Khazaee-Pool Maryam, Majlessi Fereshteh, Montazeri Ali, Pashaei Tahereh, Gholami Ali, Ponnet Koen
Department of Health Education and Promotion, School of Health, Zanjan University of Medical Sciences, Zanjan, Iran.
Department of Health Education and Promotion, School of Health, Tehran University of Medical Sciences, P.O. Box 15875-6951, Tehran, Iran.
BMC Womens Health. 2016 Jul 22;16:40. doi: 10.1186/s12905-016-0318-2.
Breast cancer preventive behaviors have an extreme effect on women's health. Despite the benefits of preventive behaviors regarding breast cancer, they have not been implemented as routine care for healthy women. To assess this health issue, a reliable and valid scale is needed. The aim of the present study is to develop and examine the psychometric properties of a new scale, called the ASSISTS, in order to identify factors that affect women's breast cancer prevention behaviors.
A multi-phase instrument development method was performed to develop the questionnaire from February 2012 to September 2014. The item pool was generated based on secondary analyses of previous qualitative data. Then, content and face validity were applied to provide a pre-final version of the scale. The scale validation was conducted with a sample of women recruited from health centers affiliated with Tehran University of Medical Sciences. The construct validity (both exploratory and confirmatory), convergent validity, discriminate validity, internal consistency reliability and test-retest analysis of the questionnaire were tested.
Fifty-eight items were initially extracted from the secondary analysis of previous qualitative data. After content validity, this was reduced to 49 items. The exploratory factor analysis revealed seven factors (Attitude, supportive systems, self-efficacy, information seeking, stress management, stimulant and self-care) containing 33 items that jointly accounted for 60.62 % of the observed variance. The confirmatory factor analysis showed a model with appropriate fitness for the data. The Cronbach's alpha coefficient for the subscales ranged from 0.68 to 0.85, and the Intraclass Correlation Coefficient (ICC) ranged from 0.71 to 0.98; which is well above the acceptable thresholds.
The findings showed that the designed questionnaire was a valid and reliable instrument for assessing factors affecting women's breast cancer prevention behaviors that can be used both in practice and in future studies.
乳腺癌预防行为对女性健康有着极其重要的影响。尽管预防行为对乳腺癌有益，但尚未作为健康女性的常规护理措施实施。为评估这一健康问题，需要一个可靠且有效的量表。本研究的目的是开发并检验一个名为ASSISTS的新量表的心理测量特性，以确定影响女性乳腺癌预防行为的因素。
2012年2月至2014年9月采用多阶段量表开发方法编制问卷。基于对先前定性数据的二次分析生成项目池。然后，运用内容效度和表面效度来提供量表的预终版。对从德黑兰医科大学附属健康中心招募的女性样本进行量表验证。对问卷进行了结构效度（探索性和验证性）、收敛效度、区分效度、内部一致性信度和重测分析。
最初从先前定性数据的二次分析中提取了58个项目。经过内容效度检验后，减少到49个项目。探索性因素分析揭示了七个因素（态度、支持系统、自我效能感、信息寻求、压力管理、刺激因素和自我护理），包含33个项目，共同解释了观察变异的60.62%。验证性因素分析表明模型与数据拟合良好。各分量表的Cronbach's alpha系数在0.68至0.85之间，组内相关系数（ICC）在0.71至0.98之间；均远高于可接受阈值。
研究结果表明，所设计的问卷是评估影响女性乳腺癌预防行为因素的有效且可靠工具，可用于实践和未来研究。
