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Developing and Validating an Adjustment Scale: The Adaptation Status Assessment of Drug-Resistant Tuberculosis Patients

Authors Liu H, Zhao J, Cao Y, Jiang H, Zhang S, Hua Z, Ren J, Ren D

Received 20 September 2019

Accepted for publication 23 December 2019

Published 13 January 2020 Volume 2020:13 Pages 67—78

DOI https://doi.org/10.2147/PRBM.S231792

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Igor Elman


Haini Liu, 1 Jingjie Zhao, 2 Yi Cao, 1 Hualin Jiang, 3 Shaoru Zhang, 1 Zhongqiu Hua, 1 Jing Ren, 1 Dan Ren 1

1Department of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, People’s Republic of China; 2College of Media, Xijing University, Xian, People’s Republic of China; 3Department of Epidemiology and Health Statistics, Health Science Center, Xi’an Jiaotong University, Xi’an City, People’s Republic of China

Correspondence: Hualin Jiang; Shaoru Zhang
Health Science Center, Xi’an Jiaotong University, No. 76 Yanta West Road, Yanta, Xi’an, Shanxi 710061, People’s Republic of China
Tel +86 029 8265 7015
Fax +86 029 8265 7017
Email 596684532@qq.com; tgshru011@126.com

Purpose: Drug-resistant tuberculosis (DR-TB) remains a major global public health issue. For DR-TB patients, effective adaptation is crucial to prevent disease progression, improve health outcomes and decrease mortality. To date, there is no appropriate tool for evaluating the adaptation status of DR-TB patients. In this work, we aim to develop an adjustment scale for DR-TB patients (AS-DRTBP) and to evaluate its psychometric properties.
Patients and Methods: The development of the AS-DRTBP was based on the theory of the Roy adaptation model (RAM). The scale was designed through a literature review, in-depth individual interviews, a Delphi survey, and pilot testing. In total, 433 patients with DR-TB were recruited to validate the instrument. The split-half reliability coefficient, Cronbach’s alpha coefficient, and test-retest reliability coefficient were calculated to assess the reliability of the instrument. Content validity, construct validity and concurrent validity tests were applied to calculate the validity of the instrument.
Results: The final AS-DRTBP consisted of four dimensions and 26 items. The Cronbach’s alpha coefficient, split-half reliability coefficient and test-retest reliability coefficient were 0.893, 0.954, and 0.853, respectively. The content validity index was 0.92. Four factors that explained 64.605% of the total variance were also further determined by confirmatory factor analysis (CFA). The CFA results showed that the fitting effect of the model was appropriate (CMIN/DF = 1.681, GFI = 0.832, AGFI = 0.799, RMSEA = 0.055, SRMR = 0.0684). The AS-DRTBP and adjustment scale had correlation in the total score, and the correlation coefficient was 0.355 (p< 0.05).
Conclusion: The findings of this study demonstrate that the AS-DRTBP is a reliable and valid instrument for measuring the adaptation status of patients with DR-TB, allowing health providers to comprehend the adaptive level of DR-TB patients and thus laying the foundation for interventions to help these patients achieve a physiologically, psychologically and socially optimal outcome.

Keywords: adaptation, drug-resistant tuberculosis, validation, reliability, adjustment

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