Construction and validation of a medication adherence risk screening scale for patients on anticoagulant therapy based on protection motivation theory

LIN Zhuomiao; XU Xin; HAN Bing; XIE Wenlong; DONG Shujie

doi:10.6039/j.issn.1001-0408.2026.20.18

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Construction and validation of a medication adherence risk screening scale for patients on anticoagulant therapy based on protection motivation theory

更新时间：2026-10-29

- Construction and validation of a medication adherence risk screening scale for patients on anticoagulant therapy based on protection motivation theory
- ZHONGGUO YAOFANG Vol. 37, Issue 20, Pages: 2739-2745(2026)
- 作者机构：
  
  1.北京大学第三医院药学部，北京　100191
  2.梅州市人民医院临床药学科，广东梅州　514000
  3.商丘市第一人民医院呼吸重症监护室，河南商丘　476000
  4.北京大学心理与认知科学学院，北京　100871
  5.武汉市中心医院药学部，武汉　430014
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2026.20.18
  CLC： R969.3;R973+.2
- Received：25 June 2026，
  
  Revised：2026-08-28，
  
  Accepted：12 October 2026，
  
  Published：30 October 2026
- 稿件说明：
移动端阅览
林卓苗,许欣,韩冰,等.基于保护动机理论的抗凝患者用药依从性风险筛查量表的构建与验证 [J].中国药房,2026,37(20):2739-2745.

LIN Zhuomiao,XU Xin,HAN Bing,et al.Construction and validation of a medication adherence risk screening scale for patients on anticoagulant therapy based on protection motivation theory[J].ZHONGGUO YAOFANG,2026,37(20):2739-2745.
林卓苗,许欣,韩冰,等.基于保护动机理论的抗凝患者用药依从性风险筛查量表的构建与验证 [J].中国药房,2026,37(20):2739-2745. DOI： 10.6039/j.issn.1001-0408.2026.20.18.

LIN Zhuomiao,XU Xin,HAN Bing,et al.Construction and validation of a medication adherence risk screening scale for patients on anticoagulant therapy based on protection motivation theory[J].ZHONGGUO YAOFANG,2026,37(20):2739-2745. DOI： 10.6039/j.issn.1001-0408.2026.20.18.

摘要

目的

编制抗凝患者用药依从性风险筛查量表并检验其信效度，为临床识别抗凝治疗依从风险及实施个体化干预提供测评工具。

方法

以保护动机理论为框架，通过文献分析、半结构化访谈、专家函询和预调查形成包含20个条目的预试量表；采用便利抽样法对多地医疗机构抗凝治疗患者发放问卷。经项目分析筛选条目，采用探索性因子分析（EFA）、验证性因子分析（CFA）检验结构效度并进一步筛选条目，以新版一般自我效能量表简表（NGSES-SF）检验效标关联效度，并评价量表的内部一致性与分半信度。

结果

共发放问卷425份，回收有效问卷411份，有效回收率为96.71%。经项目分析和EFA分析，最终正式量表包括感知严重性、感知易感性、反应效能和自我效能4个维度，共11个条目。EFA提取4个公因子，累计方差贡献率为68.805%。CFA显示，

自由度比为1.839，近似误差均方根为0.064，拟合优度指数为0.945，比较拟合指数为0.979，Tucker-Lewis指数为0.969。量表总分及各维度得分与效标量表NGSES-SF总分均呈显著正相关（

＜0.05），其中量表总分与NGSES-SF总分的相关系数为0.346。量表的内部一致性克朗巴赫系数为0.878，分半信度系数为0.743。

结论

本研究构建的抗凝患者用药依从性风险筛查量表信效度良好，可用于筛查抗凝患者的用药依从性风险，并可作为临床开展分层靶向干预的测评工具。

Abstract

OBJECTIVE

To develop a risk screening scale for medication adherence in anticoagulated patients and evaluate its reliability and validity， thereby providing an assessment tool for identifying medication adherence risks during anticoagulant therapy and implementing individualized interventions.

METHODS

Based on the protection motivation theory， a preliminary scale containing 20 items was developed through literature analysis， semi-structured interviews， expert consultation and a pilot survey. Convenience sampling was used to distribute questionnaires to patients receiving anticoagulant therapy at multiple medical institutions. Item analysis was conducted to select items. Exploratory factor analysis （EFA） and confirmatory factor analysis （CFA） were used to assess construct validity and further screen items. The New General Self-Efficacy Scale-Short Form （NGSES-SF） was used to assess criterion-related validity， and the internal consistency and split-half reliability of the scale were evaluated.

