Development And Validation Of Cancer Patient Self-management Assessment Scale

Objectives To develop self-management scale for Chinese patients with Cancer,and examine it’s reliability and validity.Provide a assessment tools for clinical intervention and to improve the level of self-management of cancer patients.Methods 1 The self-management scale was developed based on Bandura’s social cognition theory,self-efficacy theory and self-determination theory,with three selfmanagement tasks and six core self-management skills as framework.A large number of related literatures and self-management scales that developed at domestic and abroad were reviewed,according to the characteristics of cancer patients,develop 82 items pool of scale.Items preliminary screen by Delphi method,20 experts had rich experience in the field of cancer were selected,2 rounds of questionnaire and consulting were performed.Select the items through the experts’ opinions,the items’ mean of importance score and coefficient of variation,after 2 rounds of enquiry,formed the initial scale.2 Pilot investigation: 266 cancer patients were investigated with the initial version of the cancer patient selfmanagement assessment scale in the pilot investigation.Using the critical ratio,correlation coefficient,the discrete degree and factor analysis method to analysis the resulting data of pilot investigation to further screen inventory items and check the feasibility of scale.44 items were obtained.Using exploratory factor analysis develops the preliminary structure of scale,and form interim version scale.3 Reliability and validity: the reliability analysis included the internal consistency reliability,test-retest reliability and split-half reliability.The validity analysis included content validity,construct validity and criterion-related validity.Results 1 20 expert questionnaires were sent out,acquires 19 questionnaires,the second round of consultation was sent out 19 questionnaires,acquires 19.The positive coefficient of two rounds of experts were 95%(19/20),100%(19/19);Experts’ authority coefficient were 0.847 and 0.857;The Kendall harmonious coefficient of two rounds of importance(Kendall’s W)were 0.312 and 0.523 and the variation coefficient were 9.95%~52.47%,52.47%~4.64% respectively.After two rounds of expert consultation delete 33 items,add 3 items,the initial version was established,comprised 6 factors and 52 items.2 The result of pilot investigation: The items of scale were further screened,and 8 items were deleted;Exploratory factor analysis to extract the six common factor,its cumulative variance contribution rate was 61.090%,each objective factor loading were greater than 0.4,so the scale that comprised 6 factors was reasonable.According to it’s including items,the factors were named: daily life management,symptom management,emotion management,and staff communication,information management,self-efficacy.3 The result of reliability and validity: 1)Reliability:(1)Internal consistency reliability: The factors’ Cronbach alpha coefficient ranges from 0.646 to 0.920,the total scale’s Cronbach alpha coefficient was 0.959;The factors’ split-half reliability coefficient ranges from 0.626 to 0.892,the total scale’s split-half reliability coefficient was 0.932;(2)2 weeks of test-retest reliability,the range of factors’ test-retest reliability were 0.437 to 0.684,the total scale’s test-retest reliability was 0.461;2)Validity:(1)The content validity: 8 experts in the field of cancer were evaluate the content of the scale,the content validity index(CVI)of the scale was 0.9;(2)criterion-related validity: correlation analysis of cancer patient self-management assessment scale and SUPPH,each of their factors’ correlation coefficient were range from 0.088 to 0.729,the total scale scores’ correlation coefficient was 0.560;Correlation analysis of cancer patient self-management assessment scale and chronic disease selfmanagement behavior scale,each of factors’ correlation coefficient was range from 0.351 to 0.980,the total scale scores’ correlation coefficient was 0.946,had statistically significant;(3)Construct validity: internal consistency of scale show that the correlation coefficient of each items and factors were range from 0.440 to 0.908,the correlation coefficient of each factors were range from 0.438 to 0.751,between the correlation coefficient of each factors and the total scale were range from 0.705 to 0.886,had statistical significance;Confirmatory factor analysis showed that six common factor model x~2/df value was 2.868,RMSEA was 0.089,GFI,AGFI,TLI,CFI were 0.878,0.829,0.902,0.829 respectively.IFI,NFI were 0.865,0.865,the goodness of fit of the scale was fairly good.Conclusions To developed cancer patient self-management assessment scale,and the scale has acceptable validity and reliability,high stability,all the indicators meet the measurement standard.