Development and testing of the reliability and validity of a Chinese version of the Long-Term Conditions Questionnaire / 浙江大学学报·医学版

OBJECTIVES@#To develop a Chinese version of the Long-Term Conditions Questionnaire (LTCQ) and to test its reliability and validity in Chinese patients with chronic diseases.@*METHODS@#With the consent of the original authors, a Chinese version of LTCQ was developed according to the cultural adjustment guidelines. A questionnaire survey was conducted on 319 patients with chronic diseases in Sir Run Run Shaw Hospital, Wuyi County First People's Hospital and Hangzhou Gongchen Bridge Street Health Service Center. The questionnaire was evaluated by item analysis (including frequency analysis, total question correlation method and critical ratio method), reliability analysis (Cronbach's alpha coefficient) and validity analysis [including content validity (expert scoring method) and structural validity (exploratory factor analysis)].@*RESULTS@#The Chinese version of the LTCQ included 20 entries, with a Cronbach's alpha coefficient of 0.926, a retest reliability of 0.829, a split-half reliability of 0.878, an entry content validity index of 1, and a content validity index at the questionnaire level of 1. Four common factors were extracted by exploratory factor analysis, namely physical state and daily life, psychological state, support and coping, and safe environment, with a cumulative variance contribution rate of 67.244%. Discussion: The Chinese version of the LTCQ developed in this study has good reliability and validity and it may be used to assess the long-term conditions of patients with chronic diseases in China.

Development of a Chinese version of the Stress Adaption Scale and the assessment of its reliability and validity among Chinese patients with multimorbidity / 浙江大学学报·医学版

OBJECTIVES@#To develop a Chinese version of the Stress Adaption Scale (SAS) and to assess its reliability and validity among Chinese patients with multimorbidity.@*METHODS@#The Brislin model was used to translate, synthesize, back-translate, and cross culturally adapt the SAS. A total of 323 multimorbidity patients selected by convenience sampling method from four hospitals in Zhejiang province. The critical ratio method, total question correlation method, and graded response model (item characteristic curve and item discrimination) were used for item analysis. Cronbach's alpha coefficient and split-half reliability were used for the reliability analysis. Content validity analysis, structural validity analysis, and criterion association validity analysis were performed by expert scoring method, confirmatory factor analysis, and Pearson correlation coefficient method, respectively.@*RESULTS@#The Chinese version of the SAS contained 2 dimensions of resilience and thriving, with a total of 10 items. In the item analysis, the critical ratio method showed that the critical ratio of all items was greater than 3.0 (P<0.001); the correlation coefficient method showed that the Pearson correlation coefficients for all items exceeded 0.4 (P<0.01). The graded response model showed that items of the revised scale exhibited distinct item characteristic curves and all items had discrimination parameters exceeding 1.0. In the reliability analysis, Cronbach's alpha coefficient of the revised Chinese version of the SAS scale was 0.849, and the split-half reliability was 0.873. In the validity analysis, the item-level content validity index and scale-level content validity index both exceeded 0.80. In the confirmatory factor analysis, the revised two-factor model showed satisfactory fit indices (χ2/df=3.115, RMSEA=0.081, RMR=0.046, GFI=0.937, AGFI=0.898, CFI=0.936, TLI=0.915). In the criterion-related validity analysis, the Chinese version of the SAS score was negatively correlated with the Perceived Stress Scale and the Treatment Burden Questionnaire, with correlation coefficients of －0.592 and －0.482, respectively (both P<0.01).@*CONCLUSIONS@#The Chinese version of the SAS has good reliability and validity, which can be used to evaluate the stress adaption capacity among multimorbidity patients in China, and provides a reference for developing individualized health management measures.

