中国全科医学 ›› 2024, Vol. 27 ›› Issue (16): 1990-1997.DOI: 10.12114/j.issn.1007-9572.2023.0589

• 论著·认知障碍专题 • 上一篇    下一篇

基于Delphi法的社区人群轻度认知障碍疾病认知问卷编制研究

张敏1, 陆媛1,2,3,*(), 高松1,2, 于德华1,2,3   

  1. 1.200090 上海市,同济大学附属杨浦医院全科医学科
    2.200090 上海市,同济大学医学院全科医学系
    3.200090 上海市全科医学与社区卫生发展研究中心
  • 收稿日期:2023-08-13 修回日期:2024-02-29 出版日期:2024-06-05 发布日期:2024-04-08
  • 通讯作者: 陆媛

  • 作者贡献:

    张敏、陆媛、于德华进行文章的构思与设计、研究的实施与可行性分析;张敏、陆媛进行专家咨询问卷设计;张敏、高松进行专家咨询问卷收发及数据整理、分析;张敏撰写论文,进行论文的修订;陆媛负责文章的质量控制及审校,对文章整体负责。

  • 基金资助:
    上海市卫健委资助项目(201940495)

Study of the Perceptions of Mild Cognitive Impairement among Community Populations Questionnaire Developed Based on Delphi Method

ZHANG Min1, LU Yuan1,2,3,*(), GAO Song1,2, YU Dehua1,2,3   

  1. 1. Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China
    2. Department of General Practice, Tongji University School of Medicine, Shanghai 200090, China
    3. Shanghai General Practice and Community Health Development Research Center, Shanghai 200090, China
  • Received:2023-08-13 Revised:2024-02-29 Published:2024-06-05 Online:2024-04-08
  • Contact: LU Yuan

摘要: 背景 人口老龄化背景下,维护脑健康已成为健康中国建设的必然要求,开展社区人群认知障碍疾病认知研究具有重要意义,然而目前尚缺乏针对社区人群轻度认知障碍(MCI)疾病认知水平的调查工具。 目的 编制社区人群MCI疾病认知调查问卷,并检验其信效度,为促进认知障碍疾病管理提供依据。 方法 在文献研究、专题小组讨论基础上提出问卷设计的理论框架并初步编制问卷条目,于2021年4—5月采用Delphi法邀请13名相关领域专家进行2轮函询以对问卷条目进行评价,通过预调查对条目描述进行修订,于2021年10—12月通过问卷调查对条目进行难度指数分析、辨别度分析、相关性分析及信效度评价,进一步完善问卷。 结果 (1)专家函询:两轮函询专家积极程度分别为100.0%、84.6%,专家权威系数分别为0.858、0.845,两轮函询专家对各条目"重要性"评分均值分别为3.77~4.92、3.91~4.91,两轮评分变异系数分别为0.056~0.246、0.061~0.213,两轮函询肯德尔和谐系数分别为0.197、0.252(均P<0.001),两轮咨询分别收到29条、12条专家修改意见及建议。(2)问卷调查:共发放809份问卷,回收有效问卷797份,有效回收率98.52%。各条目难度指数为10%~90%,各条目辨别度指数大多高于20%,各条目得分及各维度得分均与问卷总得分呈正相关(P<0.05)。问卷Cronbach's α系数为0.712,折半信度系数为0.764。模型检验结果KMO值=0.800(>0.6),Bartlett球形检验χ2=3 049.278(P<0.05),提示适合进行因子分析。探索性因子分析结果提示,因子累积方差贡献率为54.930%。最终问卷包括"对MCI基本知识的认识与理解""个人就诊经历""MCI诊疗期望""就医决定与行为"4个维度,共20个条目。 结论 本研究基于Delphi法编制的社区人群MCI疾病认知调查问卷信效度较好,可作为调查社区人群MCI疾病认识水平的工具。

关键词: 认知功能障碍, 轻度认知障碍, 德尔菲法, 问卷编制, 社区人群

Abstract:

Background

Under the background of an aging population, maintaining brain health has become an inevitable requirement of building a healthy China, and it is of great significance to carry out research on community populations' perceptions of cognitive impairment diseases. However, there is no suitable tools for investigating community populations' perceptions level of Mild Cognitive Impairment (MCI) .

Objective

To develop a questionnaire on perceptions toward MCI and test its reliability and validity, so as to provide a basis for promoting the management of cognitive disorders.

Methods

On the basis of literature review and special group discussion, the theoretical framework of questionnaire was put forward and the items of the questionnaire were preliminarily worked out. Then the items were evaluated according to the results of two rounds of mail-based Delphi surveys conducted by 13 experts in related fields in April-May 2021. The description of the items was revised through pre-survey, and the items were analyzed through questionnaire survey by difficulty index analysis, discrimination analysis, correlation coefficient analysis, reliability and validity evaluation in October-December 2021, so as to further improve the questionnaire.

Results

(1) Delphi survey: The positive degree of experts in the two rounds of Delphi survey was 100.0% and 84.6%, and the expert authority coefficient were 0.858 and 0.845, respectively. The range of "importance" average score of each item in the two rounds of letter inquiry was 3.77-4.92 and 3.91-4.91, and the coefficient of variation of the two rounds was 0.056-0.246 and 0.061-0.213, respectively. The harmony coefficients of Kendall in the two rounds of consultation were 0.197 and 0.252, respectively (P<0.001). 29 and 12 expert opinions and suggestions were received in the two rounds of consultation. (2) Questionnaire survey: A total of 809 questionnaires were sent out and 797 valid questionnaires were recovered, with an effective recovery rate of 98.52%. The difficulty index of each item was concentrated in 10%-90%. The discrimination index of each item is mostly above 20%. The scores of each item and each dimension were positively correlated with the total score of the questionnaire (P<0.05). The Cronbach'sα coefficient of the questionnaire was 0.712, and the split-half reliability was 0.764. The KMO value of model test was 0.800, and the Chi-square value of Bartlett spherical test was 3 049.278 (P<0.05), which suggested that it was suitable for factor analysis. The results of exploratory factor analysis showed that the cumulative variance contribution rate was 54.930%. The final questionnaire included 20 items, including "understanding of basic knowledge of MCI" "personal experience" "expectation of treatment"and "decision and behavior of seeking medical treatment" four dimensions.

Conclusion

The questionnaire on perceptions toward MCI based on Delphi method has good reliability and validity, and can be used as a tool to investigate the perceptions toward MCI among residents.

Key words: Cognitive dysfunction, Mild cognitive impairment, Delphi method, Questionnaire development, Community populations