AbstractPatients suffering from chronic kidney failure ultimately need kidney replacement therapies, such as hemodialysis. Adherence to treatment in these patients can play a central role in improving health levels and feelings of well-being. The aim of this study was to determine the psychometric properties of the Persian version of the modified version of the Greek Simplified Medication Adherence Questionnaire in hemodialysis patients.

摘要患有慢性肾衰竭的患者最终需要肾脏替代疗法，如血液透析。这些患者坚持治疗可以在改善健康水平和幸福感方面发挥核心作用。这项研究的目的是确定血液透析患者中希腊简化药物依从性问卷修订版波斯版的心理测量学特性。

In a methodological study carried out in 2024, a sample of 411 hemodialysis patients was selected using a convenience sampling method. The GR-SMAQ-HD utilized in the study was translated, and its psychometric properties were evaluated through assessments of construct validity, including exploratory and confirmatory factor analysis, convergent validity, and divergent validity.

在2024年进行的一项方法学研究中，使用方便抽样方法选择了411名血液透析患者的样本。翻译了研究中使用的GR-SMAQ-HD，并通过结构效度评估评估了其心理测量学特性，包括探索性和验证性因素分析，趋同效度和发散效度。

Furthermore, the study examined the internal consistency of the scale to ensure its reliability. The mean age of the participants was 59.37 (SD = 12.99) years. The results of the tetrachoric correlation matrix with Varimax with Kaiser Normalization rotation using the first random dataset (n = 205) extracted three factors accounting for 74.4% of the variance comprising 8 items.

此外，该研究检查了量表的内部一致性，以确保其可靠性。参与者的平均年龄为59.37（SD=12.99）岁。使用第一个随机数据集（n=205），使用具有Kaiser归一化旋转的Varimax的四弦相关矩阵的结果提取了三个因子，占包含8个项目的方差的74.4%。

The results of CFA showed that the data fit the model. As for construct reliability, Cronbach’s alpha, CR, AIC, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability. In the overall population, the mean score for treatment Adherence was 5.61 (SD = 1.95, 95% CI 5.42, 5.80).

CFA结果表明，数据符合模型。至于结构可靠性，所有结构的Cronbach的alpha，CR，AIC和MaxR均大于0.7，表明内部一致性和结构可靠性良好。。

Invariance analysis shows that the model has strong measurement invariance between sex ($ΔCFI= − 0.001, ΔRMSEA= − 0.004$). The findings affirm the appropriateness of employing the Persian iteration of the GR-SMAQ-HD as a dependable and valid instrument for asses.

不变性分析表明，该模型在性别之间具有很强的测量不变性（$ΔCFI=--0.001，ΔRMSEA=--0.004$）。这些发现证实了使用GR-SMAQ-HD的波斯迭代作为评估的可靠和有效工具的适当性。

IntroductionChronic renal failure is a prevalent global health issue that impacts over 800 million individuals, positioning it as one of the leading causes of illness in the 21st century1. Chronic kidney disease (CKD) affected 9000 individuals in Iran in 2016, making it one of the leading causes of mortality in the country2 and it is projected to become the fifth leading cause of death globally by 20403.

引言慢性肾功能衰竭是一个普遍的全球健康问题，影响了8亿多人，是21世纪疾病的主要原因之一1。2016年，慢性肾病（CKD）影响了伊朗的9000人，使其成为该国的主要死亡原因之一2，预计到20403年将成为全球第五大死亡原因。

Patients suffering from chronic kidney failure ultimately need kidney replacement therapies, such as hemodialysis, peritoneal dialysis, and kidney transplantation, to sustain their lives4. Currently, hemodialysis is the most common treatment method for these patients in Iran and the world5. Hemodialysis is a complex procedure for patients who require frequent visits to a hospital or dialysis center, mostly three times a week, thereby causing significant changes in the normal lifestyle of the patients6.The quality of life of hemodialysis patients changes due to factors such as long-term treatment, the need for complex treatment regimens, financial problems, depression, fear of death, and lifestyle changes7,8.

患有慢性肾衰竭的患者最终需要肾脏替代疗法，如血液透析，腹膜透析和肾脏移植，以维持其生命4。目前，血液透析是伊朗和世界上这些患者最常见的治疗方法5。对于需要经常去医院或透析中心就诊的患者来说，血液透析是一个复杂的过程，主要是每周三次，从而导致患者正常生活方式发生重大变化6。血液透析患者的生活质量因长期治疗，需要复杂的治疗方案，财务问题，抑郁，死亡恐惧和生活方式改变等因素而发生变化7,8。

In addition, the side effects of hemodialysis such as fatigue, itching, and thirst, which impede daily activities, are considered disabling symptoms for patients and affect their quality of life9,10,11. Many evidences suggest that patients undergoing hemodialysis treatment report less quality of life compared to the general population12,13,14.

