乳腺癌化疗患者症状测评量表的编制与信效度检验

Development and psychometric testing of the symptoms assessment inventory for breast cancer patients receiving chemotherapy

目的发展适用于乳腺癌化疗患者的症状测评量表。方法在文献回顾及现有的癌症患者多症状测评工具基础上拟定乳腺癌化疗患者症状测评量表条目池:通过专家评定,形成乳腺癌化疗患者症状测评量表。采用症状测评量表及简明健康调查量表(the Medical Outcomes Study 36-item Short-Form Health Survey,SF-36)对194例治疗前、中、后的乳腺癌患者进行测评,并在1周后对30例治疗中患者进行二次测评。结果经2轮专家评定后,形成包含26个条目的量表,各条目内容效度指数数值范围为0.800～1.000,量表全体一致率为0.885.均值量表水平内容效度指数为0.977;治疗前、中、后乳腺癌患者之间的症状得分的差异具有统计学意义(P<0.01),治疗中患者得分高于治疗后患者(P<0.01),治疗后患者得分高于治疗前患者(P<0.01);治疗中患者症状得分与SF-36各维度得分均呈负相关(P<0.01);症状测评量表Cronbach'sα系数为0.818,重测信度为0.745。结论所研制的乳腺癌化疗患者症状测评量表具有较好的效度和信度,适用于在临床中测评化疗期乳腺癌患者的症状。

Objective To develop a symptoms assessment inventory for breast cancer patients who are receiving adjuvant chemotherapy. Methods The item pool was formulated based on literature review and existing instruments measuring muhiple cancer symptoms. The items were selected by Delphi method. Totally 194 breast cancer patients were investigated with the symptoms assessment inventory and the Medical Outcomes Study 36-item Short-Form Health Survey（SF-36） before,during and after treatment. Thirty patients were retested one week later. Results The 26-item symptoms assessment inventory was formulated after two rounds of expert consultation. The range of the item content validity index was 0.800-1.000,the scale content validity index was 0.977. The symptom scores of patients in different treatment stages（i.e, before,during and after treatment） were sig- nificantly different（P〈O.O1 ）. Patients who were undergoing treatment experienced much higher level of symptoms than the other groups（P〈O.O1）. The symptom score in patients during treatment stage was negatively correlated with all the factors of SF-36 （P〈0.01）. The Cronbach＇s α of the inventory was 0.818 and test-retest reliability was 0.745. Conclusions The symptoms as- sessment inventory has good validity and reliability. It can be used for the symptoms assessment of breast cancer patients who are receiving chemotherapy.