Initial validation of a self-report measure of the extent of and reasons for medication nonadherence.
Initial validation of a self-report measure of the extent of and reasons for medication nonadherence.
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DOI：
10.1097/mlr.0b013e318269e121
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发表时间：
2012-12
期刊：
影响因子：
3
通讯作者：
Yancy WS Jr
中科院分区：
文献类型：
--
作者：
Voils CI;Maciejewski ML;Hoyle RH;Reeve BB;Gallagher P;Bryson CL;Yancy WS Jr
自我报告的药物不依从性措施混淆了药物不依从性的程度和原因。每个结构都用不同类型的心理测量学模型进行评估，该模型规定了如何建立信度和效度。评估自我报告的药物不依从性测量的心理测量学特性，该测量方法分别评估不依从性的程度和不依从性的原因。横断面调查包括新的测量和比较测量，以建立收敛、判别和同时效度。新措施在2至21天后重新实施。202名患有高血压的退伍军人从达勒姆退伍军人事务医疗中心招募。一项新的自我报告测量评估了不遵守的程度和不遵守的原因。比较指标包括自我报告的药物自我效能、对药物的信念、印象管理、责任心、习惯强度和现有的不遵守措施。评估不依从性程度的三个项目为该样本产生了可靠的分数，α=0.84(95%CI：0.80，0.87)。与比较测量的相关性提供了收敛和区分效度的证据。与收缩压(r=0.27，p<；0.0001)和舒张压(r=0.27，p<；.0001)的相关性提供了同时效度的证据。未坚持的原因用21个独立的条目进行评估。组内相关系数(ICC)为0.58，相关系数为0.07~0.64。对药物不依从性的双重概念化允许对可靠性和有效性进行更强的评估，而不是以前混淆这两个结构的方法。测量符合心理测量学原则的自我报告的不依从性将使对减少不依从性的干预措施进行可靠、有效的评估。
Self-report measures of medication nonadherence confound the extent of and reasons for medication nonadherence. Each construct is assessed with a different type of psychometric model, which dictates how to establish reliability and validity. To evaluate the psychometric properties of a self-report measure of medication nonadherence that assesses separately the extent of nonadherence and reasons for nonadherence. Cross sectional survey involving the new measure and comparison measures to establish convergent, discriminant, and concurrent validity. The new measure was re-administered 2 to 21 days later. 202 veterans with treated hypertension were recruited from the Durham Veterans Affairs Medical Center. A new self-report measure assessed the extent of nonadherence and reasons for nonadherence. Comparison measures included self-reported medication self-efficacy, beliefs about medications, impression management, conscientiousness, habit strength, and an existing nonadherence measure. Three items assessing the extent of nonadherence produced reliable scores for this sample, alpha=0.84 (95% CI: 0.80, 0.87). Correlations with comparison measures provided evidence of convergent and discriminant validity. Correlations with systolic (r=0.27, p<.0001) and diastolic (r=0.27, p<.0001) blood pressure provided evidence of concurrent validity. Reasons for nonadherence was assessed with 21 independent items. Intraclass correlations (ICC) were 0.58 for the extent score and ranged from 0.07 to 0.64 for the reasons. The dual conceptualization of medication nonadherence allowed a stronger evaluation of the reliability and validity than was previously possible with measures that confounded these two constructs. Measurement of self-reported nonadherence consistent with psychometric principles will enable reliable, valid evaluation of interventions to reduce nonadherence.