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Yıl:2014; Cilt: 1; Sayı: 4>> Özet
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Literatür Sempozyum; 2014;1(4):25-30
Tedavi ile İlgili Otomatik Düşünceler Ölçeğinin Geliştirilmesi, Geçerlilik ve Güvenilirlik Çalışması
M Meriç, F Oflaz, M Ak
Beytepe Asker Hastanesi, Ankara
Amaç: Bu çalışmada, anksiyete bozukluğu hastalarının tedavi ile ilgili otomatik düşüncelerini tespit etmeye yönelik bir ölçek geliştirmek ve geçerlik ve güvenirlik analizlerini yapmak amaçlanmıştır. Yöntem: Araştırmacılar tarafından ilgili literatür taranarak ve bu konuda çalışan uzmanların görüşlerine başvurularak toplam 59 maddeli soru havuzu hazırlanmıştır. Anket son olarak 21 maddelik ölçek haline getirilmiştir. Çalışmaya Gülhane Askeri Tıp Akademisi Psikiyatri Polikliniğinde Yaygın Anksiyete Bozukluğu tanısı almış 184 hasta dâhil edilmiştir. Veri toplama araçları olarak Tedavi İle İlgili Otomatik Düşünceler Ölçeği ve ölçüt geçerliği için Otomatik Düşünceler Ölçeği uygulanmıştır. Test-tekrar test güvenirliğini gerçekleştirmek için ölçek 55 hastaya 4 hafta sonra tekrar uygulanmıştır. Kapsam geçerliği için ise İç Hastalıkları Polikliniğine başvuran, kronik hastalık tanısı almış 51 hastaya aynı ölçekler uygulanmıştır. Bulgular: Çalışmada, iç tutarlılık güvenirlik katsayısı 0.91 olarak bulunmuştur. Test-tekrar test güvenirliğinde korelasyon katsayısı 0.98 olarak bulunmuştur. Faktör analizinde ölçek maddelerinin üç faktörde toplandığı görülmüştür. Bu üç faktörün maddeleri arasındaki iç tutarlılığa bakıldığında Cronbach’s Alpha değeri sırasıyla 0.91, 0.65, 0.46 olarak belirlenmiştir. Ayrıca, araştırmacılar tarafından önceden tasarlanan üç alt ölçek güvenirlik analiz sonuçları ise “hastanın kendisi ile ilgili otomatik düşünceleri” alt ölçeği için 0.84, “hastanın kullandığı ilaçla ilgili otomatik düşünceleri” alt ölçeği için 0.81, “hastanın çevresi ile ilgili otomatik düşünceleri” alt ölçeği için 0.74 olarak bulunmuştur. Geliştirilen ölçeğin, daha önceden geçerlilik ve güvenirliği yapılmış Otomatik Düşünceler Ölçeği ile korelasyonuna bakılmış, iki ölçek arasındaki ilişki 0.503 (p=0.000) olarak bulunmuştur. Tartışma ve Sonuç: Araştırmadan elde edilen bulgular, 27 maddelik ölçeğin yüksek düzeyde geçerlik ve güvenirlik ölçütlerine sahip olduğunu göstermiştir. Cronbach alfa iç tutarlık katsayısı sonuçları “hastanın kendisi ile ilgili otomatik düşünceleri”, “hastanın kullandığı ilaçla ilgili otomatik düşünceleri” ve “hastanın çevresi ile ilgili otomatik düşünceleri” şeklinde alt ölçekler halinde kullanılabileceğini destekler yöndedir. Ölçeğin otomatik düşünceler ölçeği ile korelasyonun yüksek olduğu ve birbirini destekleyecek nitelikte olduğu düşünülmüştür. Bu çalışma sonucunda elde edilen veriler ölçeğin anksiyete bozukluklarında, hastaların tedavi ile ilgili otomatik düşüncelerini belirlemede kullanılabilecek geçerli ve güvenilir bir veri toplama aracı olduğunu ortaya koymuştur.
Development, Reliability and Validity Study of Automatic Thoughts Related to Treatment Scale
Purpose: In this study, we aimed to develop a scale to identify automatic thoughts of patients with anxiety disorder about the treatment and perform validity and reliability analyses. Method: A question pool with 59 items was prepared by searching the relevant literature and consulting experts. Ultimately, the questionnaire became a 21-items scale. 184 patients who were diagnosed as generalized anxiety disorder at psychiatry policlinic of Gülhane Military Medicine Academy were included in this study. Automatic Thoughts Scale for Treatment was used for data collection, and Automatic Thoughts Scale was used for scale validity. The scale was re-applied to 55 patients after 4 weeks to confirm test-retest reliability. Same scales were applied to 51 patients with diagnosis of chronic illness that were referred to Internal Medicine policlinic. Findings: Internal consistency reliability coefficient was found as 0.91. The correlation coefficient of testretest reliability was found as 0.98. In factor analysis, scale items were collected under 3 factors. When we examined internal consistency of items of these three factors Cronbach’s Alpha value was found as 0.91, 0.65, and 0.46, respectively. In addition, according to sub-scale reliability analysis results, the reliability coefficients were 0.84 for “automatic thoughts about him/her”, 081 for “automatic thoughts about drug used”, and 0.74 for “automatic thoughts about environment”. The correlation of this newly developed scale with Automatic Thoughts Scale- which was shown to be valid and reliable before- was examined and the relation between two scales was found as 0.503 (p=0.000). Findings and Discussion: Findings of this study demonstrates that this 27-items scale has high validity and reliability. Cronbach’s Alpha internal consistency coefficients support that using subscales as “automatic thoughts about him/her”, “automatic thoughts about drug used”, and “automatic thoughts about environment” is reasonable. The scale has a high correlation with Automatic Thoughts Scale and these two scales are thought to be supportive for each other. The data of this study showed that this scale would be used as a valid and reliable data collection tool to identify automatic thoughts of patients with anxiety disorder about treatment.

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