不孕不育症病人遗传咨询认知-行为问卷研制及影响因素分析

    Development and influencing factors analysis of the genetic counseling cognition-behavior questionnaire for infertility patients

    • 摘要:
      目的编制不孕不育症病人遗传咨询认知-行为评价问卷,对其进行信效度评价,并使用该问卷对不孕不育症病人遗传咨询认知-行为水平进行调查,同时对其影响因素进行分析。
      方法研究分两阶段进行,第一阶段为量表内容的确定及预调查,同时进行问卷信效度检验;第二阶段使用问卷评价不孕不育症病人遗传咨询认知-行为水平,并分析相关影响因素。
      结果经过专家修订及预调查,编制了不孕不育症病人对遗传咨询认知-行为水平测定的20个条目的最终调查问卷。问卷信度检验结果为:总量表的内部一致性Chronbach's α系数为0.898,各因子的Chronbach's α系数为0.889~0.900之间。I-CVI范围为0.879~1.000,S-CVI/UA值为0.883,S-CVI/Ave的值为0.972。KMO值=0.886,Bartlett球形检验值为1 124.960(df=190,P < 0.01)。采取正交旋转主成分分析法,提取出5个特征根大于1的公因子,累积贡献率62.128%,20个条目的载荷量均≥0.4,载荷范围在0.487~0.796之间。研究对象按照性别分为2组,对比2组一般资料情况,2组得分差异有统计学意义(t=4.01,P < 0.01);有序多分类logistic回归分析结果显示,不孕不育症病人遗传咨询认知-行为水平高龄组(35岁及以上)得分高于低龄组(35岁以下)OR=0.566,95%CI=(0.421,0.760),P < 0.01;男性较女性得分水平更高OR=1.735,95%CI=(1.338,2.250),P < 0.01;与无业及其他比较,职业中干部OR=7.149,95%CI=(4.158,12.293),P < 0.01、专职专业技术人员OR=6.514,95%CI=(4.411,9.621),P < 0.01、商业服务业人员OR=2.737,95%CI=(1.931,3.885),P < 0.01得分水平更高;(配偶)无不良妊娠史得分水平低OR=0.336,95%CI=(0.256,0.440),P < 0.01。
      结论该调查问卷信效度良好,可作为评价不孕症病人遗传咨询认知-行为水平及相关因素分析的测量工具。不孕不育症病人遗传咨询认知-行为水平与年龄、性别、职业、(配偶)不良妊娠史有关。

       

      Abstract:
      ObjectiveTo compile a genetic counseling cognition-behavior questionnaire for infertility patients, evaluate its reliability and validity, investigate the genetic counseling cognition-behavior level of infertility patients using the questionnaire, and analyze its influencing factors at the same time.
      MethodsThe study was conducted in two stages, the first stage was to determinate and pre-survey the scale content, and test the reliability and validity of the questionnaire; the second stage was to use the questionnaire to evaluate the genetic counseling cognition-behavior level of infertility patients, and analyze its related influencing factors.
      ResultsAfter expert revision and preliminary investigation, a final questionnaire with 20 items of genetic counseling cognition-behavior level was developed for infertility patients.The reliability test results of the questionnaire were as follows: the internal consistency of the Chronbach's α coefficient of the total scale was 0.898, and that of each factor was 0.889-0.900, the I-CVI ranged 0.879-1.000, the S-CVI/UA was 0.883, and the S-CVI/Ave was 0.972.The KMO value was 0.886, and the Bartlett sphericity test value was 1 124.960(df=190, P < 0.01).Five common factors with characteristic roots greater than 1 were extracted by orthogonal rotating principal component analysis, and the cumulative contribution rate was 62.128%, the load of 20 items were all ≥ 0.4, and the load range was 0.487-0.796.The subjects were divided into two groups according to gender.The difference of the score between two groups was statistically significant by comparing the general data of two groups(t=4.01, P < 0.01).The results of ordered multiple logistic regression analysis showed that the score of cognitive behavior level of genetic counseling in elderly group(35 years and above) was higher than that in younger group(below 35 years old)OR=0.566, 95%CI=(0.421, 0.760), P < 0.01.Scores of male were higher than that of femaleOR=1.735, 95%CI=(1.338, 2.250), P < 0.01.Compared with unemployed and others, the scores in cadreOR=7.149, 95%CI=(4.158, 12.293), P < 0.01, full-time professional and technical personnelOR=6.514, 95%CI=(4.411, 9.621), P < 0.01, business service personnelOR=2.737, 95%CI=(1.931, 3.885), P < 0.01) were higher, and the score of patients without adverse pregnancy history was lowerOR=0.336, 95%CI=(0.256, 0.440), P < 0.01.
      ConclusionsThe questionnaire has good reliability and validity, and can be used as a measurement tool to evaluate the genetic counseling cognition-behavior level and related factors analysis of infertility patients.The cognition-behavior level of genetic counseling in infertility patients is related to the age, sex, occupation, and adverse pregnancy history.

       

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