Introduction
Methods
Design and sample
The instrument
Translation procedure
Items | Item content (English/Chinese) | Scores |
---|---|---|
Q1 | My chance of developing hypertension is high | 1 2 3 4 5 |
我患高血压的几率很高 | ||
Q2 | The possibility that I will develop hypertension in a few years is very high | 1 2 3 4 5 |
几年后, 我患高血压的可能性非常大 | ||
Q3 | I can have hypertension even without the feeling of its symptoms | 1 2 3 4 5 |
即使没有症状, 我也会患上高血压 | ||
Q4 | I am more likely to catch HTN than other people | 1 2 3 4 5 |
我比其他人更容易患高血压 | ||
Q5 | Hypertension is a serious disease | 1 2 3 4 5 |
高血压是严重的疾病 | ||
Q6 | Hypertension is a lifelong disease | 1 2 3 4 5 |
高血压是终身的疾病 | ||
Q7 | Complication of hypertension can cause permanent damage | 1 2 3 4 5 |
高血压的并发症可造成永久性损害 | ||
Q8 | Hypertension can cause death | 1 2 3 4 5 |
高血压能导致死亡 | ||
Q9 | Sudden falling may happen due to hypertension | 1 2 3 4 5 |
高血压可能导致突然跌倒 | ||
Q10 | Hypertension will cause dependence on others 高血压会导致依赖他人 | 1 2 3 4 5 |
Q11 | Hypertension can threaten patients’ relationship with their family | 1 2 3 4 5 |
高血压会严重影响患者与家人间的关系 | ||
Q12 | Hypertension can cause sexual dysfunction 高血压会导致性功能障碍 | 1 2 3 4 5 |
Q13 | Hypertension can cause financial burden | 1 2 3 4 5 |
高血压会增加经济负担 | ||
Q14 | Early detection of HTN makes prevention of complications easier | 1 2 3 4 5 |
早期发现高血压更容易预防并发症 | ||
Q15 | Timely initiation of treatment makes prevention of complications easier | 1 2 3 4 5 |
及时开始治疗可以更容易地预防并发症 | ||
Q16 | Keeping blood pressure close to normal prevents hypertension complications | 1 2 3 4 5 |
保持血压接近正常可预防高血压并发症 | ||
Q17 | Lack of health information can prevent getting healthcare services | 1 2 3 4 5 |
由于缺乏健康信息, 我很难获得医疗服务 | ||
Q18 | Lack of transportation makes it difficult for me to get healthcare service | 1 2 3 4 5 |
交通不便使我很难获得医疗服务 | ||
Q19 | The cost of screening service makes it difficult for me to get the service | 1 2 3 4 5 |
检查服务的费用使我很难获得医疗服务 | ||
Q20 | Lack of nearby health facilities makes it difficult for me to get services 附近缺乏医疗机构使我去医院看病变得困难 | 1 2 3 4 5 |
Q21 | I can know my status by checking my BP regularly | 1 2 3 4 5 |
通过规律监测血压我可以了解自身状况 | ||
Q22 | I am sure of when to contact health workers while I am feeling unusual health conditions | 1 2 3 4 5 |
当我感觉到异常的健康状况时, 我知道何时联系医生 | ||
Q23 | I follow health information about hypertension | 1 2 3 4 5 |
我遵从有关高血压的健康信息 |
Data collection
Statistical analysis
Results
The sample
Variables | Categories | N | Percentage/\(\overline{\boldsymbol X}\)±S |
---|---|---|---|
Sex | Male | 168 | 51.69% |
Female | 157 | 48.31% | |
Age (years) | 45–91 | 325 | 70.56 ± 10.57 |
Marriage | Single | 7 | 2.15% |
Married | 248 | 76.31% | |
Widowed | 70 | 21.54% | |
Education | Illiteracy | 89 | 27.38% |
Primary school | 86 | 26.46% | |
Junior high school | 66 | 20.32% | |
Senior high school | 47 | 14.46% | |
College school | 37 | 11.38% | |
Monthly income(CNY) | < 2000 | 132 | 40.61% |
2001–3000 | 28 | 8.62% | |
3001–4000 | 64 | 19.69% | |
> 4000 | 101 | 31.08% | |
Residence | City | 100 | 30.77% |
Suburb | 84 | 25.85% | |
Rural | 141 | 43.38% | |
Duration of hypertension | < 5 years | 58 | 17.85% |
6–10 years | 75 | 23.07% | |
11–20 years | 96 | 29.54% | |
