Reliability and validity evaluation of the appropriate antibiotic use self-eficacy scale for Chinese

Wang et al. BMC Public Health (2022) 22:1344

https://doi.org/10.1186/s12889-022-13729-1

RESEARCH

Reliability and validity evaluation

of the appropriate antibiotic use self-efcacy

scale for Chinese adults

Liying Wang, Chunguang Liang*

, Haitao Yu, Hui Zhang and Xiangru Yan

Abstract

Background: Antibiotic resistance is one of the greatest threats to global public health. Inappropriate use of antibi￾otics can lead to an increase in antibiotic resistance. Individual self-efcacy in the appropriate use of antibiotics plays a

key role, especially in China where the population has easy access to antibiotics. However, there are no tools available

to assess the self-efcacy of appropriate antibiotic use for Chinese adults. We aimed to translate and develop a Chi￾nese version of the Appropriate Antibiotic Use Self-Efcacy Scale (AAUSES), and validate its reliability and validity.

Methods: A total of 659 adults were recruited to participate in the questionnaire. The original version scale was frst

translated into Chinese using the backward and forward translation procedures. The internal consistency reliability of

the scale was measured by the Cronbach alpha coefcient, the test-retest reliability, and the corrected item-total cor￾relation. The validity of the scale was assessed by the content validity index, exploratory factor analysis, and confrma￾tory factor analysis.

Results: The content validity index of the scale was 0.96. Exploratory factor analysis (EFA) supported a 4-factor struc￾ture of the translated questionnaire, and the discriminant validity of the scale was good. Confrmatory factor analysis

(CFA) showed in the model ftness index, the chi-square degree of freedom was 2.940, the goodness-of-ft index(GFI)

was 0.929, the incremental ft index (IFI) was 0.908, the comparative ft index(CFI) was 0.906, root mean square error

of approximation(RMSEA) was 0.077, and standardized root mean residual (SRMR) was 0.0689, and the model ftting

indexes were all in the acceptable range. Cronbach alpha coefcient for the scale was 0.910. The test-retest reliability

was 0.947, and the corrected item-total correlations for the items ranged from 0.488 to 0.736. Self-efcacy for appro￾priate antibiotic use in adults varied by education, occupation, income, place of residence, and whether or not they

had heard of antibiotic resistance.

Conclusions: The results indicated that the Chinese version of the AAUSES had good reliability and validity. There￾fore, it can be considered a tool to evaluate the appropriate antibiotic use self-efcacy of adults in China.

Keywords: Appropriate antibiotic use, Antibiotic resistance, Self-medication, Antibiotics use self-efcacy, Medication

self-efcacy

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Introduction

Antibiotics are among the most cost-efective and life￾saving drugs, helping to extend the life expectancy of

patients [1]. Researchers predicted that without dramatic

changes, antibiotic consumption in 2030 could be 200%

higher than in 2015 [2]. However, inappropriate and

Open Access

*Correspondence: [email protected]

School of Nursing, Jinzhou Medical University, No 40, Section 3, Songpo Road,

121001 Jinzhou, China