RESULTS

A total of 425 questionnaires were distributed， and 411 valid questionnaires were recovered， yielding an effective recovery rate of 96.71%. The final scale consisted of four dimensions：perceived severity， perceived susceptibility， response efficacy and self-efficacy， with a total of 11 items. EFA extracted four common factors， with a cumulative variance contribution rate of 68.805%. CFA showed the Chi-square degrees of freedom ratio was 1.839， the root mean square error of approximation was 0.064， the goodness-of-fit index was 0.945， the comparative fit index was 0.979， and the Tucker-Lewis index was 0.969. The total score of the scale and the scores of each dimension were significantly positively correlated with the scores of the criterion scale NGSES-SF （

＜0.05）， and the correlation coefficient between the total score of the scale and the total score of NGSES-SF was 0.346. The Cronbach’s

coefficient for internal consistency was 0.878， and the split-half reliability coefficient was 0.743.

CONCLUSIONS

The medication adherence risk screening scale for patients on anticoagulant therapy constructed in this study demonstrated good reliability and validity， which can be used to screen for medication adherence risk in patients on anticoagulant therapy， and serve as an assessment tool for stratified targeted interventions in clinical practice.

关键词

Keywords

references

van Gelder I C ， Rienstra M ， Bunting K V ， et al . 2024 ESC guidelines for the management of atrial fibrillation deve-loped in collaboration with the European Association for Cardio-Thoracic Surgery（EACTS） [J ] . Eur Heart J ， 2024 ， 45 （ 36 ）： 3314 - 3414 .

Stersi M A D ， Nader-Mota G C ， Suzuki E Y ， et al . Advances in transdermal drug delivery systems for antithrombotic therapy：a systematic review [J ] . ACS Pharmacol Transl Sci ， 2025 ， 8 （ 11 ）： 3801 - 3820 .

Jackevicius C A ， Tsadok M A ， Essebag V ， et al . Early non-persistence with dabigatran and rivaroxaban in patients with atrial fibrillation [J ] . Heart ， 2017 ， 103 （ 17 ）： 1331 - 1338 .

Oake N ， Jennings A ， Forster A J ， et al . Anticoagulation intensity and outcomes among patients prescribed oral anticoagulant therapy：a systematic review and meta-analysis [J ] . CMAJ ， 2008 ， 179 （ 3 ）： 235 - 244 .

Morisky D E ， Green L W ， Levine D M . Concurrent and predictive validity of a self-reported measure of medication adherence [J ] . Med Care ， 1986 ， 24 （ 1 ）： 67 - 74 .

Pan J J ， Xue X R ， Li H Y ， et al . Determinants of medication adherence and knowledge among patients with type 2 diabetes mellitus：a cross-sectional study in northwestern China [J ] . PLoS One ， 2026 ， 21 （ 2 ）： e0343091 .

蔡秋妮，钟玲娟，陈丽芬，等 . 综合护理干预对肿瘤并发深静脉血栓患者治疗依从性的影响 [J ] . 护理学杂志， 2010 ， 25 （ 12 ）： 31 - 32 .

Desteghe L ， Vijgen J ， Koopman P ， et al . Telemonitoring-based feedback improves adherence to non-vitamin K antagonist oral anticoagulants intake in patients with atrial fibrillation [J ] . Eur Heart J ， 2018 ， 39 （ 16 ）： 1394 - 1403 .

Thakkar J ， Kurup R ， Laba T L ， et al . Mobile telephone text messaging for medication adherence in chronic di-sease：a meta-analysis [J ] . JAMA Intern Med ， 2016 ， 176 （ 3 ）： 340 - 349 .

许丽丽，李舒悦，王丽曼，等 . 基于文献计量学和可视化技术的抗栓治疗危险因素分析 [J ] . 医药导报， 2024 ， 43 （ 4 ）： 614 - 619 .

Yang C S ， Deng W Q ， Zeng L N ， et al . Predicting medication adherence among children with epilepsy：application of the protection motivation theory [J ] . Epilepsy Behav ， 2025 ， 162 ： 110153 .

