Validation of the Chinese version of the EORTC colorectal cancer-specific quality-of-life questionnaire module (QLQ-CR38)

The European Organization for Research and Treatment of Cancer colorectal cancer (CRC)-specific quality-of-life questionnaire module (QLQ-CR38) assesses health-related quality of life in patients with CRC. We studied its psychometric properties and clinical validity in Hong Kong Chinese patients with CRC. The 38 items, forming functional and symptom scales, were administered to 256 Chinese patients diagnosed with CRC from a clinical oncology outpatient unit. Multitrait scaling analyses confirmed the hypothesized scale structure of the functional scales but not of the symptom scales, particularly those measuring chemotherapy side effects and gastrointestinal symptoms. The functional scales, but not the symptom scales, showed good internal consistency reliability. Convergent and divergent validity were satisfactory, as indicated by the correlations with other measures. The scales effectively differentiated between clinically distinct patient groups. As expected from a module designed to be used in conjunction with the core questionnaire, correlations between the QLQ-CR38 and the QLQ-30 are only weak to moderate. The functional scales of the Chinese version of the QLQ-CR38 show good psychometric performance and suitability for use with the QLQ-C30. Although, the results lend support to the clinical validity of the QLQ-C38, the symptom scales would benefit from further refinement to enhance their usefulness.     

Psychometric Properties of Instruments Used to Measure Fatigue in Children and Adolescents With Cancer: A Systematic Review

ContextDespite the recognized distressing symptom of fatigue in children with cancer, little information is available to assist in the selection of an instrument to be used to measure fatigue.ObjectivesThe objectives of this study were to 1) describe the instruments that have been used to measure cancer-related fatigue in children and adolescents and 2) summarize the psychometric properties of the most commonly used instruments used to measure fatigue in children and adolescents with cancer.MethodsFive major electronic databases were systematically searched for studies using a fatigue measurement scale in a population of children or adolescents with cancer. Fatigue scales used in those studies were included in the review.ResultsFrom a total of 1753 articles, 25 were included. We identified two main fatigue measurement instruments used in a pediatric oncology population: 1) the Fatigue Scale-Child/Fatigue Scale-Adolescent and the proxy report versions for parents and staff and 2) the PedsQL? Multidimensional Fatigue Scale. These two scales show similar attributes with reasonably good internal consistency and responsiveness.ConclusionEither the Fatigue Scale or PedsQL Multidimensional Fatigue Scale can be incorporated into clinical research. Future research should focus on identifying specific fatigue measures more suited to different purposes such as comparative trials or identification of high-risk groups.     

Psychometric Properties of the Knowledge,Attitude, and Practice Behavior of Oncology Nurses on Advance Care Planning Instrument

ObjectiveAdvance care planning has been practiced in Western countries for several years, but non-Western cultures face challenges in implementation. This study was dedicated to translating the instrument measure into Chinese, examining its psychometric qualities and exploring the relationships among knowledge, attitudes, and practicing behaviors in advance care planning among oncology nurses in China.Data SourcesThe research adopted a cross-sectional design from September 3 to October 5, 2021. After translation and cultural adaptation, oncology nurses (N = 249) were involved. The research used psychometric evaluation to verify that the content validity, structural validity, internal consistency, and test-retest reliability enhanced the analytical rigorous instrument.ConclusionThe translated and adapted instruments showed reasonable psychometric properties. The Chinese version of the KAB-ACP for oncology nurses is a consistent, valid, and reliable instrument for assessing knowledge, attitude, and practice behavior of Chinese-speaking nurses who work in advance care planning by researchers or clinicians.Implications for Nursing PracticeMeasures of oncology nurses’ knowledge, attitudes, and practice behaviors will allow for more targeted interventions that will improve end-of-life care outcomes.     

