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      Translation and psychometric properties of the Chinese version of the Leeds Attitudes to Concordance II scale

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          Abstract

          Background

          Concordance is characterised as a negotiation-like health communication approach based on an equal and collaborative partnership between patients and health professionals. The Leeds Attitudes to Concordance II (LATCon II) scale was developed to measure the attitudes towards concordance. The purpose of this study was to translate the LATCon II into Chinese and psychometrically test the Chinese version of LATCon II (C-LATCon II).

          Methods

          The study involved three phases: i) translation and cross-cultural adaptation; ii) pilot study; and iii) a cross-sectional survey ( n = 366). Systematic random sampling was used to recruit hypertensive patients from nine communities covering around 78,000 residents in China. Tests of psychometric properties included content validity, construct validity, criteria-related validity (correlation between the C-LATCon II and the Therapeutic Adherence Scale for Hypertensive Patients (TASHP)), internal reliability, and test-retest reliability ( n = 30).

          Results

          The study found that the C-LATCon II had a satisfactory content validity (item-level Content Validity Index (CVI) = 0.83-1, scale-level CVI/universal agreement = 0.89, and scale-level CVI/averaging calculation = 0.98), construct validity (four components extracted explained 56.66 % of the total variance), internal reliability (Cronbach’s alpha of overall scale and four components was 0.78 and 0.66-0.84, respectively), and test-retest reliability (Pearson’s correlation coefficient = 0.82, p < 0.001; interclass correlation coefficient = 0.82, p < 0.001; linear weighted kappa statistic for each item = 0.40-0.65, p < 0.05). Criteria-related validity showed a weak association (Pearson’s correlation coefficient = 0.11, p < 0.05) between patients’ attitudes towards concordance during health communication and their health behaviours for hypertension management.

          Conclusions

          The C-LATCon II is a validated and reliable instrument which can be used to evaluate the attitudes to concordance in Chinese populations. Four components (health professionals’ attitudes, partnership between two parties, therapeutic decision making, and patients’ involvement) describe the attitudes towards concordance during health communication.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12911-015-0184-0) contains supplementary material, which is available to authorized users.

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          Most cited references31

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          Determining the number of factors to retain in an exploratory factor analysis using comparison data of known factorial structure.

          Exploratory factor analysis (EFA) is used routinely in the development and validation of assessment instruments. One of the most significant challenges when one is performing EFA is determining how many factors to retain. Parallel analysis (PA) is an effective stopping rule that compares the eigenvalues of randomly generated data with those for the actual data. PA takes into account sampling error, and at present it is widely considered the best available method. We introduce a variant of PA that goes even further by reproducing the observed correlation matrix rather than generating random data. Comparison data (CD) with known factorial structure are first generated using 1 factor, and then the number of factors is increased until the reproduction of the observed eigenvalues fails to improve significantly. We evaluated the performance of PA, CD with known factorial structure, and 7 other techniques in a simulation study spanning a wide range of challenging data conditions. In terms of accuracy and robustness across data conditions, the CD technique outperformed all other methods, including a nontrivial superiority to PA. We provide program code to implement the CD technique, which requires no more specialized knowledge or skills than performing PA. (c) 2012 APA, all rights reserved
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            [Content validity index in scale development].

            Content validity is the degree to which an instrument has an appropriate sample of items for the construct being measured and is an important procedure in scale development. Content validity index (CVI) is the most widely used index in quantitative evaluation. There are 2 kinds of CVI: I-CVI and S-CVI. A method to compute a modified kappa statistic (K*) can be used to adjust I-CVI for chance agreement. S-CVI/UA and S-CVI/Ave are both scale level CVI with different formulas. Researchers recommend that a scale with excellent content validity should be composed of I-CVIs of 0.78 or higher and S-CVI/UA and S-CVI/Ave of 0.8 and 0.9 or higher, respectively. The characteristics and qualifications of the experts, process and main results of content validity evaluation should be reported in scale-related manuscript.
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              Service utilization in community health centers in China: a comparison analysis with local hospitals

              Background Being an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs) have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to identify the utilization and the efficiency of community health resources that are able to provide basic medical and public health services. Methods The study was approved by Peking University Health Science Center Institutional Reviewing Board (NO: IRB00001052-T1). Data were collected from all the local health bureaux and processed using SPSS software. Methods of analysis mainly included: descriptive analysis, paired T-test and one-way ANOVA. Results The six main functions of the CHCs were not fully exploited and the surveys that were collected on their efficiency and utilization of resources indicate that they have a low level of performance and lack the trust of local communities. Furthermore, the CHCs seriously lack funding support and operate under difficult circumstances, and residents have less positive attitudes towards them. Conclusion The community health service must be adjusted according to the requirements of urban medical and health reform, taking into account communities' health needs. More research is required on the living standards and health needs of residents living within the CHC's range, taking into consideration the users' needs in expanding the newly implemented service, and at the same time revising the old service system so as to make the development of CHCs realistic and capable of providing a better service to patients. Several suggestions are put forward for an attainable scheme for developing a community health service.
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                Author and article information

                Contributors
                +86 13515209027 , zhangsteven@163.com
                ann.bonner@qut.edu.au
                dj.anderson@qut.edu.au
                Journal
                BMC Med Inform Decis Mak
                BMC Med Inform Decis Mak
                BMC Medical Informatics and Decision Making
                BioMed Central (London )
                1472-6947
                1 August 2015
                1 August 2015
                2015
                : 15
                : 60
                Affiliations
                [ ]School of Nursing, Nantong University, No. 19 Qixiu Road, Chongchuan District, Nantong City, Jiangsu Province People’s Republic of China 226001
                [ ]School of Nursing, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD Australia 4059
                [ ]Kidney Health Service, Royal Brisbane & Women’s Hospital, Herston, QLD Australia 4059
                Article
                184
                10.1186/s12911-015-0184-0
                4522111
                26232245
                b0b24028-b50b-4208-ad06-6b45af230311
                © He et al. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 February 2015
                : 16 July 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Bioinformatics & Computational biology
                concordance,health communication,scale,translation,psychometric properties,china

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