上,确保农村人口以及高龄、低文化程度、低收入者生殖健康水平的提高。更多还原

【Abstract】 Objectives(1)To develop a Knowledge-Attitude-Practice (KAP) scale of reproductive tract infections for reproductive age women. To examine the reliability and validity of the scale.(2)To evaluate the reproductive age women’s KAP status of Reproductive tract infections and explore the influencing factors. To provide an objective evidence for assessing the efficiency of the Health Education of Reproductive tract infections.Methods(1)The development of the KAP scale of Reproductive tract infections was based on the frame work of KAP theory and Health Belief Model, combining the extensive literature review and reference to the relevant domestic and international scale questionnaires, and form the Primary entry library through expert advice and face to face interviews.(2) To use cross-sectional study.100 reproductive age women from Xiangya Third Hospital were carried out a pre-survey during June and July,2009. Three methods were used in item analyzing, such as t-test, correlation analysis and factor analysis. Item reserved formed the KAP scale of reproductive tract infections for reproductive age women.842 reproductive age women from five hospitals, of one, two, three different levels, were investigated by a stratified cluster sampling method during August and October,2009 in Changsha. The reliability and validity of the scale were also tested. The reliability analysis included the Cronbach’s a, split-half reliability and test-retest reliability. The validity analysis included content validity, construct validity and differential validity.(3) All datas were processed by using SPSS 13.0 and Amoss7.0 statistical software package. Statistical methods included statistical description, two independent samples t test, correlation analysis, exploratory factor analysis, confirmatory factor analysis, one-way ANOVA and multiple linear regression analysis. Results(1) 842 women have been surveyed in this study within which valid questionnaires are 800 and qualified rate of questionnaires are 95.01%. Female genital tract infection rate of child-bearing age in Changsha City was 72.3%, accounted for 58.82% of chronic cervicitis.(2)A 51-item test version of KAP scale for reproductive age women was developed, including 3 domains (Knowledge, Attitude and Belief, Behavior).(3) Reliability test:The Cronbach’s a coefficients for the scale and Subscales were 0.908 and between 0.851 and 0.878, respectively. Split-half test coefficients for the scale and subscales were 0.894 and between 0.613 and 0.730(P<0.01), respectively. Test-retest coefficients for the scale and subscales were 0.751 and between 0.703 and 0.783(P <0.01), respectively.(4)Validity test:The content validity index (CVI) for the overall scale was 0.91; Factor analysis conforms to logic relation, and the cumulative variance ranged from 53.023% to 69.954%. Correlation coefficients showed that correlations ranged from 0.211 to 0.441 between all the factors and from 0.631 to 0.873 between the subscales and total scale(P<0.01), respectively. Age, literacy, job profession, marital status and husband’s job profession were also found to influence the KAP status of Reproductive tract infections(P<0.01), respectively, which descripted the scale’s differential validity was good.(5)KAP Scale scores of reproductive tract infections at the secondary level and below accounted for 66.2%. One-way ANOVA analysis showed that women’s childbearing age, educational level, occupation, husband’s educational level and occupation, marital status, household location affect their knowledge, attitudes, beliefs and behavior (P<0.01). Multiple linear regression analysis showed that educational level, occupation, household income, marital status are the main factors.(P<0.01),R=0.445, R2=0.198.Conclusions(1) KAP Scale for the female reproductive tract infections was preliminary completion.(2) Reliability studies have shown that the scale homogeneity, test-retest reliability and split-half reliability is better, to achieve psychometric requirements.Validity studies have shown that the scale content validity, construct validity and discriminant validity is better, to achieve scale preparation of the basic requirements.(3) KAP of reproductive tract infections for women of childbearing age is poor. The main affect factors were educational level, occupation, household income, marital status.(4) Give priority to carriing out health education for Child-bearing age female of different ages, different educational level, different household income and the different household location and ensure that the rural population and the elderly, low education, low income levels to improve the reproductive health on the bases of improvement of the productive tract infection KAP levels of the whole population更多还原