此外，血液透析的副作用，如疲劳，瘙痒和口渴，阻碍了日常活动，被认为是患者的致残症状，并影响了他们的生活质量9,10,11。许多证据表明，与普通人群相比，接受血液透析治疗的患者的生活质量较低[12,13,14]。

Institutionalizing treatment adherence in hemodialysis patients is one of the important nursing goals to improve the quality of life of these patients. Adherence to treatment in these patients can play a central role in improving health levels and feelings of well-being15.Medication adherence is very important for hemodialysis.

将血液透析患者的治疗依从性制度化是改善这些患者生活质量的重要护理目标之一。这些患者坚持治疗可以在改善健康水平和幸福感方面发挥核心作用15.药物依从性对于血液透析非常重要。

Data availability

数据可用性

The data supporting this study’s findings are available from the corresponding author upon reasonable request.

。

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Download referencesAcknowledgementsWe sincerely thank all the patients who participated in this study; their cooperation was invaluable in advancing our research. This article stems from research project code 18792, with ethical approval IR.MAZUMS.REC.1402.535, approved by the Student Research Committee of Mazandaran University of Medical Sciences.

下载参考文献致谢我们衷心感谢所有参与本研究的患者；他们的合作对于推进我们的研究非常宝贵。本文来源于研究项目代码18792，并获得了IR.MAZUMS的道德批准。REC.1402.535，由马赞达兰医科大学学生研究委员会批准。

We also express our gratitude to Mazandaran University of Medical Sciences for their support and approval of this project.FundingNo funds, grants, or other support was received.Author informationAuthors and AffiliationsPsychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, IranHamid Sharif-NiaDepartment of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, IranHamid Sharif-NiaDepartment of Nursing, University of West Attica, Athens, GreeceVictoria AlikariWilliam James Centre for Research ISPA – Instituto Universitário, Lisboa, PortugalJoão MarôcoDepartment of Nursing, Behshahr Faculty of Nursing, Mazandaran University of Medical Sciences, Sari, IranReza FatehiStudent Research Committee, Mazandaran University of Medical Sciences, Sari, IranReza Fatehi & Poorya NowroziDepartment of Nursing, Faculty of Medical Sciences, Gorgan Branch, Islamic Azad University, Gorgan, IranEsmaeil HoseinzadehAuthorsHamid Sharif-NiaView author publicationsYou can also search for this author in.

我们还感谢马赞达兰医科大学对该项目的支持和批准。资金没有收到资金，赠款或其他支持。作者信息作者和所属机构马赞达兰医科大学医学研究中心，萨里，伊兰哈米德·谢里夫·尼阿护理系，阿莫尔护理和助产学院，马赞达兰医科大学，萨里，伊兰哈米德·谢里夫·尼阿护理系，西阿提卡大学，雅典，GreeceVictoria AlikariWilliam James研究中心ISPA-里斯本大学研究所，里斯本，波尔图加尔霍奥马尔科护理系，贝沙尔护理学院，马赞达兰医科大学，萨里，伊兰雷扎·法特希斯特学生研究委员会，马赞达兰大学医学科学，Sari，IranReza Fatehi＆Poorya Nowrozide护理系，医学院，伊斯兰阿扎德大学戈尔根分校，戈尔根，IranEsmaeil HoseinzadehAuthorsHamid Sharif NiaView作者出版物您也可以在中搜索这位作者。

PubMed Google ScholarVictoria AlikariView author publicationsYou can also search for this author in

PubMed Google ScholarVictoria AlikariView作者出版物您也可以在

PubMed Google ScholarJoão MarôcoView author publicationsYou can also search for this author in

PubMed Google ScholarJoão MarôcoView作者出版物您也可以在

PubMed Google ScholarReza FatehiView author publicationsYou can also search for this author in

PubMed Google ScholarReza FatehiView作者出版物您也可以在

PubMed Google ScholarEsmaeil HoseinzadehView author publicationsYou can also search for this author in

PubMed Google ScholarEsmaeil HoseinzadehView作者出版物您也可以在

PubMed Google ScholarPoorya NowroziView author publicationsYou can also search for this author in

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PubMed Google ScholarContributionsPerformance of data gathering: R.F.; Planning and supervision of the work: H.S.H.; Performance of the analysis: H.S.H., and J.M., Manuscript draft: E.H., and All authors; and comment on the final manuscript: P.N., V.A., and All authors.Corresponding authorsCorrespondence to.

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Reprints and permissionsAbout this articleCite this articleSharif-Nia, H., Alikari, V., Marôco, J. et al. Psychometric properties of the Greek simplified medication adherence questionnaire among Iranian hemodialysis patients.

转载和许可本文引用本文Sharif Nia，H.，Alikari，V.，Marôco，J。等人。伊朗血液透析患者中希腊简化药物依从性问卷的心理测量学特性。

Sci Rep 14, 28372 (2024). https://doi.org/10.1038/s41598-024-80134-6Download citationReceived: 11 June 2024Accepted: 15 November 2024Published: 17 November 2024DOI: https://doi.org/10.1038/s41598-024-80134-6Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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KeywordsTreatment adherenceHemodialysisValidityReliabilityPsychometrics

关键词治疗依从性血液透析验证可靠性心理测量学