School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Nurs Res. 2010 Mar-Apr;59(2):119-26. doi: 10.1097/NNR.0b013e3181d1a8d5.
Although uncertainty has been characterized as a major stressor for children and adolescents with cancer, it has not been studied systematically.
The objective of this study was to describe the development and initial psychometric evaluation of a measure of uncertainty in school-aged children and adolescents with cancer.
Interview data from the first author's qualitative study of uncertainty in children undergoing cancer treatment (Stewart, 2003) were used to generate 22 items for the Uncertainty Scale for Kids (USK), which were evaluated for content validity by expert panels of children with cancer and experienced clinicians (Stewart, Lynn, & Mishel, 2005). Reliability and validity were evaluated in a sample of 72 children aged 8 to 17 years undergoing cancer treatment.
The USK items underwent minor revision following input from content validity experts, and all 22 were retained for testing. The USK demonstrated strong reliability (Cronbach's alpha = .94, test-retest r = .64, p = .005), and preliminary evidence for validity was supported by significant associations between USK scores and cancer knowledge, complexity of treatment, and anxiety and depression. Exploratory factor analysis yielded two factors, not knowing how serious the illness is and not knowing what will happen when, which explained 50.4% of the variance.
The USK, developed from the perspective of children, performed well in the initial application, demonstrating strong reliability and preliminary evidence for construct and discriminant validity. It holds considerable promise for moving the research forward on uncertainty in childhood cancer.
尽管不确定性已被认为是癌症患儿和青少年的主要应激源，但尚未对此进行系统研究。
本研究旨在描述用于评估癌症患儿和青少年不确定性的测量工具的开发和初步心理计量学评估。
采用第一作者对癌症治疗中儿童不确定性的定性研究（Stewart，2003）中的访谈数据，生成 22 个用于儿童不确定性量表（USK）的项目，该量表由癌症患儿和经验丰富的临床医生的专家小组进行内容有效性评估（Stewart、Lynn 和 Mishel，2005）。在接受癌症治疗的 72 名 8 至 17 岁的儿童样本中评估了可靠性和有效性。
USK 项目在内容有效性专家的输入下进行了微小修订，所有 22 个项目都保留用于测试。USK 表现出很强的可靠性（Cronbach's alpha =.94，重测信度 r =.64，p =.005），并且 USK 得分与癌症知识、治疗复杂性以及焦虑和抑郁之间的显著关联支持了初步的有效性证据。探索性因素分析得出了两个因素，即不知道疾病的严重程度和不知道将来会发生什么，这两个因素解释了 50.4%的方差。
从儿童的角度出发开发的 USK 在初步应用中表现良好，具有很强的可靠性和结构有效性和判别有效性的初步证据。它为推进儿童癌症不确定性研究提供了很大的希望。
