Garg Stuti P, Weissman Joshua P, Chwa Emily S, Galiano Robert D
From the Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine.
Plast Reconstr Surg Glob Open. 2023 Jul 12;11(7):e5118. doi: 10.1097/GOX.0000000000005118. eCollection 2023 Jul.
Currently, patient reported outcome scales used to assess scar impact focus solely on psychosocial well-being, symptoms, and appearance. There remains a need to develop a broadened measure of scar impact on patients, focusing on sexual and career aspects. This study investigates the content validity of the novel Career and Sexual Well-being (CS) Scar Impact Scale.
The CS scale contains five questions and was developed from previous patient thematic analysis interviews describing scar impact, and covers self-conscious behavior, new partners, hiding of the scar, being hindered in the workplace, and concerns regarding unprofessional appearance. Cognitive interviews and established guidelines were used to ensure that the scale was comprehensive, reproducible, and easily understandable.
In total, 86 patients completed cognitive interviews. Patients had a clear understanding of the questions and elicited their intent in the interviews. An estimated 86% of patients rated the CS scale coverage of scar impact on career and sexual health at a three or above out of four; 95% said the specific instructions were clear, and 92% stated it took them less than 4 minutes to complete the scale. After the first round of interviews, a question about "perception/self-consciousness in a professional environment" was added based on patient suggestions.
The CS scar scale demonstrated face validity, acceptability, and field-readiness through cognitive interviewing of patients at our institution. Sexual well-being and career performance are important yet often neglected themes with which scars should be assessed. Usage of these tools would serve to improve current scar scales.
目前，用于评估瘢痕影响的患者报告结局量表仅关注心理社会幸福感、症状和外观。仍需要开发一种更广泛的衡量瘢痕对患者影响的方法，重点关注性和职业方面。本研究调查了新型职业与性健康（CS）瘢痕影响量表的内容效度。
CS量表包含五个问题，是根据之前描述瘢痕影响的患者主题分析访谈编制而成，涵盖自我意识行为、新伴侣、瘢痕遮盖、在工作场所受到阻碍以及对不专业外表的担忧。采用认知访谈和既定指南以确保该量表全面、可重复且易于理解。
共有86名患者完成了认知访谈。患者对问题有清晰的理解，并在访谈中阐明了问题意图。估计86%的患者对CS量表在职业和性健康方面对瘢痕影响的覆盖程度给出了四分制中三分及以上的评分；95%的患者表示具体说明清晰，92%的患者表示完成该量表花费他们不到4分钟。在第一轮访谈后，根据患者建议增加了一个关于“在专业环境中的感知/自我意识”的问题。
通过对我们机构的患者进行认知访谈，CS瘢痕量表显示出表面效度、可接受性和现场适用性。性健康和职业表现是瘢痕评估中重要但常被忽视的主题。使用这些工具将有助于改进当前的瘢痕量表。
