摘要
目的 编制适应中国文化背景下的晚期癌症患者家属预立医疗照护计划(ACP)参与决策平衡量表,并检验其信效度。方法以跨理论模型-决策平衡为理论框架,通过文献分析、质性访谈及研究小组讨论的方法建立量表的条目池,再经专家会议和晚期癌症患者家属语义调试预调查完成条目筛选并形成测试量表。于2024年10-12月使用该量表对重庆市5所三级甲等综合医院住院治疗的310名晚期癌症患者家属进行调查,使用SPSS、AMOS等软件对数据进行项目分析和信效度检验,最终形成正式量表。结果晚期癌症患者家属ACP参与决策平衡量表包含选择代价、选择获益2个维度,共12个条目。该量表的Cronbach's α系数为0.875,折半信度为0.905,重测信度为0.856。条目水平的内容效度指数为0.880~1.000,量表水平的内容效度指数为0.980。探索性因子分析提取2个公因子后量表的累计方差贡献率为65.365%;验证性因子分析χ^(2)/df值为1.743,模型拟合适配度符合要求,且该量表具有良好的聚合效度及区分效度。结论本研究编制的晚期癌症患者家属ACP参与决策平衡量表信效度良好,可作为评估晚期癌症患者家属ACP参与决策水平的测评工具,也可较为系统、全面、有效地评估、收集、分析其ACP参与决策的行为意向和所面临的障碍。
Objective To develop a culturally adapted Advance Care Planning(ACP)Decision Balance Scale for Family Members of Patients with Advanced Cancer in China,and to test its reliability and validity.Methods Based on the transtheoretical model-decisional balance framework,the item pool was established through literature analysis,qualitative interviews,and research team discussions.After expert panel meetings and semantic debugging pre-surveys among family members of patients with advanced cancer,item screening was conducted to form the pilot scale.From October to December 2024,the scale was administered to 310 family members of inpatients with advanced cancer in five Class II Grade A hospitals in Chongqing.SPSS and AMOS software were used for item analysis and reliability and validity testing,and the final formal scale was developed.Results The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer consisted of 2 dimensions,perceived cost of choice and perceived benefit of choice,with a total of 12 items.The Cronbach's α coefficient of the scale was 0.875,the split-half reliability was 0.905,and the test-retest reliability was 0.856.The item-level content validity index ranged from 0.880 to 1.000,and the scale-level content validity index was 0.980.Exploratory factor analysis extracted 2 common factors,with a cumulative variance contribution rate of 65.365%.Confirmatory factor analysis showed χ^(2)/df=1.743,and the model fit indices met the requirements.The scale also demonstrated good convergent validity and discriminant validity.Conclusions The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer developed in this study demonstrated good reliability and validity.It can be used as a tool to assess the level of ACP decision-making participation of family members of patients with advanced cancer,and to systematically,comprehensively,and effectively evaluate,collect,and analyze their behavioral intentions and barriers regarding ACP decision-making.
作者
吴艾泓
罗晓庆
甘秀妮
吴茜
夏雪兰
张铃洁
郑敏
Wu Aihong;Luo Xiaoqing;Gan Xiuni;Wu Qian;Xia Xuelan;Zhang Lingjie;Zheng Min(Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)
出处
《中华现代护理杂志》
2025年第30期4114-4120,共7页
Chinese Journal of Modern Nursing
基金
重庆市教委十四五重点学科支持项目([2021]8号)。
关键词
肿瘤
预立医疗照护计划
决策平衡
晚期癌症
家属
量表编制
信效度
Neoplasms
Advance care planning
Decisional balance
Advanced cancer
Familymembers
Scale development
Reliability and validity