Psychometric properties of functional postural control tests in children: A systematic review

BackgroundPostural control deficits are one of the most common impairments treated in pediatric physiotherapeutic practice. Adequate evaluation of these deficits is imperative to identify postural control deficits, plan treatment and assess efficacy. Currently, there is no gold standard evaluation for postural control deficits. However, the number of studies investigating the psychometric properties of functional pediatric postural control tests has increased significantly.ObjectiveTo facilitate the selection of an appropriate pediatric functional postural control test in research and clinical practice.MethodsSystematic review following the PRISMA guidelines. PubMed, Web of Science and Scopus were systematically searched (last update: June 2022; PROSPERO: CRD42021246995). Studies were selected using the PICOs-method (pediatric populations (P), functional assessment tools for postural control (I) and psychometric properties (O). The risk of bias was rated with the COSMIN checklist and the level of evidence was determined with GRADE. For each test, the postural control systems were mapped, and the psychometric properties were extracted.ResultsSeventy studies investigating 26 different postural control tests were included. Most children were healthy or had cerebral palsy. Overall, the evidence for all measurement properties was low to very low. Most tests (95%) showed good reliability (ICC>0.70), but inconsistent validity results. Structural validity, internal consistency and responsiveness were only available for 3 tests. Only the Kids-BESTest and FAB covered all postural control systems.ConclusionCurrently, 2 functional tests encompass the entire construct of postural control. Although reliability is overall good, validity results depend on task, age and pathology. Future research should focus on test batteries and should particularly explore structural validity and responsiveness in different populations with methodologically strong study designs.     

Screening tools for post–intensive care syndrome and post-traumatic symptoms in intensive care unit survivors: A scoping review

BackgroundEvidence suggests that intensive care unit (ICU) survivors often suffer long-term complications such as post–intensive care syndrome (PICS) and post-traumatic stress disorder (PTSD) from critical illness and ICU stay. PICS and PTSD affect both ICU survivors and their families, which overburdens the healthcare systems. Lack of evidence on the comparative psychometric properties of assessment tools is a major barrier in evidence-based screening for post-ICU symptomatology and health-related quality of life.ObjectivesWe aimed to identify existing tools for screening PTSD and PICS in ICU survivors and their families and to examine evidence on the validity, reliability, sensitivity, and specificity of existing tools, as reflected in published peer-reviewed studies.MethodA scoping review based on literature searches (CINAHL, MEDLINE, EMBASE, PsycINFO, Scopus, Health and Psychosocial Instruments, Dissertations and Theses Global, and Google Scholar) and predefined eligibility criteria was conducted according to current scoping review guidelines.FindingsWe identified 44 studies reporting on the development and assessment of psychometric properties of PICS/PTSD in ICU survivors or families globally. We identified five tools addressing all three aspects of PICS manifestations, one tool for both physical and mental aspects of PICS, and fivefive tools for quality-of-life assessment in ICU survivors. Altogether, 25 tools assess only one aspect of PICS: five for cognitive impairment, seven for physical impairment, and 13 for mental health impairment and PTSD in ICU survivors. However, only two tools were found for PICS-family assessment. Other findings include (i) unclear validity and often limited feasibility of tools, (ii) low diagnostic accuracy of cognitive assessment tools, and (iii) evidence of appropriate psychometric properties and feasibility of psychological health assessment tools.ConclusionThese results have implications for the selection and implementation of the assessment methods as a means for promoting meaningful patient-centred clinical outcomes to minimise long-term sequelae, reduce the rate of rehospitalisation, and optimise recovery after ICU discharge.     

中文版高血压患者服药依从性量表测量学特性的系统评价

目的 系统评价中文版高血压患者服药依从性量表的测量学特性及研究的方法学质量,为医护人员选择高质量的量表提供循证依据。方法 系统检索PubMed、Embase、Web of Science、中国知网、维普数据库、万方数据库、中国生物医学文献数据库中与高血压患者服药依从性量表测量学特性评价相关的研究,检索时限为建库至2022年2月3日。按照健康测量工具遴选标准（consensus-based standards for the selection of health measurement instruments,COSMIN）要求,由2名研究者独立进行文献筛选和资料提取,采用COSMIN偏倚风险清单及质量标准评定量表测量学特性并形成最终推荐意见。结果 共纳入10项研究,涉及9个中文版高血压患者服药依从性量表,均未报告跨文化效度、测量误差、假设检验、反应度。因内容效度均为不充分或不确定,证据质量为中等或以下,最终9个量表均为B级推荐。结论 与其他8个量表相比,服药依从性自我效能量表修订版的测量学特性评价最为均衡,具有较好的信效度,但该量表的其他测量学特性仍有待验证。     

