The Development And Preliminary Clinical Application Of Self-Perceived Burden Scale For Cancer Patients

Cancer diagnosis,subsequent treatment and a variety of uncertaintieshave brought serious psychological distresses to cancer patients and theirfamilies. Foreign studies indicate that there are35to50percent of cancerpatients suffered from significant psychological problems. Among theseproblems, self-perceived burden (SPB), which means the fear of draggingdown their families, is commonly existed in the patients due to a variety ofreasons. In recent years, research on SPB of cancer patients has become ahot spot in the field of tumor psychological rehabilitation. In China, therelevant research is still in the exploratory stage without enough effective measurement tools available. Therefore, it is necessary to establish a set ofthe SPB assessment tools suitable for domestic cancer patients. This studyaims to work out a self-perceived burden scale for cancer patients(SPBS-CP), verify its performance and establish its norm, so as to providean effective tool for the clinical evaluation of the level of cancer patients’self-perceived burden as well as relevant researches.PartⅠSELECTION OF THE ENTRIES IN SPBS-CP ANDDEVELOPMENT OF THE TESTING VERSIONObjectiveWith reference to foreign assessment tools of the SPBS, draw up aSPBS-CP suitable for Chinese cancer patients, and build scale item pool todevelop the testing version of SPBS-CP.MethodsLiterature research, brain storm, group (cancer patients) evaluation,expert consultation and other methods were employed to form a series of SPBS-CP entries. Through in-depth interviews, quantitative investigationanalysis and Delphi method, the entries were preliminarily selected andmodified to form the initial scale.ResultThe testing version of SPBS-CP, including21entries in fivedimensions, i.e., care burden, financial burden, family burden,psychological/emotional burden and the burden of treatment, wasdeveloped.ConclusionThe SPBS-CP scale, including five dimensions and21entries, wasinitially developed. PartⅡEVALUATION AND ESTABLISHMENT OF SPBS-CP TESTINGVERSIONObjectiveValidate the clinical SPBS-CP, and test its reliability, validity andresponsiveness.Methods330cases from3general hospitals in Shandong Province wereselected to carry out on-spot investigation and evaluate the reliability,validity and responsiveness of SPBS-CP.ResultsSPBS-CP includes21entries in four dimensions, economic/family,care, emotional and treatment burdens. The cumulative percent of factoranalysis was67.765%; the content validity was0.81; Cronbach’sαwas0.938; the test-retest correlation coefficient of each entry was between0.590and0.718; corrected item-total correlation was0.798; the split-half reliability of each dimension was between0.661and0.864, while the totalscale’s split-half reliability was0.914; the standard validity correlationcoefficient was among0.555~0.771; reactivity results indicated that thedimension3and4were not statistically significant, and the remainingdimensions and total scale difference was statistically significant; most ofthe scale difficulty was above0.5.ConclusionThere is good reliability, validity, responsiveness and difficulty inSPBS-CP, and it be used in clinic for further verification and application. PartⅢPRELIMINARY CLINICAL APPLICATION OF SPBS-CPObjectiveWith SPBS-CP preliminarily applied in patients with advanced cancer,evaluate the mid and late stage cancer patient SPB level and establish thenorm in Shandong Province.Methods330cancer patients and341chronic patients from three generalhospitals in Shandong were selected to carry out on-spot inquisition, thenthe reliability, validity and responsiveness of SPBS-CP was verified.Tentatively exploration on the influential factors of SPB was conductedthrough one-way ANOVA,multiple stepwise regression analysis andindependent sample t test, etc.; standard conversion was employed toestablish the norm in ShandongResultsSBP of cancer patients was moderate to severe, and it was related with working conditions, health condition of caregivers, income and illness state.Total score and the demarcation value of four factors are as follows: SPB<30is classified as no significant burden,30≤SPB <50as mild burden,50≤SPB <70as moderate burden and≥70as severe burden.ConclusionSBP of cancer patients was moderate to severe; working conditions,caregiver’s health, income and illness state had effects on the level ofpatients’ SBP..