Development Of Recurrence Risk Perception Questionnaire For Patients With Breast Cancer And Its Reliability And Validity Test

Objective(1)To explore the inner experience of breast cancer patients on recurrence risk perception,so as to provide reference for the compilation of the questionnaire for recurrence risk perception evaluation of breast cancer patients.(2)To develop a recurrence risk perception questionnaire for patients with breast cancer,and to test its reliability and validity,so that provide an evaluation tool for the risk perception of recurrence in breast cancer patients.Methods(1)The dimensions of the questionnaire were initially constructed based on the health belief model and risk perception attitude framework,and the questionnaire entry pool was initially constructed based on literature review and qualitative research.(2)Expert letter consultation:The Delphi method:inviting experts in related fields to conduct expert consultation on the questionnaire item pool to calculate the positive coefficient of experts,the degree of expert authority,the degree of expert opinion coordination and the degree of concentration,then the items were screened and improved according to the results of statistical analysis and the opinions of experts.(3)Reliability and validity test:Through questionnaire survey,500 breast cancer patients were selected by convenient sampling method for reliability and validity testing.Item screening:project analysis;Reliability:internal consistency reliability,split half reliability and retest reliability;Validity:structural validity,convergent validity and discriminant validity.Results(1)Qualitative research:Combining theoretical analysis,literature review and qualitative research,an item pool consisting of 6 dimensions and 37 items was formed.(2)Expert correspondence consultation:Two rounds of expert correspondence were issued 9 expert letter questionnaires,and 9 copies were recovered,with a recovery rate of 100%.The positive coefficient of the two rounds of expert correspondence consultation was 100%,the degree of expert authority was 0.79 and0.85,the coordination degree of Kendall(Kendall’s W)was 0.26 and 0.29,the coefficient of item variation(CV)is 0～0.50 and 0～0.16,and the mean of importance was 2.89～5.00 and 4.11～5.00,respectively.According to the results of two rounds of expert opinions and correspondence consultation,items were deleted,2 items were added,and 2 items were split,a revised version of the questionnaire with 37 items was formed,including6 dimensions of perceived possibility,perceived warning symptoms of relapse,perceived risk factors of disease recurrence,perceived health behavior risk factors,perceived psychological risk factors and perceived severity.(3)Reliability and validity test:In the preliminary survey,patients indicated that the expressions of each dimension and item of the questionnaire were clear and easy to understand,and the time spent in filling the questionnaire was less than 15 minutes.A total of 445 valid questionnaires were collected for factor analysis,including 204 exploratory factor analysis and 241 confirmatory factor analysis.Exploratory factor analysis:KMO was 0.89,andX~2 of Bartlett’s test was 5173.558(df=528,P<0.001).It extracts 6 common factors and explain 65.96%of the total variance,the factor load of all items>0.4,resulting in a questionnaire consisting of 6 dimensions and 37 items.Questionnaire overall Cronbach’sαwas 0.94,the dimension Cronbach’sαwas 0.82～0.90;The overall half-reliability of the questionnaire was 0.81,and the half-reliability of each dimension was 0.83～0.90.The overall retest reliability of the questionnaire was 0.84,and the retest reliability of each dimension was 0.86～0.94.Scale content validity index was 0.98,Item Content Validity Index is0.78～1.00.Confirmatory factor analysis:a total of 24 covariance correlations were added to the revised model,the revised fitting index:X~2/df=2.93,RMSEA=0.09,CFI=0.89,TLI=0.88,IFI=0.90,NFI=0.85,within the acceptable range.Convergent validity test:each entry in the factor loading was 0.51～0.83,AVE values of the mean variance of each dimension ranged was 0.64～0.82,the combination of reliability CR value was 0.94～0.96,discriminant validity test:each dimension correlation coefficient is 0.09～0.49(P<0.01),and less than the square root of AVE.ConclusionsThe"Recurrence Risk Perception Assessment Questionnaire of Breast Cancer Patients"constructed in this study has good reliability and validity,and can be used as a measurement tool to evaluate recurrence risk perception in breast cancer patients.