Validation of the Dutch Version of the Breakthrough Pain Assessment Tool in Patients With Cancer

ContextEssential for adequate management of breakthrough cancer pain is a combination of accurate (re-)assessment and a personalized treatment plan. The Breakthrough Pain Assessment Tool (BAT) has been proven to be a brief, multidimensional, reliable, and valid questionnaire for the assessment of breakthrough cancer pain.ObjectivesThe aim of this study was to examine the validity and reliability of the Dutch Language version of the BAT (BAT-DL) in patients with cancer.MethodsThe BAT was forward-backward translated into the Dutch language. Thereafter, the psychometric properties of the BAT-DL were tested, that is factor structure, reliability (internal consistency and test-retest reliability), validity (content validity and construct validity), and the responsiveness to change.ResultsThe BAT-DL confirmed the two-factor structure in 170 patients with cancer: pain severity/impact factor and pain duration/medication efficacy factor. The Cronbach's alpha coefficient was 0.72, and the intraclass correlation for the test-retest reliability was 0.81. The BAT-DL showed to be able to differentiate between different group of patients and correlated significantly with the Brief Pain Inventory. In addition, the BAT-DL was capable to detect clinically important changes over time.ConclusionThe BAT-DL is a valid and reliable questionnaire to assess breakthrough pain in Dutch patients with cancer and is a relevant questionnaire for daily practice.     

A psychometric evaluation of measures of spirituality validated in culturally diverse palliative care populations

Context

Despite the need to accurately measure spiritual outcomes in diverse palliative care populations, little attention has been paid to the properties of the tools currently in use.

Objectives

This systematic review aimed to appraise the psychometric properties, multifaith appropriateness, and completion time of spiritual outcome measures validated in multicultural advanced cancer, HIV, or palliative care populations.

Methods

Eight databases were searched to identify relevant validation and research studies. A comprehensive search strategy included search terms in three categories: palliative care, spirituality, and outcome measurement. Inclusion criteria were: validated in advanced cancer, HIV, or palliative care populations and in an ethnically diverse context. Included tools were evaluated with respect to psychometric properties (validity, reproducibility, responsiveness, and interpretability), multifaith appropriateness, and time to complete.

Results

A total of 191 articles were identified, yielding 85 tools. Twenty-six tools (representing four families of measures and five individual tools) met the inclusion criteria. Twenty-four tools demonstrated good content validity and 12 demonstrated adequate internal consistency. Only eight tools demonstrated adequate construct validity, usually because specific hypotheses were not stated and tested. Seven tools demonstrated adequate test-retest reliability; two tools showed adequate responsiveness, and two met the interpretability criterion. Data on the religious faith of the population of validation were available for 11 tools; of these, eight were tested in multifaith populations.

Conclusion

Results suggest that, at present, the McGill Quality of Life Questionnaire, the Measuring the Quality of Life of Seriously Ill Patients Questionnaire, and the Palliative Outcome Scale are the most appropriate multidimensional measures containing spiritual items for use in multicultural palliative care populations. However, none of these measures score perfectly on all psychometric criteria, and their multifaith appropriateness requires further testing.     

Reproducibility,Construct Validity,and Responsiveness of the Tetraplegia Upper Limb Activities Questionnaire,TUAQ. Part 2

