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

Antibiotic resistance is one of the greatest threats to global public health. Inappropriate use of antibiotics can lead to an increase in antibiotic resistance. Individual self-efficacy 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-efficacy of appropriate antibiotic use for Chinese adults. We aimed to translate and develop a Chinese version of the Appropriate Antibiotic Use Self-Efficacy Scale (AAUSES), and validate its reliability and validity.

A total of 659 adults were recruited to participate in the questionnaire. The original version scale was first translated into Chinese using the backward and forward translation procedures. The internal consistency reliability of the scale was measured by the Cronbach alpha coefficient, the test-retest reliability, and the corrected item-total correlation. The validity of the scale was assessed by the content validity index, exploratory factor analysis, and confirmatory factor analysis.

The content validity index of the scale was 0.96. Exploratory factor analysis (EFA) supported a 4-factor structure of the translated questionnaire, and the discriminant validity of the scale was good. Confirmatory factor analysis (CFA) showed in the model fitness index, the chi-square degree of freedom was 2.940, the goodness-of-fit index(GFI) was 0.929, the incremental fit index (IFI) was 0.908, the comparative fit 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 fitting indexes were all in the acceptable range. Cronbach alpha coefficient 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-efficacy for appropriate antibiotic use in adults varied by education, occupation, income, place of residence, and whether or not they had heard of antibiotic resistance.

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