Nesvold Inger-Lise, Fosså Sophie D, Naume Bjørn, Dahl Alv A
Department of Cancer Rehabilitation - Physiotherapy, The Norwegian Radium Hospital, Rikshospitalet University Hospital, Montebello, 0310 Oslo, Norway.
Breast Cancer Res Treat. 2009 Sep;117(2):281-8. doi: 10.1007/s10549-008-0288-7. Epub 2008 Dec 27.
Arm/shoulder problems and lymphedema are common in patients treated for breast cancer. The Kwan's arm problem scale (KAPS) is a 13 items self-rating form developed for examination of such problems. Since no such testing has been done, we wanted to examine the psychometric properties of the KAPS. At a median of 47 months (range 32-87 months) post-surgery, 256 stage II breast cancer survivors filled in the KAPS. Findings from physical examination of arm/shoulder function, assessment of lymphedema, and established measures of quality of life (QOL), mental distress and fatigue were used to study convergent and discriminant validity. Factor structure and internal consistency were tested in split-half samples. The total KAPS as well as its two subscales showed high internal consistency (alpha > or = 0.92). A two factor solution explained 70% of the variance in the total KAPS score. Convergent validity was shown as the total KAPS score explained 32.5% of the variance in abduction of the ipsilateral shoulder. Discriminant validity was shown as the total KAPS score explained only 6.7% of the variance in abduction of the contralateral shoulder. Concurrent validity was confirmed since the total KAPS explained 54.8% of the variance in arm symptom subscale of breast cancer-specific QOL. Area under the curve was 0.80 for problems of using the arm at a cut-off of the total KAPS score of 21.5. The results show that the KAPS has good psychometric properties supported by high reliability and considerable convergent and discriminant validity.
手臂/肩部问题和淋巴水肿在接受乳腺癌治疗的患者中很常见。关氏手臂问题量表（KAPS）是一种为检查此类问题而编制的13项自评表格。由于尚未进行过此类测试，我们想检验KAPS的心理测量特性。在术后中位时间47个月（范围32 - 87个月）时，256名II期乳腺癌幸存者填写了KAPS。通过对手臂/肩部功能的体格检查结果、淋巴水肿评估以及既定的生活质量（QOL）、心理困扰和疲劳测量方法来研究聚合效度和区分效度。在分半样本中测试了因子结构和内部一致性。KAPS总分及其两个子量表均显示出较高的内部一致性（α≥0.92）。一个双因子解决方案解释了KAPS总分方差的70%。聚合效度表现为KAPS总分解释了同侧肩部外展方差的32.5%。区分效度表现为KAPS总分仅解释了对侧肩部外展方差的6.7%。同时效度得到证实，因为KAPS总分解释了乳腺癌特异性QOL手臂症状子量表方差的54.8%。当KAPS总分截断值为21.5时，使用手臂问题的曲线下面积为0.80。结果表明，KAPS具有良好的心理测量特性，具有高信度以及可观的聚合效度和区分效度。
