Developmemt And Reliability And Validity Of The Social Alienation Scale For Lung Cancer Survivors

ObjectiveIn this study,the social alienation scale for lung cancer survivors was developed and its reliability and validity were tested,aiming to provide an objective and effective measurement tool for clinical assessment of the social alienation level of lung cancer survivors.MethodsThe first stage:Based on the literature review,Nicholson’s conceptual model of social alienation was taken as the guide,and relevant measurement tools at home and abroad were used to construct the dimensions and items of the social alienation scale for lung cancer survivors.Objective sampling method was adopted to select 13 lung cancer survivors for semi-structured interview,explore their real experience of social alienation,and expand the scale items,so as to form the initial pool of items.Using Delphi expert consultation method,15 experts were selected.After two rounds of expert letter consultation,the scale items were screened,modified and improved.A small-scale preliminary experiment was conducted on 30 lung cancer survivors by convenience sampling method to test the acceptability and understandability of the scale,and a clinical version of the scale was developed according to the survey results.The second stage:A total of 183 cases of lung cancer survivors revisited in the oncology ward or outpatient department of a Grade A hospital in Jinan,Shandong Province were investigated from June 2022 to November 2022 by convenience sampling method.Item analysis(critical ratio method,correlation coefficient method)was used to screen the items again.Structural validity,content validity and criterion validity were used to conduct validity test.Cronbach’sαcoefficient,split half reliability and retest reliability were used to conduct reliability test,and finally the clinical application version of the social alienation scale for lung cancer survivors was formed.ResultsThe first stage:After literature review and semi-structured interview,the initial scale consisted of 5 dimensions and 38 items.A total of 15 experts participated in the expert letter consultation.The positive coefficient of the first round of expert letter consultation was83.33%,that of the second round was 100%,the coefficient of expert authority degree was0.857,and the coordination degree of the two rounds of experts was 0.149 and 0.154(P<0.05).In the first round of expert letter consultation,items were screened based on the importance rating of scale items by experts,5 items were deleted,and 5 items with repeated semantics were merged into 2 items based on expert opinions.The results of the second round of expert letter consultation showed that the item importance score all met the requirements.Based on the expert opinions,2 items was deleted,and the 2 items with repeated semantics were merged into 1 item,which finally formed the scale with 27 items in5 dimensions.After two rounds of expert letter consultation,the modified scale was pretested,the scale recovery rate was 100%,and the filling time was 10～15 minutes.All of them were acceptable,and the contents of the scale items were not modified.Finally,the scale version entered into the reliability and validity test included 5 dimensions,with a total of 27 items.The second stage:A total of 183 valid questionnaires were collected in this study.The result of project analysis shows that one item is deleted,and the other items meet the criteria of item retention.Structure validity test results showed that KMO value=0.911,Bartlett spherical inspection(χ~2=3227.251,P<0.001),factor analysis can be performed.Three rounds of exploratory factor analysis were carried out.Three items were deleted in the first round of factor analysis,and one item was deleted in the second round.Five common factors were extracted in the third round,and the cumulative variance contribution rate was 71.565%.There was no double load for each item in the scale,and the load of each item on the corresponding factor was greater than 0.40.At the same time,the correlation analysis results showed that the correlation coefficient between each dimension of the scale was 0.362～0.618,and the correlation coefficient between each dimension and the total table was0.721～0.831(P<0.05).The content validity results showed that the scale I-CVI was0.833～1.000 and the S-CVI was 0.958 and the correlation coefficient between the scale and the criterion scale was 0.630.Reliability analysis results showed that the Cronbach’sαcoefficient of the scale was 0.935,the Cronbach’sαcoefficient of each dimension was between 0.749 and 0.907,the half-way reliability of the total volume table was 0.950,and the retest reliability was 0.889.ConclusionsThe Social Alienation Scale for Lung Cancer Survivors compiled in this study includes22 items in 5 dimensions,including social connection,social avoidance,loneliness,alienation and meaninglessness.It has good reliability and validity,and can be used for clinical assessment of the social alienation status of lung cancer survivors.