> 20 years | 96 | 29.54% | |
Family history | Yes | 171 | 52.62% |
No | 154 | 47.38% | |
Blood pressure control level | Under 140/90mmHg | 215 | 66.16% |
140–160/90–100 mmHg | 73 | 22.46% | |
Above 160/100 mmHg | 37 | 11.38% | |
Medical insurance | Rural medical insurance | 140 | 43.08% |
Urban medical insurance | 182 | 56.00% | |
None | 3 | 0.92% |
Item analysis
Items | Item content | Means | r | P |
---|---|---|---|---|
Q1 | My chance of developing hypertension is high | 2.692 | 0.644 | < 0.001 |
Q2 | The possibility that I will develop hypertension in a few years is very high | 2.338 | 0.610 | < 0.001 |
Q3 | I can have hypertension even without the feeling of its symptoms | 2.560 | 0.674 | < 0.001 |
Q4 | I am more likely to catch HTN than other people | 2.713 | 0.677 | < 0.001 |
Q5 | Hypertension is a serious disease | 4.073 | 0.462 | < 0.001 |
Q6 | Hypertension is a lifelong disease | 4.738 | 0.260 | < 0.001 |
Q7 | Complication of hypertension can cause permanent damage | 4.683 | 0.349 | < 0.001 |
Q8 | Hypertension can cause death | 3.855 | 0.290 | < 0.001 |
Q9 | Sudden falling may happen due to hypertension | 2.760 | 0.325 | < 0.001 |
Q10 | Hypertension will cause dependence on others | 2.418 | 0.433 | < 0.001 |
Q11 | Hypertension can threaten patients’ relationship with their family | 2.356 | 0.441 | < 0.001 |
Q12 | Hypertension can cause sexual dysfunction | 2.443 | 0.426 | < 0.001 |
Q13 | Hypertension can cause financial burden | 4.024 | 0.350 | < 0.001 |
Q14 | Early detection of HTN makes prevention of complications easier | 4.784 | 0.376 | < 0.001 |
Q15 | Timely initiation of treatment makes prevention of complications easier | 4.809 | 0.410 | < 0.001 |
Q16 | Keeping blood pressure close to normal prevents hypertension complications | 4.784 | 0.375 | < 0.001 |
Q17 | Lack of health information can prevent getting healthcare services | 2.550 | 0.348 | < 0.001 |
Q18 | Lack of transportation makes it difficult for me to get healthcare service | 2.400 | 0.437 | < 0.001 |
Q19 | The cost of screening service makes it difficult for me to get the service | 2.480 | 0.418 | < 0.001 |
Q20 | Lack of nearby health facilities makes it difficult for me to get services | 2.372 | 0.469 | < 0.001 |
Q21 | I can know my status by checking my BP regularly | 4.452 | 0.398 | < 0.001 |
Q22 | I am sure of when to contact health workers while I am feeling unusual health conditions | 4.560 | 0.388 | < 0.001 |
Q23 | I follow health information about hypertension | 3.033 | 0.252 | < 0.001 |
Content validity
Process | Results |
---|---|
Content validity | The Item-level Content Validity Index (I-CVI) was 0.83 ~ 1.00, and the Scale-level Content Validity Index (S-CVI) was 0.84 |
Construct validity | 1. Exploratory Factor Analysis (1) The principal component analysis (2) Six factors with an Eigenvalue of > 1 (3) Kaiser–Meyer–Olkin (0.762) and Bartlett spherical test value 5401.941 (df = 210, P < 0.001) (4) Explained 77.898% of the total variance |
2. Confirmatory Factor Analysis CMIN/DF = 2.491, CFI = 0.952, IFI = 0.952, TLI = 0.941, and RMSEA = 0.068 | |
Discriminant validity | The independent sample t-test The P value < 0.001 |
Exploratory factor analysis
