The Development And Psychometric Assessment Of The Supportive Care Needs Scale For Esophagectomy Patients After Discharge

Objective:Construct the Supportive care needs scale for esophagectomy patients after discharge,so as to provide a scientific,feasible and reliable assessment tool for postoperative care personnel,and to provide basis for the development of targeted Supportive care for esophagectomy patients after discharge.Methods:(1)Iteam pool was established: Through literature review and qualitative interview,item pool of supportive care needs scale for patients with esophageal cancer after discharge was formed based on the theoretical framework of supportive care needs.(2)Formation of clinical test version of scale: Using Delphi method,20 esophageal cancer medical/nursing and nursing education experts from 9 provinces or municipalities in China were selected for two rounds of expert letter consultation to screen items and evaluate content validity.Then 20 patients after discharge were selected for pre-test to form clinical test version of scale.(3)Formation of Clinical version and inspection: 325 patients who have been discharged from 3 first class tertiary hospitals of Jiangsu province after esophagectomy were selected for clinical measurement of the scale by convenient sampling method.Six invalid questionnaires were eliminated and 319 questionnaires were effectively collected.Criticial Ration,correlation coefficient and Cronbach’s αcoefficient method were used to analyze items again.The reliability of the scale wastested by internal consistency reliability and split reliability.Content validity,structure validity,convergent validity and criterion-related validity were used to test the validity of the scale.Finally,a clinical application version of the scale was formed.Results:(1)Formation of scale: The clinical version of scale concluded 4 dimensions and 49 items.(2)Reliability of the scale: The Cronbach’s α coefficient of the scale was 0.971,and the coefficient of each dimension was 0.894 ~ 0.946.The scale’s split reliability coefficient was 0.935.(3)Validity of the scale:(1)Content validity: S-CVI /Ave=0.97,and the I-CVI of each item was between 0.78 and 1.00.(2)Construct validity: The four extracted common factors explained for 61.587% variance.The factor loading of each item was0.416~0.803.The factor loading of physiological needs domain was 0.475~0.768;The factor loading of informational needs domain was 0.502 ~ 0.860;The factor loading of Emotional/psychological needs domain was 0.696 ~ 0.879;The factor loading of social needs domain was 0.759~0.846.Correlation coefficients between each item and domain were 0.516~0.873,and they were 0.664~0.855 among all the domains,and they were 0.821~0.954 between all the domains and the total score of the scale.(3)Convergent validity: The total score of SCNS-ED was significantly correlated with the score of EORTC QLQ-C30 and QLQ-OES18 in all domains,and the absolute value of the correlation coefficient was 0.308~0.670(P<0.01).(4)Criterion-related validity: The SCNS-ED was significantly correlated with the SCNS-SF34 in all domains and total score,and the correlation coefficient was0.510~0.840(P<0.01).Conclusions:(1)The clinical version of Supportive care needs scale for esophagectomy patients after discharge was developed.(2)The scale has a good reliability and validity,fits psychometric requirements,and it can be used for the evaluation of supportive care needs of esophagectomy patients after discharge.