癌痛自我管理行为问卷的编制及信效度检验  

Development and reliability and validity of the Self-management Behavior Questionnaire for Cancer Pain

作　　者：曾昭春 杨银芝 刘国红[3] 张丽君 张军杰 韩玲 李媛芳 Zeng Zhaochun;Yang Yinzhi;Liu Guohong;Zhang Lijun;Zhang Junjie;Han Ling;Li Yuanfang(Department of Integrated Traditional Chinese and Western Medicine(The 5th Division of Internal Medicine),Affiliated Cancer Hospital of Guangzhou Medical University,Guangzhou 510095,China)

机构地区：[1]广州医科大学附属肿瘤医院中西医结合科(内科五区),广东广州510095 [2]广州医科大学附属肿瘤医院门诊部,广东广州510095 [3]广东省第二人民医院物资采购管理科 [4]广州医科大学附属肿瘤医院胃肠外科一区,广东广州510095 [5]广州医科大学附属肿瘤医院重症医学科,广东广州510095 [6]广州医科大学附属肿瘤医院放疗科一区,广东广州510095

出　　处：《护理学杂志》2024年第12期5-9,共5页Journal of Nursing Science

基　　金：广州市中医药和中西医结合科技项目(20222A010051);广州市卫生和计划生育科技项目(20181A011100)。

摘　　要：目的编制癌痛自我管理行为问卷并检验其信效度,为评估癌痛患者自我管理行为提供有效工具。方法基于行为维持理论和NCCN成人癌痛临床实践指南中的癌痛管理5A目标,在文献调研及半结构式访谈的基础上,通过改良德尔菲法专家咨询、预调查形成癌痛自我管理行为问卷测试版。分别于2019年12月至2020年12月选取230例、2021年4月至2022年9月选取412例癌痛患者进行问卷调查。结果探索性因子分析提取4个公因子(包括癌痛评估记录与互动、非药物措施应用、癌痛药物使用、日常生活应对)共15个条目,累计方差贡献率为69.502%。验证性因子分析结果显示,模型拟合良好(χ^(2)/df=2.859,RMSEA=0.057,GFI、AGFI、NFI、CFI均>0.900)。问卷水平的内容效度指数与条目水平的内容效度指数均为1.000。问卷的Cronbach′sα系数为0.871,McDonald′sω系数为0.899,重测信度为0.846。结论癌痛自我管理行为问卷具有较好的信效度,可作为评估癌痛患者癌痛自我管理行为现状的工具。Objective To develop a questionnaire on self-management behavior of cancer pain and to test its reliability and validity,to provide a valid tool for evaluating the self-management behavior of cancer pain patients.Methods Based on the maintenance behavior theory and the 5A goal of cancer pain management in the NCCN Clinical Practice Guidelines for Adult Cancer Pain,the first draft of the questionnaire was formed through expert consultation of the modified Delphi method and pre-survey on the basis of literature review and semi-structured interviews.From December 2019 to December 2020,230 patients with cancer pain were selected for first round of questionnaire survey;from April 2021 to September 2022,412 cancer pain patients were selected for second round of questionnaire survey.Results The questionnaire included 15 items factored into 4 dimensions,including cancer pain assessment record and interaction,application of non-pharmacological measures,cancer pain drug use,and daily life coping.Four common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 69.502%.The results of confirmatory factor analysis showed that the model fitted well(χ^(2)/df=2.859,RMSEA=0.057;GFI,AGFI,NFI,and CFI>0.900).The overall content validity index of the questionnaire and the content validity index of each item were both 1.000.The Cronbach′sαcoefficient was 0.871,the McDonald′sωcoefficient was 0.899,and the test-retest reliability was 0.846.Conclusion The cancer pain self-management behavior questionnaire has good reliability and validity,and can be used as a tool to evaluate the current status of cancer pain self-management behavior in cancer pain patients.

关 键 词：癌症 癌痛 疼痛控制 自我管理行为 疼痛评估 非药物措施 信度 效度 

分 类 号：R473.73[医药卫生—护理学]