Items | F1 | F2 | F3 | F4 | F5 | F6 | Communalities |
---|---|---|---|---|---|---|---|
Q1 | 0.963 | 0.037 | 0.017 | 0.000 | 0.073 | 0.019 | 0.935 |
Q2 | 0.869 | 0.017 | 0.130 | -0.011 | -0.015 | 0.086 | 0.780 |
Q3 | 0.965 | 0.053 | 0.036 | 0.027 | 0.062 | 0.055 | 0.943 |
Q4 | 0.951 | 0.073 | 0.015 | 0.046 | 0.105 | 0.028 | 0.924 |
Q10 | 0.072 | 0.021 | 0.889 | 0.046 | 0.004 | 0.034 | 0.800 |
Q11 | 0.096 | 0.037 | 0.891 | 0.027 | -0.032 | 0.046 | 0.809 |
Q17 | 0.018 | 0.703 | 0.154 | 0.059 | -0.220 | -0.037 | 0.571 |
Q18 | 0.042 | 0.945 | -0.032 | -0.020 | 0.026 | 0.020 | 0.897 |
Q19 | 0.053 | 0.919 | -0.067 | -0.033 | 0.020 | 0.025 | 0.855 |
Q20 | 0.045 | 0.917 | 0.052 | 0.023 | 0.008 | 0.030 | 0.847 |
Q12 | 0.055 | 0.060 | 0.776 | 0.008 | 0.233 | -0.020 | 0.664 |
Q13 | 0.026 | 0.439 | 0.006 | 0.087 | 0.276 | 0.019 | 0.278 |
Q14 | 0.019 | 0.037 | 0.029 | 0.881 | 0.231 | 0.129 | 0.849 |
Q15 | -0.001 | 0.056 | 0.105 | 0.925 | 0.211 | 0.137 | 0.934 |
Q16 | 0.030 | 0.023 | 0.089 | 0.900 | 0.186 | 0.069 | 0.860 |
Q21 | 0.109 | 0.179 | -0.063 | 0.160 | 0.773 | 0.142 | 0.692 |
Q22 | 0.087 | 0.007 | -0.008 | 0.331 | 0.762 | 0.148 | 0.720 |
Q5 | 0.156 | 0.088 | 0.294 | -0.027 | 0.118 | 0.623 | 0.521 |
Q6 | -0.022 | 0.033 | -0.118 | 0.124 | 0.134 | 0.756 | 0.621 |
Q7 | 0.026 | 0.002 | -0.019 | 0.130 | 0.230 | 0.787 | 0.690 |
Q8 | 0.079 | -0.111 | 0.295 | 0.153 | -0.323 | 0.568 | 0.556 |
Q9 | -0.050 | -0.022 | 0.753 | 0.155 | -0.239 | 0.163 | 0.677 |
Items | F1 | F2 | F3 | F4 | F5 | F6 | Communalities |
---|---|---|---|---|---|---|---|
Q1 | 0.965 | 0.034 | 0.018 | 0.005 | 0.020 | 0.061 | 0.936 |
Q2 | 0.867 | 0.015 | 0.136 | -0.018 | 0.081 | 0.002 | 0.777 |
Q3 | 0.966 | 0.047 | 0.037 | 0.031 | 0.055 | 0.047 | 0.943 |
Q4 | 0.954 | 0.065 | 0.015 | 0.056 | 0.031 | 0.081 | 0.925 |
Q5 | 0.151 | 0.071 | 0.312 | -0.035 | 0.616 | 0.167 | 0.534 |
Q6 | -0.016 | 0.019 | -0.119 | 0.142 | 0.764 | 0.085 | 0.625 |
Q7 | 0.033 | -0.014 | -0.020 | 0.155 | 0.797 | 0.166 | 0.688 |
Q8 | 0.075 | -0.069 | 0.294 | 0.117 | 0.557 | -0.350 | 0.544 |
Q9 | -0.052 | 0.000 | 0.749 | 0.136 | 0.155 | -0.270 | 0.678 |
Q10 | 0.070 | 0.022 | 0.891 | 0.047 | 0.029 | -0.006 | 0.802 |
Q11 | 0.094 | 0.043 | 0.891 | 0.027 | 0.040 | -0.045 | 0.809 |
Q12 | 0.060 | 0.035 | 0.773 | 0.038 | -0.015 | 0.185 | 0.639 |
Q14 | 0.023 | 0.003 | 0.032 | 0.897 | 0.136 | 0.164 | 0.852 |
Q15 | 0.001 | 0.034 | 0.108 | 0.938 | 0.141 | 0.150 | 0.935 |
Q16 | 0.031 | 0.013 | 0.090 | 0.910 | 0.073 | 0.123 | 0.858 |
Q17 | 0.013 | 0.740 | 0.150 | 0.044 | -0.046 | -0.155 | 0.599 |
Q18 | 0.042 | 0.944 | -0.033 | -0.010 | 0.020 | 0.101 | 0.905 |
Q19 | 0.055 | 0.913 | -0.071 | -0.020 | 0.027 | 0.076 | 0.848 |
Q20 | 0.044 | 0.923 | 0.051 | 0.030 | 0.028 | 0.085 | 0.865 |
Q21 | 0.105 | 0.122 | -0.034 | 0.203 | 0.148 | 0.857 | 0.825 |
Q22 | 0.088 | -0.049 | 0.012 | 0.378 | 0.159 | 0.769 | 0.769 |
Confirmatory factor analysis
Model | CMIN/DF | NFI | RFI | IFI | TLI | CFI | PNFI | PCFI | RMSEA |
---|---|---|---|---|---|---|---|---|---|
Initial model | 3.027 | 0.905 | 0.885 | 0.934 | 0.920 | 0.934 | 0.750 | 0.774 | 0.071 |
Modified model | 2.491 | 0.923 | 0.905 | 0.952 | 0.941 | 0.952 | 0.756 | 0.780 | 0.068 |
