Development And Reliability And Validity Tests Of Symptom Cluster Assessment Scale For Patients With Gout

ObjectiveFirst,develop a symptom group assessment scale for gout patients and test its reliability and validity.Second,investigate the status quo of gout patients’ symptom groups and analyze their influencing factors.Method1.Based on the symptom experience model as the theoretical framework,the symptom entry pool of gout patients was initially formed through a literature review and semi-structured interview.The pretest scale was formed by Delphi expert letter consultation and pre-survey.The first round of questionnaire survey was conducted among 170 gout patients treated in Shandong Gout Clinical Medical Center by pretest scale,and the items of the scale were screened by item analysis.The second round of questionnaire survey was conducted on 272 patients with gout using the item-screened scale.Use content validity,structure validity,convergence validity,discriminative validity,criterion association validity,Cronbach’s α coefficient,semi-reliability,and repeated-measures reliability to measure the reliability and validity of the scale to form a formal scale.2.Using the self-compiled demographic characteristics and disease characteristics questionnaire,chronic disease self-efficacy scale,and the official version of the gout symptom group assessment scale prepared in this study,140 gout patients from Gout Clinical Medical Center in Shandong Province were conveniently selected for questionnaire survey to analyze the status quo of gout symptom groups.To explore the influencing factors of symptom groups in patients with gout.Results1.After a literature search and semi-structured interview,44 items were initially formed in the scale item pool.Twenty-five experts from six provinces and cities participated in the correspondence,with 89.3%and 92.0%response rates,respectively.The authority coefficients of the experts were 0.911 and 0.906,respectively.The coordination coefficients of the experts were 0.420 and 0.426,respectively.After two rounds of consultation and the preliminary investigation,a pre-test scale including 24 items was formed.After item selection,2 items that do not meet the standard are deleted,forming a formal scale including 22 items.The total content validity of the scale was 0.889,and the content validity of each item was 0.833～1.000.Six common factors were extracted from the exploratory factor analysis(joint symptom group,movement limitation symptom group,psycho-sleep symptom group,urinary system symptom group,systemic manifestation symptom group,and tophus symptom group),and the contribution of the cumulative variance was 67.301%.The correlation coefficient among the six factors was between 0.127 and 0.530,and the coefficient of correlation between each factor and the total result of the scale was between 0.470 and 0.826.Confirmatory factor analysis revealed that the model was well fitted(χ~2/df=2.680,SRMR=0.076,RMSEA=0.079,TLI=0.884,CFI=0.903).In the convergent and discriminative validity tests,the combination reliability of each factor ranges from 0.761 to 0.936,and the AVE of each dimension ranges from 0.515 to 0.747.The correlation between dimensions reaches a significant level,and all of them are smaller than the corresponding square root of AVE(P<0.001).The correlation coefficients between the scale’s total score,the scores of each factor,and the total score of the gout impact scale were 0.119～0.489(P<0.001).The overall Cronbach’s α coefficient,broken half reliability,and retest reliability were 0.863,0.836,and 0.947,respectively.The range of Cronbach’s α coefficient for each dimension was 0.622 to 0.929,the range of the broken half reliability for each dimension was 0.672 to 0.838,and the range of the retest reliability for each dimension was 0.846 to 0.987.2.Application results showed that 83.2%of gout patients had two or more symptoms.Joint pain and swelling are stable,severe,and alarming symptoms across multiple dimensions.The total score of the symptom group assessment scale for gout patients was(36.53±6.81).The scores of the joint symptom group,movement limitation symptom group,psycho-sleep symptom group,urinary system symptom group,systemic symptom group,and tophus symptom group were(13.52±3.56)points,(7.99±3.21)points,(8.73 ± 2.35)points,(3.23 ± 1.76)points,(3.68 ± 1.10)points,(4.43 ± 1.26)points,respectively.Multiple linear regression analysis suggested that age,per capita monthly household income,disease stage,complications,medication,and self-efficacy were the main factors affecting the symptom group of gout patients.Conclusion1.Based on a literature review and semi-structured interview,this study formed the pre-test scale of symptom group assessment for gout patients through expert letter consultation and pre-experiment.After item screening and reliability and validity test,a 22-item symptom group assessment scale for gout patients was formed.It can assist clinical nurses in accurately and comprehensively evaluating patients,identifying symptom groups,and laying a foundation for patients to develop personalized symptom management.2.Patients with gout experience multiple symptoms and have numerous symptom groups;The factors affecting symptom groups are complex.Studies have shown that improving patients’ self-efficacy can enhance the efficiency of symptom management,improve their quality of life,and promote their physical and mental health.