Hangzhou Normal University, Hangzhou, Zhejiang Province, China.
The Children's Hospital Zhejiang University School of Medicine (National Clinical Research Center for Child Health), Hangzhou, Zhejiang Province, China.
J Clin Nurs. 2023 Apr;32(7-8):1186-1217. doi: 10.1111/jocn.16272. Epub 2022 Mar 13.
Tailored management of cancer-related fatigue (CRF) is important for effective coping; however, it has been hindered by the lack of a comprehensive tool that assesses both symptoms and treatable influencing factors.
The aim was to develop a cancer-related fatigue comprehensive assessment scale (CRF-CAS) and assess its psychometric properties.
This was a mixed-method study.
The study included two phases which were conducted in Zhejiang Province, China. In phase one, a literature search, brainstorming sessions, Delphi studies, cognitive interviews and a pilot study were conducted to construct and revise CRF-CAS indicators. In phase two, a questionnaire-based survey was conducted among cancer survivors. Item analysis was used to select and optimize indicators. Cronbach's α was calculated for reliability analysis. Validity analysis included concurrent validity and structural validity.
A 93-item tool was initially constructed. Phase one ended with revision and optimization. The preliminary scale included five dimensions (CRF symptoms, physical activity, cognitive-emotional status, sleep status, nutritional status) and 30 items. The mean item-content validity index (I-CVI) and scale-level CVI universal agreement (S-CVI/UA) were .98, and the adjusted mean values of Kappa for indicators ranged from .91-1, as evaluated by the expert group. The Pearson correlation coefficient between the CRF-CAS and criterion scales ranged from .337-.862. Cronbach's α coefficient ranged from .624-.728. Respondents agreed that the scale was acceptable for administration and that it contributed to decision-making in fatigue management. Confirmatory factor analysis (CFA) indicated that the CRF-CAS fit well.
The construction process of the CRF-CAS, involving panel discussion and expert and participant evaluations, was shown to be scientific and feasible. The CRF-CAS had relatively good validity and reliability in version 5 of its preliminary scale, which requires further improvement in future studies.
针对癌症相关疲乏（CRF）进行定制化管理对于有效应对至关重要；然而，由于缺乏一种全面的工具来评估症状和可治疗的影响因素，这一目标一直难以实现。
本研究旨在开发一种癌症相关疲乏综合评估量表（CRF-CAS），并评估其心理测量学特性。
这是一项混合方法研究。
本研究包括两个阶段，在中国浙江省进行。第一阶段进行了文献检索、头脑风暴会议、德尔菲研究、认知访谈和预试验，以构建和修订 CRF-CAS 指标。第二阶段，对癌症幸存者进行了问卷调查。项目分析用于选择和优化指标。Cronbach's α 用于进行可靠性分析。有效性分析包括同时有效性和结构有效性。
最初构建了一个包含 93 个项目的工具。第一阶段以修订和优化结束。初步量表包括五个维度（CRF 症状、身体活动、认知-情绪状态、睡眠状态、营养状态）和 30 个项目。专家组评估的项目内容效度指数（I-CVI）和量表水平一致性（S-CVI/UA）的平均值为.98，指标的调整后的 Kappa 值范围为.91-1。CRF-CAS 与标准量表之间的 Pearson 相关系数范围为.337-.862。Cronbach's α 系数范围为.624-.728。受访者认为该量表易于管理，并有助于决策疲劳管理。验证性因子分析（CFA）表明 CRF-CAS 拟合良好。
CRF-CAS 的构建过程涉及小组讨论和专家及参与者的评估，证明是科学和可行的。在其初步量表的 5 版本中，CRF-CAS 具有较好的有效性和可靠性，但在未来的研究中需要进一步改进。
