Children's Mercy Hospital, Division of Hematology/Oncology and BMT, Kansas City, MO, USA.
College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
Palliat Support Care. 2024 Apr;22(2):274-280. doi: 10.1017/S1478951523000810.
Adolescents and Young Adults (AYAs) with cancer experience symptoms related to disease and treatment. To manage these symptoms, they need to develop self-management behaviors, yet no tool exists to assess these behaviors. The Symptom Self-Management Behaviors Tool (SSMBT) was developed to meet this need.
The study consisted of 2 phases. Phase 1 evaluated content validity, and Phase 2 evaluated reliability and validity. The SSMBT initially contained 14 items with 2 dimensions: (1) behaviors used to Manage Symptoms and (2) behaviors used to communicate with providers regarding symptoms. Four oncology professionals and 5 AYAs with cancer assessed the content validity. Evaluation of reliability and validity involved 61 AYAs with cancer. Reliability was evaluated using Cronbach's alpha. Construct validity was assessed with factor analysis. Discriminant validity was assessed using associations with symptom severity and distress.
Content validity evaluation supported the importance of the items. Factor analysis supported a two-factor structure: Manage Symptoms (8 items) and Communicate with Healthcare Providers (4 items) subscales. Internal consistency reliability for the total SSMBT was acceptable with Cronbach's alpha = 0.74. Cronbach's alpha value for the Manage Symptoms subscale was = 0.69 and for the Communicate with Healthcare Providers subscale was = 0.78. The SSMBT total and the Manage Symptoms subscale scores were moderately correlated with symptom severity ( = 0.35, = 0.014; = 0.44, = 0.002, respectively), partially supporting discriminant validity.
Systematic assessment of behaviors AYAs use is critical for clinical practice and evaluate interventions to improve self-management. The SSMBT demonstrates initial reliability and validity but requires further evaluation for clinical interpretation and future use.
患有癌症的青少年和年轻人（AYAs）会出现与疾病和治疗相关的症状。为了控制这些症状，他们需要养成自我管理行为，但目前尚无评估这些行为的工具。因此开发了症状自我管理行为工具（SSMBT）。
该研究分为两个阶段。第一阶段评估内容的有效性，第二阶段评估信度和效度。SSMBT 最初包含 14 个项目，分为两个维度：（1）用于管理症状的行为，（2）与提供者沟通症状的行为。四名肿瘤学专业人员和五名患有癌症的 AYA 评估了内容的有效性。涉及 61 名患有癌症的 AYA 评估了信度和效度。采用 Cronbach's alpha 评估信度。采用因子分析评估结构效度。采用与症状严重程度和痛苦的相关性评估判别效度。
内容有效性评估支持项目的重要性。因子分析支持两因素结构：管理症状（8 项）和与医疗保健提供者沟通（4 项）子量表。SSMBT 的总内部一致性信度可接受，Cronbach's alpha 值为 0.74。管理症状子量表的 Cronbach's alpha 值为 0.69，与医疗保健提供者沟通子量表的 Cronbach's alpha 值为 0.78。SSMBT 总分和管理症状子量表得分与症状严重程度呈中度相关（=0.35，=0.014；=0.44，=0.002，分别），部分支持判别效度。
系统评估 AYA 使用的行为对于临床实践和评估干预措施改善自我管理至关重要。SSMBT 显示出初步的信度和效度，但需要进一步评估，以用于临床解释和未来使用。