ObjectiveTo test reliability, construct validity and responsiveness of the Tetraplegia Upper Limb Activities Questionnaire (TUAQ), a patient-reported outcome measure that assesses perceived performance and satisfaction with 10 standardized activities.DesignOutcome measure psychometric evaluation.SettingSpinal cord injury units in 2 countries.ParticipantsReproducibility: 47 individuals with tetraplegia. Construct validity and responsiveness: 33 individuals with tetraplegia undergoing surgery to restore hand function (N=80).InterventionsReproducibility: The TUAQ was completed on 2 occasions, 2 weeks apart. Construct validity and responsiveness: Participants completed the TUAQ prior to surgery and 3-12 months after hand reconstruction surgery. Internal consistency was examined using Cronbach α. Two agreement parameters were examined: the SEM and minimal detectable change with 90% confidence interval (MDC₉₀). Construct validity was evaluated using Pearson product moment correlation against a priori hypotheses. Responsiveness was assessed using paired t tests and effect size.ResultsTest-retest reliability and internal consistency was high (intraclass correlation coefficient of 0.89 for performance scale and 0.88 for satisfaction, Cronbach α of 0.92 and 0.90, respectively). For agreement the SEM scores were 4.7 and 3.5, with MDC₉₀ of 10.9 and 8.2, respectively. Responsiveness and construct validity showed sound results with no ceiling or floor effects and with large effect size (>1.05).ConclusionsThe TUAQ demonstrates good psychometric properties for reliability and agreement for persons with tetraplegia and responsiveness and construct validity for surgical reconstruction of hand function for persons with tetraplegia. The TUAQ appears appropriate to be used as a patient-reported outcome measure for clinical and research purposes in this population.     

Psychometric properties of the Dutch-Flemish Patient-Reported Outcomes Measurement Information System Pain Behavior item bank in patients with musculoskeletal complaints

We studied the psychometric properties of the 39-item v1.1 Dutch-Flemish Patient-Reported Outcomes Measurement Information System Pain Behavior item bank in a sample of 1,602 patients with musculoskeletal complaints. We evaluated the assumptions of the underlying item response theory (IRT) model (unidimensionality and local dependency with confirmatory factor analyses), and monotonicity with scalability coefficients). We studied the IRT model fit of all items and estimated the item parameters of the IRT model. Differential item functioning (DIF) was studied for age and gender, and DIF for language was studied as a measure of cross-cultural validity. Confirmatory factor analyses showed suboptimal fit of a unidimensional model, but a bifactor model showed low risk of bias when a unidimensional model was assumed (Omega H = .92, explained common variance of .70). Fifteen item pairs (2%) were locally dependent. Five items showed poor scalability. All items fitted the IRT model; slope parameters ranged from .60 to 2.00, and threshold parameters from –2.05 to 6.80. One item showed DIF for age, 1 item DIF for gender, and 5 items showed DIF for language, but the impact on total scores was low. Our study shows limitations of the Dutch-Flemish Patient-Reported Outcomes Measurement Information System Pain Behavior item bank when used in a primary care population with musculoskeletal complaints.PerspectiveWe studied the psychometric properties of the Dutch-Flemish Patient-Reported Outcomes Measurement Information System Pain Behavior item bank in a large primary care population of patients with musculoskeletal complaints. It showed that the Pain Behavior item bank has limitations when used in this population.     

The Leuven questionnaire for Patient Self-care during Chemotherapy (L-PaSC): Instrument development and psychometric evaluation

PurposeSince chemotherapy has largely become an outpatient treatment, adequate self-management is of great importance. Available instruments focus exclusively on dealing with side effects. However, self-care during chemotherapy not only concerns symptom self-management. The aim of this study was to develop a valid instrument to assess patient self-care during chemotherapy.MethodFirst, we developed a topic list for our construct by performing a theory and literature review. Second, an expert panel of nine oncologists and oncology nurses evaluated content validity of the developing construct and its items using a triple Delphi procedure. A preliminary psychometric evaluation in 144 patients allowed identification and correction of items with poor psychometric properties. A convenience sample of 448 patients was used to evaluate item statistics (item difficulty), reliability (Cronbach alpha) and construct validity (exploratory factor analysis) of the final instrument.ResultsWe developed a 22-item instrument with 7 themes expressing the most relevant aspects of patient self-care during chemotherapy. Seven items cover symptom self-management, while 15 items reflect other aspects of self-care during chemotherapy. Content validity was excellent (CVI = 0.78–1.00). Item difficulty index of the questions ranged from 0.17 to 0.89. Internal consistency is acceptable (Cronbach alpha = 0.76). Exploratory factor analysis defines two underlying factors: adhering to treatment recommendations and managing treatment-related negative events on the one hand, and relieving symptoms on the other hand.ConclusionsThe L-PaSC demonstrated good content validity and psychometric properties. The L-PaSC can be applied in research and clinical practice for evaluating patient self-care during chemotherapy.     