Standard value | < 5.000 | > 0.900 | > 0.900 | > 0.900 | > 0.900 | > 0.900 | > 0.500 | > 0.500 | < 0.080 |
Discriminant validity
Items | Low-score group Mean ± SD | High-score group Mean ± SD | t | P |
---|---|---|---|---|
Q1 | 1.65 ± 1.02 | 3.77 ± 0.85 | -15.215 | < 0.001 |
Q2 | 1.50 ± 0.72 | 3.25 ± 0.91 | -14.398 | < 0.001 |
Q3 | 1.58 ± 0.85 | 3.67 ± 0.88 | -16.174 | < 0.001 |
Q4 | 1.57 ± 0.91 | 3.88 ± 0.93 | -16.901 | < 0.001 |
Q5 | 3.61 ± 0.85 | 4.86 ± 0.34 | -8.475 | < 0.001 |
Q6 | 4.55 ± 0.79 | 3.10 ± 0.76 | -3.360 | 0.001 |
Q7 | 4.48 ± 0.67 | 4.87 ± 0.42 | -4.603 | < 0.001 |
Q8 | 3.56 ± 0.87 | 4.10 ± 0.82 | -4.313 | < 0.001 |
Q9 | 2.41 ± 0.98 | 3.10 ± 0.69 | -5.333 | < 0.001 |
Q10 | 2.04 ± 0.70 | 2.81 ± 0.67 | -7.653 | < 0.001 |
Q11 | 2.03 ± 0.72 | 2.82 ± 0.66 | -7.759 | < 0.001 |
Q12 | 2.13 ± 0.67 | 2.79 ± 0.68 | -6.650 | < 0.001 |
Q14 | 4.56 ± 0.63 | 4.96 ± 0.22 | -5.639 | < 0.001 |
Q15 | 4.62 ± 0.51 | 4.98 ± 0.10 | -6.699 | < 0.001 |
Q16 | 4.58 ± 0.57 | 4.95 ± 0.25 | -5.565 | < 0.001 |
Q17 | 2.13 ± 1.01 | 2.96 ± 0.75 | -6.294 | < 0.001 |
Q18 | 1.87 ± 0.71 | 2.86 ± 0.63 | -9.861 | < 0.001 |
Q19 | 1.91 ± 0.77 | 2.97 ± 0.69 | -9.547 | < 0.001 |
Q20 | 1.82 ± 0.71 | 2.84 ± 0.57 | -10.651 | < 0.001 |
Q21 | 4.04 ± 1.03 | 4.79 ± 0.47 | -6.282 | < 0.001 |
Q22 | 4.28 ± 0.62 | 4.79 ± 0.47 | -6.206 | < 0.001 |
Internal consistency reliability
Items | Item content | r | P |
---|---|---|---|
Q1 | My chance of developing hypertension is high | 0.644 | < 0.001 |
Q2 | The possibility that I will develop hypertension in a few years is very high | 0.610 | < 0.001 |
Q3 | I can have hypertension even without the feeling of its symptoms | 0.674 | < 0.001 |
Q4 | I am more likely to catch HTN than other people | 0.677 | < 0.001 |
Q5 | Hypertension is a serious disease | 0.462 | < 0.001 |
Q6 | Hypertension is a lifelong disease | 0.260 | < 0.001 |
Q7 | Complication of hypertension can cause permanent damage | 0.349 | < 0.001 |
Q8 | Hypertension can cause death | 0.290 | < 0.001 |
Q9 | Sudden falling may happen due to hypertension | 0.325 | < 0.001 |
Q10 | Hypertension will cause dependence on others | 0.433 | < 0.001 |
Q11 | Hypertension can threaten patients’ relationship with their family | 0.441 | < 0.001 |
Q12 | Hypertension can cause sexual dysfunction | 0.426 | < 0.001 |
Q14 | Early detection of HTN makes prevention of complications easier | 0.376 | < 0.001 |
Q15 | Timely initiation of treatment makes prevention of complications easier | 0.410 | < 0.001 |
Q16 | Keeping blood pressure close to normal prevents hypertension complications | 0.375 | < 0.001 |
Q17 | Lack of health information can prevent getting healthcare services | 0.348 | < 0.001 |
Q18 | Lack of transportation makes it difficult for me to get healthcare service | 0.437 | < 0.001 |
Q19 | The cost of screening service makes it difficult for me to get the service | 0.418 | < 0.001 |
Q20 | Lack of nearby health facilities makes it difficult for me to get services | 0.469 | < 0.001 |
Q21 | I can know my status by checking my BP regularly | 0.398 | < 0.001 |
Q22 | I am sure of when to contact health workers while I am feeling unusual health conditions | 0.388 | < 0.001 |