Summary of the best evidence of diet and physical activity management in patients with metabolic syndrome / 浙江大学学报·医学版

To evaluate and summarize the evidence of diet and physical activity management in patients with metabolic syndrome (MS). BMJ Best Practice, UpToDate, Joanna Briggs Institute (JBI) database, Agency for Healthcare Research and Quality (AHRQ) network, National Institute for Health and Clinical Excellence (NICE) network, Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), Medlive, Registered Nurses' Association of Ontario (RNAO) network, American Diabetes Association (ADA) network, New Zealand Guideline Group (NZGG) network, Canadian medical association clinical practice guidelines network, PubMed, EmBase, Web of Science, CINAHL, Cochrane Library, CNKI, China Science and Technology Journal Database, Wanfang Knowledge Data Service Platform and Chinese biomedical database were searched systematically to obtain guidelines, evidence summary, expert consensus, best practice information book, clinical decision-making, recommended practice, and systematic review on diet and physical activity management in patients with MS. The retrieval period is from the establishment of database to November 2021. Two researchers with evidence-based medicine background evaluated the quality and evidence level of the included literature. A total of 36 articles met the criteria, including 3 guidelines, 5 expert consensus, 1 clinical decision and 27 systematic reviews. We summarized 49 pieces of evidence related to diet and physical activity in patients with MS, involving 15 aspects, namely diet goals, diet patterns, diet time, carbohydrate intake, fat intake, fiber intake, salt intake, fruits, vegetables and grains intake, coffee intake, effects of diet, principle of physical activity, intensity, form, time of physical activity, effects of physical activity, physical activity prescription of patients with MS and cardiovascular disease, and the joint effects of diet and physical activity. Diet and physical activity management can effectively improve the health outcomes of patients with MS. Health professionals should choose and apply the best evidence with consideration of the clinical situation and patient preference.

Design and development of a Wechat applet for intelligent health management of metabolic syndrome / 浙江大学学报·医学版

: To design and develop a Wechat applet for intelligent health management of metabolic syndrome. Based on the needs and requirements of individuals undergoing health check-up, patients with metabolic syndrome and medical workers, a Wechat applet for metabolic syndrome management was designed and developed, which involving health data collection, health risk prediction, health management knowledge base fusion and intelligent recommendation, data privacy and security. The platform consists of three user ports: individuals undergoing health check and patients with metabolic syndrome, the medical workers and the system administrators. The main functions of the platform included metabolic syndrome risk prediction, intelligent recommendation of health management strategies, health behavior record and supervision, experts' consultation and health knowledge guide. The Wechat applet developed in this study can be used for metabolic syndrome risk prediction for general population, and health management for patients with metabolic syndrome, which helps them to enhance health management awareness and health behavior adherence.

Influence of perceived stress on health-promoting behaviors in patients with metabolic syndrome: the multiple mediating roles of adaptability and social support / 浙江大学学报·医学版

: To explore the potential associations between perceived stress and health-promoting behaviors based on the theoretical schema of the middle-range theory of adaptation to chronic illness. From January to May 2021, a convenience sampling method was used to recruit 230 young and middle-aged patients with metabolic syndrome who underwent physical examination in the inpatient center of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. The Health-Promoting Health Profile-Ⅱ, Chinese Perceived Stress Scale, Coping and Adaptation Processing Scale-Short Form, and Multi-dimensional Scale of Perceived Social Support were used in the cross-sectional study. The chain mediation effect procedure and bootstrap sampling test were used to examine the mediating role of adaptability and social support between perceived stress and health-promoting behaviors. The mean score of health-promoting behaviors was 100.0±14.6, the mean score of perceived stress was 22.0± 6.9, the mean score of adaptability was 47.0±6.1, and the mean score of social support was 63.8±10.8. Perceived stress had a negative impact on patients' health-promoting behaviors (=-0.309, <0.05). The adaptability (effect size= -0.112, 95%:-0.199~-0.038) and social support (effect size= -0.032, 95%:-0.083~played a mediating role and a chain mediating role in the process of perceived stress influencing patients' health-promoting behaviors (effect size= -0.045, 95%:-0.093~-0.020). Adaptability and social support play an intermediary role between perceived stress and health-promoting behaviors in young and middle-aged patients with metabolic syndrome. Healthcare professionals can motivate patients to develop healthy behaviors by developing intervention strategies on adaptability and social support.