| Objective The purpose of the study was to prepare the assessment scale about self-management behavior for tumor patients with TIVAPs,and provide an effective evaluation tool for the evaluation and monitoring of self-management behavior of TIVAPs for patients.Another purpose was to analyze the influence factors of self-management behavior of tumor patients with TIVAPs,and provide reference for health education related TIVAPs in the future.MethodsThis study included three parts: Delphi expert consultation for developing scale of self-management behavior for tumor patients with TIVAPs,the analysis of this scale reliability and validity,and the analysis of influence factors self-management behavior for tumor patients with TIVAPs.The first part(Delphi expert consultation): Based on the theory of self-efficacy,and the framework of self-management tasks,combined with the opinions of the infusion expert nurses,we developed the scale item pool through literature review.Through two rounds of expert letter consultation,the items were screened according to the opinions put forward by experts,and item screening criteria,such as,the mean value of item importance(Not less than 3.50),the coefficient of variation(Less than 0.25)and the ratio of full marks(Not less than 20%).The second part(The analysis of this scale reliability and validity): A questionnaire survey was conducted among 478 patients with TIVAPs.Firstly,item analysis(correlation coefficient,critical ratio,and Cronbach’s α coefficient)was used to screen the items.Retest reliability and Cronbach’s α coefficient were used for reliability analysis.Content validity and structure validity were used for validity analysis.Exploratory factor analysis was used to test this scale structure validity for the remaining items after item analysis.Validation factor analysis was used to test the scale’s structure fit,convergence validity and discriminant validity.The third stage(The analysis of influence factor self-management behavior for tumor patients with TIVAPs): We analyzed the influence factors of self-management behavior of tumor patients with TIVAPs from the general information,the health promoting lifestyle,self-efficacy and social support.Firstly,we used T test,analysis of variance and Pearson correlation analysis for univariate analysis.And then those statistically significant indicators from univariate analysis were included in the multiple linear regression analysis.Finally,regression model about self-management behavior of tumor patients with TIVAPs was established.ResultsThe first part(Delphi expert consultation): A total of 26 experts were invited for the first round of expert consultation,22 questionnaires were received in first round of expert consultation,and 19 questionnaires were received in the second round.The expert participation positive coefficient was 84.62%(22/26)and 86.36%(19/22),respectively.The opinion submission rate was 68.18%(15/22)and 47.37%(9/19),respectively.The expert authority coefficient was 0.94 and 0.98 respectively.The Kendall’s W coefficient was 0.26 and 0.50 respectively.The first round of expert consultation included a total of 8 first-level indicators and 49 second-level indicators.After the first round of experts’ letter consultation,combined with the opinions put forward by experts,and item screening criteria,one items of the first-level indicators were revised without deletion.And 17 items of the second-level indicators were modified,merged two items,deleted 7 items and added 11 items.Finally,8 items of the first-level indicators and 52 items of the second-level indicators were formed.After the second round of expert letter consultation,one item of the first-level indicator was reduced.And 10 items of the second-level indicator were modified,merged 8 items after the modification,and deleted 6 items.Finally,7 items of first-level indicators and 42 items of the second-level indicators were formed.The second part(The analysis of this scale reliability and validity): 42 items passed the screening criteria of item analysis.The reliability analysis results showed that the Cronbach’s α coefficient of the scale was 0.931,and the retest reliability of the scale was 0.900.The validity analysis results showed that a total of 9 items were deleted and 33 items remained after 4 exploratory factor analyses.A total of 7 common factors were extracted in the fourth exploratory factor analysis.The cumulative variance contribution rate was 65.675%.Factor load of all items were more than 0.40.Confirmatory factor analysis results showed that after the adjusted model,CMIN/DF value was 2.348,RMSEA value was 0.06,RMR value was 0.056,CFI,IFI,TLI index were more than 0.90,estimate all items were more than 0.50,AVE values were more than 0.50,the CR value were more than 0.70,and the correlation coefficient absolute value were less than the square root of AVE.Model modification process deleted four items.Finally,a total 7 dimensions and 29 items were formed.The item I-CVI index was between 0.80 and 1.00,and the scale S-CVI/AVE index was 0.99.The third stage(The analysis of influence factor self-management ability for tumor patients with TIVAPs): Multiple linear regression analysis results showed that health responsibility(HR)and spiritual growth(SG)were included in the regression model,which could explain 28.40% variation in self-management ability for tumor patients with TIVAPs,and the regression model was statistically significant(F=24.18,P<0.001).ConclusionThe tumor patients with TIVAPs self-management behavior assessment scale which is developed in our study has good reliability and validity.And the scale structure is reasonable,which can be applied in clinical practice.Health responsibility(HR)and spiritual growth(SG)are the main influence factors of the self-management behavior for tumor patients with TIVAPs.The two factors should be taken into full consideration when health education programs for tumor patients with TIVAPs are formulated in the future. |
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