Development And Evaluation Of Cancer Labeling Self-perceived Discrimination Scale For Chinese Cancer Patients

Objectives:Cancer patients are susceptible to"discrimination" in social life.Different patients have different perception of disease discrimination.This study intends to develop a "cancer labeling self-perceived discrimination scale(CLSPDS)"based on the CSPDS that has been developed in previous studies.Through various visible and easy-to-see "cancer labels",the discrimination of cancer is further embodied and conceptualized to assess the subjective perception of discrimination.It is intended to be used in psychological counseling,psychotherapy and social intervention for various cancer patients.Methods:(1)Semi-structured interviews for patients with different labels and different types of cancer:through ward interviews,selected cancer patients with obvious labeling characteristics and different cancers to conduct semi-structured interviews,mainly to discuss the discrimination including but not(Limited to)life health,psychological and spiritual burden,employment and reemployment pressure,family economic burden,doctor-patient relationship,medical insurance issues,community care,social support and other major aspects.(2)Expert consultation:According to the interview results,extracted and constructed the item pool in the second-level scale,and invited experts and scholars in oncology,nursing,psychology,sociology and other related fields to carry out expert consultation to evaluate the content validity index,calculate the I-CVIs value,evaluate the applicability,and modify it until the I-CVIs value ?0.8.(3)Cognitive interviews:Cancer patients(small samples)corresponding to the initial version of the scale were invited to conduct cognitive interviews,qualitative evaluation of the scale items,and repeated revision of the items to guarantee that each item was concise,clear,accurate,without ambiguity.At last the initial version of the scale suitable for large sample reliability and validity test was formed.(4)Reliability and validity test:Used the initial version of the scale to conduct a questionnaire survey on the corresponding cancer patients(large samples),complete the final screening of the items based on the data analysis results,form the official version of the scale,and conduct project analysis,reliability test,validity test,and feasibility analysis,Subgroup analysis.Results:Cancer labeling self-perceived discrimination scale(CLSPDS)contains 16 items,including 2 subscales:10 items for clinical symptoms and 6 items for treatment.CLSPDS has good reliability(Cronbach's alpha coefficient=0.936,Spearman-Brown coefficient=0.913,ICC?0.928)and good effectiveness(I-CVIs>0.80,X2/df?1,321,GFI?0.952,AGFI?0.931).The completion time is 4.23±1.20(Mean±SD)min,and the CLSPDS scores of female patients and patients with long-term illness are higher(P<0.05).Conclusions:Cancer labeling self-perceived discrimination scale(CLSPDS)developed by this research institute is effective and reliable.It can be used to assess the level of discrimination caused by cancer patients with poor labeling of cancer,and may become a health education,psychological consultation and Evaluation tool for treatment and social intervention.