Rogers R W . A protection motivation theory of fear appeals and attitude change 1 [J ] . J Psychol ， 1975 ， 91 （ 1 ）： 93 - 114 .

陈潇，张玉侠，俞静娴 . 肝移植受者症状体验量表的构建及信效度检验 [J ] . 中华护理杂志， 2020 ， 55 （ 11 ）： 1630 - 1635 .

彭琳，张秀霞 . 糖尿病病人健康相关行为保护动机量表的编制及信效度检验 [J ] . 护理研究， 2023 ， 37 （ 11 ）： 1926 - 1933 .

邓小梅，张静平，侯毅芳，等 . 住院患者负性情绪筛查量表的编制与信效度检验 [J ] . 中华行为医学与脑科学杂志， 2021 ， 30 （ 8 ）： 745 - 750 .

叶增杰，刘美玲，骆东妹，等 . 中文版父母用疾病不确定量表在肿瘤患儿父母中的重新修订及信效度检验 [J ] . 中华护理杂志， 2016 ， 51 （ 4 ）： 494 - 498 .

Mokkink L B ， Terwee C B ， Patrick D L ， et al . The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments：an international Delphi study [J ] . Qual Life Res ， 2010 ， 19 （ 4 ）： 539 - 549 .

Yan M Y ， Sun W D ， Wu Y B ， et al . Willingness to bear the first child among the Chinese childless population：a national survey study [J ] . Reprod Health ， 2025 ， 22 （ 1 ）： 47 .

Dong S J ， Li Y J ， Liao Z Q ， et al . A comparative study of EQ-5D-5L and SF-6D scales based on patients receiving oral anticoagulant therapy [J ] . Heal Qual Life Outcomes ， 2026 ， 24 （ 1 ）： 24 .

Conley C C ， Wernli K J ， Knerr S ， et al . Using protection motivation theory to predict intentions for breast cancer risk management：intervention mechanisms from a randomized controlled trial [J ] . J Cancer Educ ， 2023 ， 38 （ 1 ）： 292 - 300 .

董惠珍，董建俐，李俊卓，等 . 保护动机理论在慢性病患者健康行为中的应用研究进展 [J ] . 职业与健康， 2026 ， 42 （ 5 ）： 706 - 710 .

Chamroonsawasdi K ， Chottanapund S ， Pamungkas R A ， et al . Protection motivation theory to predict intention of healthy eating and sufficient physical activity to prevent diabetes mellitus in Thai population：a path analysis [J ] . Diabetes Metab Syndr Clin Res Rev ， 2021 ， 15 （ 1 ）： 121 - 127 .

Fu F ， Jiang J ， Gu W C ， et al . Factors influencing medication adherence for deep vein thrombosis prevention in post-discharge patients after joint replacement surgery：a qualitative study based on protection motivation theory [J ] . BMJ Open ， 2025 ， 15 （ 5 ）： e090983 .

Park S ， Jang I . Factors affecting medication adherence in patients with mechanical heart valves taking warfarin：the role of knowledge on warfarin，medication belief，depression，and self-efficacy [J ] . Int J Environ Res Public Health ， 2021 ， 18 （ 10 ）： 5214 .

Abdollahi S Z ， Mahmoodabad S S M ， Lotfi M H ， et al . Development and validation of a questionnaire based on the protection motivation theory to predict cigarette smo-king preventive behavior in the Iranian university students [J ] . J Educ Health Promot ， 2023 ， 12 ： 12 .

Fu F ， Deng X R ， Gu W C ， et al . Development and validation of a motivation scale for deep vein thrombosis prophylaxis in postdischarge hip and knee arthroplasty patients [J ] . Sci Rep ， 2026 ， 16 ： 237 .

Omer A A A ， Kusuma I Y ， Csupor D ， et al . Outcomes of pharmacist-led patient education on oral anticoagulant therapy：a scoping review [J ] . Res Soc Adm Pharm ， 2025 ， 21 （ 6 ）： 463 - 479 .

Zhang X L ， Lang S L ， Liu F . Impact of health education based on protective motivation theory on the mood state，cancer-related fatigue，and hope level of gastric cancer patients [J ] . Iran J Public Health ， 2024 ， 53 （ 1 ）： 126 - 135 .

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