Development and psychometric evaluation of uncertainty about disease and treatment scale in hemodialysis patients: a sequential-exploratory mixed-method study

Sobhan Rahimi Esbo; Fatemeh Ghaffari; Zahra Fotokian; Hossein-Ali Nikbakht; Kiana Saadati

doi:10.1186/s40359-024-01685-x

Development and psychometric evaluation of uncertainty about disease and treatment scale in hemodialysis patients: a sequential-exploratory mixed-method study

BMC Psychol. 2024 Apr 5;12(1):187. doi: 10.1186/s40359-024-01685-x.

Authors

Sobhan Rahimi Esbo¹, Fatemeh Ghaffari², Zahra Fotokian³, Hossein-Ali Nikbakht⁴, Kiana Saadati⁵

Affiliations

¹ Student Research Committee, Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R., Iran.
² Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R., Iran.
³ Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R., Iran. zfotoukian@yahoo.com.
⁴ Social Determinants of Health Research Center, Health Research Institute, Department of Biostatistics & Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, I.R., Iran.
⁵ Student Research Committee, Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, I.R, Iran.

Abstract

Background and objective: The need for long-term treatment and frequent visits to treatment centers for hemodialysis can lead to psychological problems such as Uncertainty about Disease and Treatment (UC about D&T) in patients with chronic kidney failure. In order to understand uncertainty about disease and treatment and to plan for preventive measures and care interventions in various dimensions, there is a need for reliable and valid tools. The present study was conducted to design and psychometrically evaluate the Uncertainty about Disease and Treatment Scale (UC about D&TS) in patients undergoing hemodialysis.

Methods: This study is of a methodological type and conducted in two stages. The first stage included a deductive (literature review) and an inductive approach (face-to-face interviews). In the second stage, psychometric indices of the UC about D&TS, including face validity (qualitative-quantitative), content validity (qualitative-quantitative), construct validity (exploratory factor analysis), and reliability (using Cronbach's alpha and McDonald's omega) were examined.

Results: In the literature review stage, 66 items were extracted, and in the qualitative stage, 48 items were extracted. After merging similar items, 29 items were entered into the psychometric process. No items were removed in the face and content validity stages. In the construct validity stage, five factors were extracted, including self-uncertainty, uncertain situation, uncertain future, uncertainty of treatment outcomes, and information uncertainty, which constituted a total of 82.16% of the total variance. In this stage, five items were removed from the study due to a corrected item-total correlation below 0.32, and four items were removed due to cross-loading. The α and Ω were calculated as 0.828 and 0.818, respectively. The measurement stability and standard error of measurement were estimated at 0.977 and 2.019, respectively.

Conclusion: The results showed that the UC about D&TS is a valid and reliable measure for patients undergoing hemodialysis. This scale is specifically designed to measure UC about D&T in hemodialysis patients, and it is recommended that healthcare providers (Hcps) use this scale in follow-up visits.

Keywords: Disease; Hemodialysis; Psychometric evaluation; Scale; Treatment; Uncertainty.

Publication types

Review

MeSH terms

Factor Analysis, Statistical
Humans
Psychometrics
Renal Dialysis*
Reproducibility of Results
Uncertainty