Aims: To develop and preliminarily test the reliability and validity of a behaviour questionnaire for stoma self-management for patients with bladder cancer after radical cystectomy and ileal conduit.
Design: A psychometric instrument validation study conducted in two phases.
Methods: The initial version of behaviour questionnaire was developed based on guidelines for people living with a stoma. Five experts validated the content of the preliminary 29-item questionnaire. A cross-sectional survey was then conducted in Beijing for preliminary reliability and validity tests between 4 December 2017-28 April 2018. A total of 151 participants in the survey, 147 of whom completed the study and 16 completed a 2-week test-retest reliability test.
Results: The content validity indices were satisfied. A principal component analysis with direct oblimin rotation was performed. Sixteen items were retained, and three factors were identified, namely, pouching system change, emotional management, and role management. The 16-item questionnaire showed acceptable internal consistency and test-retest reliability. The mediational effect of self-management behaviour on the relationship between self-efficacy and stoma quality of life was confirmed via convergent validity testing.
Conclusion: The behaviour questionnaire for stoma self-management appears to have adequate initial reliability and validity. More observational and interventional studies need to be conducted for further evaluation of its psychometric properties.
Impact: This study developed a reliable instrument to measure self-management behaviours for persons living with a stoma after radical cystectomy and ileal conduit. The questionnaire has practical value for both healthcare providers and researchers working in this field. The 16-item questionnaire can be administered quickly in clinical practice. Based on the questionnaire and the elicited mediational model, psycho-education programs tailored to improve self-management should be designed, implemented, and re-inspected regarding their effectiveness for the target population in China.
目的: 编制膀胱癌根治性膀胱切除回肠导管术后造口自我管理行为问卷,并对其信度和效度进行初步检验。 设计: 心理测量仪器验证研究应分两个阶段进行。 方法: 最初版行为问卷是以造口患者指南为基础编制。五位专家对最初版行为问卷中的29项内容进行验证。2017年12月4日至2018年4月28日期间,在北京进行横向调查,以执行初步信度和效度试验。调查过程,共151名参与者,其中147人完成研究,16人完成为期2周的重测信度试验。 结果: 内容效度指标合格。现已采用直接斜交转轴法,以便对主成分进行分析。其中,16个项目得到保留,并确定三大因素,分别是造口袋变更、情绪管理和角色管理。此16项问卷内容中载有可接受的内部一致性和重测信度等信息。可通过收敛效度检验证实了自我管理行为对自我效能和造口质量关系的中介作用。 结论: 造口自我管理行为问卷的初始信度和效度适用。需要执行更多的观察和干预研究,以进一步评估其心理测量学特性。 影响: 研究过程中,已成功开发一种可靠的工具,用于对膀胱切除术和回肠导管术后患者造口自我管理行为进行衡量。该问卷对医疗服务提供者和研究者都有实用价值。上述16项问卷内容均可在临床实践中快速实施。应以问卷调查和诱导中介模型为基础,针对中国的目标人群设计、实施并重新检查旨在改善自我管理的心理教育项目的有效性。.
Keywords: cystectomy; instrument development; nursing; self-management; urinary bladder neoplasms; urinary diversion.
© 2020 John Wiley & Sons Ltd.