转移性乳腺癌患者心理社会健康快速筛查工具的研究

Development and validation of a rapid psychosocial well-being screening tool in patients with metastatic breast cancer

目的本研究旨在研制并验证针对转移性乳腺癌(Metastatic Breast Cancer,MBC)患者的快速心理社会健康筛查工具(MBC-PsySoc-Well-being)。方法采用混合研究方法,分两个阶段进行。第1阶段,采用焦点小组访谈法,与患者、护理人员和医疗专业人员分别进行小组讨论,制订筛查工具的条目内容。第2阶段,进行信效度检验。由5名专家审查工具的内容效度。在53例MBC患者中进行信效度检验,包括结构效度、效标关联效度、内部一致性系数和重测信度检验。结果根据焦点小组访谈结果,对6个主题进行分析,基于这些主题制订了8个条目。专家评判条目目标一致性指数为0.6~1.0。探索性因子分析提取出3个因子:好奇并主动寻求信息,热切希望回归正常生活,以及调整为积极的生活方式。该工具与欧洲癌症研究与治疗组织研制的生活质量核心调查问卷得分呈正相关(r=0.404,P=0.003),Cronbach?蒺sα系数为0.686,相隔2周测量的条目得分相关系数为0.410~0.673。结论本研究期望引起对MBC患者心理社会健康快速筛查工具研发的重视。仍需进一步进行更大样本量的深入研究,以确定该评估工具的信效度。

Objective The aim of this study was to develop and validate a rapid psychosocial well-being screening tool for metastatic breast cancer patients(MBC-PsySoc-Well-being).Methods Applying a mixed method approach,the study was conducted in two phases.Phase 1,a focus group method was employed for item development,and three focus group sessions were conducted,with patients,caregivers,and medical professionals,respectively.Phase 2,validity and reliability testing were performed.Five experts reviewed items for content validity.Construct validity,criterion-related validity,internal consistency,and test-retest reliability were conducted among a sample of 53 patients with metastatic breast cancer.Results Six themes were qualitatively analyzed based on focus group participants’responses.Eight items were then developed based on these themes.The index of Item-Objective Congruence scored by the experts ranged from 0.6 to 1.0.An exploratory factor analysis yielded three factors:Being curious and active in information seeking,Enthusiasm to return to a normal life,and Adjusting to positive lifestyle.The total scores of MBC-PsySoc-Well-being and the European Organization for Research and Treatment of Cancer’s Quality of Life Core Questionnaire(EORTC QLQ-C30)were moderately correlated(r=0.404,P=0.003).Cronbach’sαcoefficient of the overall scale was 0.686.Pearson correlation coefficients of items between two tests within 14-day ranged from 0.410 to 0.673.Conclusion This study represents an initiative to develop a rapid psychosocial well-being screening tool for patients with metastatic breast cancer.The results from validity and reliability testing indicate that the scale is moderately suitable for application to patients with metastatic breast cancer.However,a larger scale study should be further administered to confirm the validity and reliability of the measurement.