Development And Validation Of The Exercise Self-efficacy Scale For Lung Cancer Patients

Objective:We developed an exercise self-efficacy scale for lung cancer patients by using the standard measurement development methods,and evaluate its reliability and validity.Methods:(1)Establishment of item pool:the primary item pool was designed based on the Bandura's self-efficacy theory and conceptual framework,literature review,Existing scales,and clinical characteristics of lung cancer patients.(2)Preliminary screening of items through Delphi method and pre-experiment:the two rounds of Delphi method consultations involved a total of 17 domestic experts in the field of cancer treatment/nursing and psychology,and the items were modified based on expert opinions,the mean value of the importance of the items,and the coefficient of variation.A pre-test version of the scale was formed.Six lung cancer patients were selected for pre-testing at a third-level hospital in Anhui Province.Patients were asked to read the pre-test version of the scale,give their opinions,and modify the items based on the feedback results.A clinical test version of the scale was formed.(3)Quantitative screening of items and reliability and validity tests:206 lung cancer patients selected from two tertiary Class A hospitals in Anhui province using a convenient sampling method.Items were selected by using the critical ratio method,total correlation method and Cronbach's?coefficient method.Reliability was tested using Cronbach's?coefficient and split-half reliability.Validity was tested using content validity,criterion-related validity,construct validity,and discriminant validity.Results:(1)A 41-item pool with two dimensions of efficacy expectation and outcome expectation was formed.(2)In the Delphi method,18 questionnaires were distributed in the first round,16 were returned,17 questionnaires were distributed in the second round,and 16 were recovered.The positive coefficients of the experts in the two rounds were88.9%(16/18)and 94.4%(16/17).Expert authority coefficients were 0.805 and 0.825;Kendall's W coefficients were 0.212 and 0.511.The mean of the importance scores of the items ranged from 3.06 to 4.94,2.88 to 4.94,and the coefficients of variation ranged from 0.05 to 0.55,0.05 to 0.38,respectively.The first round of consultation deletes 9items,merges 9 items,adds 5 items,a total of 32 items enter the second round of consultation.The second round of consultation deletes 4 items,merges 4 items,and splits 1 items.Pre-tested version of the scale consisting of 26 items was formed.1 item was deleted in the pre-test,clinical test version of the scale consisting of 25 items was formed.(3)None of the items met the quantitative screening criteria.The Cronbach's?coefficient of the total scale was 0.930,the dimensions of efficacy expectation and outcome expectation were 0.944 and 0.831.The split-half reliability of the total scale was 0.907,and the dimensions of efficacy expectation and outcome expectation were0.903,0.658.The Item-level content validity index(I-CVI)ranged from 0.833 to 1.000,and the average of all I-CVIs(S-CVI)was 0.993.The criterion-related validity of total scale was 0.774,and the criterion-related validity of efficacy expectation,outcome expectation dimensions were 0.810,0.404.Confirmatory factor analysis showed that?~2/df?RMSEA?CFI?IFI?TLI?NFI were 2.010?0.070?0.908?0.909?0.900?0.835,and the model fits well.There are significant differences in the high and low grouping of the total scale,and he high and low grouping of the two dimensions scores(P<0.001),scale has good discriminant validity.Conclusions:The exercise self-efficacy scale compiled by this study includes two dimensions of efficacy expectation and outcome expectation,with a total of 25 items.It has good psychological measurement properties and can be used to measure the exercise self-efficacy of lung cancer patients in China.