Yan Chao, Li Yonghong, Ai Ji, Yang Shenghuan
Nursing Department, Guizhou Aerospace Hospital, Guizhou Zunyi, 563000, China.
Nursing Department, Affiliated Hospital of Zunyi Medical University, Guizhou Zunyi, Guizhou, 563000, China.
BMC Psychol. 2025 Apr 2;13(1):322. doi: 10.1186/s40359-025-02391-y.
The global cancer burden is becoming increasingly severe. In the context of patient-centred medicine, respecting patients' autonomy and preferences is of paramount importance. However, there is currently a lack of scientific tools in China to measure the autonomous preferences of advanced cancer patients. We aim to optimise assessment tools for patients' autonomous preferences and validate their effectiveness, thereby filling a gap in related research, in hopes of improving the quality of medical care in China.
① To assess the semantic clarity of entries of the Chinese Autonomy Preference Index (API) and determine whether patients can accurately comprehend their content. ② To validate the application effect of cognitive interviews in the translation of the scale into the Chinese culture and context.
In March and April 2023, we selected 17 advanced cancer patients by convenience sampling in Zunyi, Guizhou, China, to participate in this study. We assessed their understanding of each item in the Chinese API scale through cognitive interviews and made the corresponding revisions to the scale items based on the interview results.
The respondents' understanding of various API entries after translation and adaptation was assessed. Based on the interview results, ambiguous entries were revised to create a refined Chinese version of the API. Ultimately, the API comprises two dimensions and 23 entries. The results of the first round of interviews revealed doubts or ambiguities in the semantic expression and understanding of 5 items, which were then revised following discussions by the research team. The second round of interviews confirmed that the interviewees could correctly understand the content of the entries without further modifications.
① Cognitive interviews can address discrepancies in the understanding of scale items among the target population and mitigate measurement errors stemming from item content ambiguity. ② Targeted questionnaire revisions have improved the accuracy, reliability, and applicability of the Chinese version of the API questionnaire. The Chinese version of the Autonomy-Preference-Index offers clinical healthcare professionals an effective measurement tool to assess the autonomous preferences of advanced cancer patients.
全球癌症负担日益严峻。在以患者为中心的医疗背景下，尊重患者的自主性和偏好至关重要。然而，目前中国缺乏科学工具来衡量晚期癌症患者的自主偏好。我们旨在优化患者自主偏好的评估工具并验证其有效性，从而填补相关研究空白，以期提高中国的医疗质量。
①评估中文版自主性偏好指数（API）条目的语义清晰度，确定患者是否能准确理解其内容。②验证认知访谈在将该量表翻译至中国文化和背景中的应用效果。
2023年3月和4月，我们在中国贵州遵义通过便利抽样选取了17名晚期癌症患者参与本研究。我们通过认知访谈评估他们对中文版API量表各条目的理解，并根据访谈结果对量表条目进行相应修订。
评估了受访者对翻译和改编后的各种API条目的理解。根据访谈结果，对含糊不清的条目进行修订，创建了一个精简的中文版API。最终，API包括两个维度和23个条目。第一轮访谈结果显示，有5个条目的语义表达和理解存在疑问或含糊之处，研究团队经讨论后对其进行了修订。第二轮访谈证实，受访者能够正确理解条目的内容，无需进一步修改。
①认知访谈可以解决目标人群对量表条目的理解差异问题，并减少因条目内容含糊不清而产生的测量误差。②有针对性的问卷修订提高了中文版API问卷的准确性、可靠性和适用性。中文版自主性偏好指数为临床医护人员提供了一种有效的测量工具，用于评估晚期癌症患者的自主偏好。
