糖尿病患者におけるFoot Care Confidence Scale日本語版の妥当性と信頼性の検証

Study of the Validity and Reliability of the Japanese Version of the Foot Care Confidence Scale (J-FCCS)for Diabetics

要旨

　糖尿病は生活習慣病の代表的なものであり，近年増加している糖尿病性足病変は自己管理行動によって予防できることから，フットケア自己管理行動に関する自己効力感を明らかにすることは重要である．そのため米国で開発されたFCCSの日本語版作成に取り組んだ．

　本研究の目的は12項目からなる糖尿病患者のフットケア自己管理行動に対するSelf-Efficacyを測定するツール，Foot Care Confidence Scale(FCCS)の日本語版(J-FCCS)を作成し，その妥当性と信頼性を検討することである．

　方法は，糖尿病医療に従事する専門家5名で内容妥当性を検討の後，J-FCCSの12項目を決定した．その後，A大学医学部附属病院の外来に通院中である糖尿病患者130名(有効回答数122名)を対象にJ-FCCSの妥当性と信頼性を検討した．この調査は大阪大学医学部倫理委員会の審査を受けている．

　その結果，因子分析で1因子が抽出され，基準関連妥当性の検討では既存のツールであるSelf-Efficacy of Health Behaviorとの相関を求め，結果は0.34であった．内的整合性は，折半法(0.87)とCronbach's α係数(0.95)で検討した．

　これらから，Jananese-Foot Care Confidence Scaleは糖尿病患者のフットケア自己管理行動におけるSelf-Efficacyを測定するツールとして使用可能であると考える．

Abstract

　Foot diseases due to diabetes are increasing, so it is important to understand self-efficacy in foot self-care behaviors to help prevent such disease. The purpose of this study is to assess the validity and reliability of the Japanese version of the Foot Care Confidence Scale for Diabetics (J-FCCS).

　We studied the validity and reliability of J-FCCS by interviewing 122 diabetics at the outpatient clinic of a medical school hospital. Ethical considerations were taken into account.

　Validity was studied by 5 specialists in diabetes. Construct validity was evaluated by factor analysis of J-FCCS and the Self-Efficacy of Health Behavior, a tool already in use that measures feelings of self-efficacy for health behaviors in patients with diabetics. Criterion-related validity was studied by finding the correlation between the two scales. Reliability was studied by the split-half method and Cronbach's alpha coefficient to test for internal consistency.

　One factor was extracted using the main factor method and a correlation coefficient of 0.34 was found to support criterion-related validity. Cronbach's alpha coefficient was 0.95 and the correlation coefficient using the split-half method was 0.87, both of which support reliability.

　These results show that the Japanese Foot Care Confidence Scale can be used to measure the self-efficacy of foot self-care behavior in diabetics.