关键词: 肺疾病, 慢性阻塞性；社区卫生服务；奥马哈系统；问卷编制；信效度检验

Abstract: Objective　To develop a questionnaire with good reliability and validity to evaluate the demand of community health service for patients with chronic obstructive pulmonary disease （COPD） systematically.Methods　The questionnaire was based on the Omaha System.Literature review，group discussion and Delphi consultation were used to develop the initial questionnaire and a convenience sampling method was adopted to select patients with COPD in the Department of Respiration from 4 Grade Ⅲ Level A comprehensive hospitals in Tianjin from December 2016 to April 2017.A formal questionnaire was formed by using critical ratio （CR） method，correlation analysis，content validity index （CVI），exploratory factor analysis，retest reliability，and Cronbach's alpha coefficient to test its reliability and validity.Results　Through literature review，group discussion and expert consultation，the initial questionnaire was formed by 4 dimensions and 34 items.A total of 187 questionnaires was distributed and 177 valid questionnaires were collected，with an effective recovery rate of 94.7%.The results of the project analysis showed that the critical ratio value （CR value） of each item was 2.64 to 9.21 （P<0.05）．Except for A1 （reducing the medical service price related to COPD treatment in community hospitals），A3 （increasing the proportion of COPD drug reimbursement），and A4 （increasing the common drug type of COPD in community hospitals），the Pearson correlation coefficient of items and the total score （r value） were all >0.4.Content validity index of items （I-CVI） were 0.93-1.00，average content validity index of scale （S-CVI/Ave）=0.99.Four common factors were extracted after deleting one item in factor analysis，with a cumulative variance contribution rate of 55.76%.A total of 33 items of community health service demand questionnaire for patients with COPD was determined and divided into 4 dimensions：environmental requirements （9 items），psychosocial needs （6 items），physiological needs （6 items），and health-related behavior needs （12 items）．The overall test-retest reliability of the questionnaire was 0.88，of which each dimension was 0.76 to 0.90.The overall Cronbach's alpha coefficient of the questionnaire was 0.91，of which each dimension was 0.75 to 0.90.Conclusion　The community health service demand questionnaires for patients with COPD presents good reliability and validity.It can be served as an effective assessment tool for community health service agencies.

Key words: Pulmonary disease, chronic obstructive；Community health service；Omaha System；Questionnaire development；Reliability and validity