Department of Oncology Nursing, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
School of Nursing, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
BMC Palliat Care. 2022 Jun 6;21(1):102. doi: 10.1186/s12904-022-00987-4.
Approximately 60% of outpatients with advanced cancer experience pain; therefore, self-management of opioid use is important for appropriate pain relief. To date, no studies have clearly described the concept of opioid self-management or assessed the factors involved, including the improvement of self-management abilities. This study developed, and evaluated the validity and reliability of an opioid self-management scale for advanced cancer patients with pain (OSSA). Opioid self-management in advanced cancer patients with pain was defined as the management of opioid medication performed by patients with advanced cancer to relieve cancer pain on their own.
Three phases were required for validation and reliability of the OSSA: 1) testing content validity, 2) testing face validity, and 3) testing construct validity, concurrent validity and reliability.
After a three-phase process, the OSSA consisted of 33 items on six subscales. The structural equation modeling was such that the χ value was 709.8 (p < 0.001, df = 467), goodness-of-fit index was 0.78, adjusted goodness-of-fit index was 0.73, root mean squares of approximation was 0.063, and comparative fit index was 0.92. The Pearson correlation coefficients between the total OSSA score and the 24-hour average pain or pain relief over 24 hours were - 0.21 (p < 0.05) and 0.26 (p < 0.01), respectively. Cronbach's α was 0.93. The intraclass correlation coefficient range was 0.59-0.90.
The findings of this study show that the OSSA has acceptable validity and reliability, and that better self-management leads to greater pain relief. The OSSA can be considered effective for use in research, but shortened version should be prepared for realistic and practical clinical use.
约 60%的晚期癌症患者有疼痛症状；因此，自行管理阿片类药物的使用对缓解疼痛至关重要。迄今为止，尚无研究明确描述阿片类药物自我管理的概念，也未评估相关因素，包括自我管理能力的提高。本研究开发并评估了适用于晚期癌症伴疼痛患者的阿片类药物自我管理量表（OSSA）的有效性和信度。晚期癌症伴疼痛患者的阿片类药物自我管理被定义为晚期癌症患者自行管理阿片类药物以缓解癌症疼痛的行为。
OSSA 的验证和可靠性需要经过三个阶段：1）测试内容效度，2）测试表面效度，3）测试结构效度、同时效度和信度。
经过三个阶段的过程，OSSA 包括 6 个分量表的 33 个项目。结构方程模型的 χ 值为 709.8（p<0.001，df=467），拟合优度指数为 0.78，调整拟合优度指数为 0.73，近似均方根为 0.063，比较拟合指数为 0.92。OSSA 总分与 24 小时平均疼痛或 24 小时内疼痛缓解程度的 Pearson 相关系数分别为-0.21（p<0.05）和 0.26（p<0.01）。Cronbach's α 为 0.93。组内相关系数范围为 0.59-0.90。
本研究结果表明，OSSA 具有可接受的有效性和信度，更好的自我管理可带来更大的疼痛缓解。OSSA 可考虑用于研究，但应准备更简短的版本，以适应现实和实际的临床应用。