Psychometric Assessment of the MSAS-SF and the FACIT-Fatigue Scale in Spanish-Speaking Patients With Cancer in Uruguay

ContextSeveral instruments have been developed to assess the symptom burden and fatigue produced by cancer and its treatment. However, little research has been conducted in Latin American Spanish–speaking patients.ObjectivesThe aim of the study was to assess the psychometric properties of the Spanish versions of two commonly used patient-reported outcome measures, the Memorial Symptom Assessment Scale-Short Form (MSAS-SF), and the fatigue subscale of the Functional Assessment of Cancer Therapy-General (FACT-G), the FACIT-Fatigue.MethodsA classic psychometric approach was followed to assess the reliability and validity of the instruments. Responsiveness to change and effect sizes were calculated.ResultsThe translated version of the MSAS-SF proved to be comprehensible and easy to complete. Cronbach alpha reliability coefficients ranged from acceptable to excellent for the MSAS-SF subscale scores and the FACIT-Fatigue. There was evidence of convergent validity between the physical and the psychological subscales of the instruments. The MSAS-SF could discriminate among the known groups according to Eastern Cooperative Oncology performance status and level of anemia, and showed responsiveness to change of symptom burden at two times of treatment.ConclusionThe study showed that both the MSAS-SF and the FACIT-Fatigue have good reliability and validity for use with patients with cancer in Uruguay. When used simultaneously, these instruments may provide a complete picture of the impact of cancer and its treatment on the patient's quality of life.     

Selection of quality-of-life measures for a prevention trial: a psychometric analysis

Quality-of-life (QoL) outcomes have become increasingly important in the evaluation of health interventions. The objective of the present study was to determine which of three generic QoL instruments was most suitable for use in an 8-year nutritional primary prevention trial. We compared the Duke Health Profile, the Nottingham Health Profile, and the Short Form Health Survey Questionnaire (SF36). We conducted the comparison in two stages: (1) a statistical analysis of data from a pilot study (n = 963) comparing the psychometric properties of the three instruments; and (2) an assessment of the practicality of the tools. With regard to psychometric properties, convergent validity was comparable for the three scales, and the correlation with Global Health Assessment ranged from 0.24 to 0.72. Discriminant validity was best for the SF36, with a difference between scores in healthy subjects and those with chronic disease in the range of 4.4 to 15.8 (scores could range from 0 to 100, where 100 indicates perfect health). Reproducibility was good for all three instruments, with a test-retest intraclass correlation coefficient of over 0.60 for most dimensions. DHP and SF36 performed best in terms of responsiveness. We judged the practicality of the three tools as satisfactory. We chose the SF36 for its high responsiveness. We also selected the Duke Health Profile for its practicality and favorable psychometric properties.     

Easy-to-use clinical measures of walking ability in children and adolescents with cerebral palsy: a systematic review

Objective: The aims of this systematic review were to identify quick, simple and easy-to-use measures of walking ability currently used to assess children and adolescents with cerebral palsy (CP), and to evaluate the clinical utility and psychometric properties of these measures.

Data sources: The PubMed, CINAHL, SPORTDiscus and MEDLINE databases were searched up to March 2015.

Review methods: Two independent reviewers rated the methodological quality of the identified measures using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist.

Results: The 1-Minute Walk Test, Timed Up and Go Test, ABILOCO-Kids, Gillette Functional Assessment Questionnaire and Functional Mobility Scale were identified. Each measure can be carried out within 5?min with limited equipment, and does not require examiner training. There was “limited” to “strong” evidence on the reliability and validity of these measurements, whereas evidence on measurement error and responsiveness was limited.

Conclusion: The identified measures in this systematic review may be considered for the clinical measurement of walking ability in children and adolescents with CP in a quick, simple and easy-to-use manner. However, there is overall a lack of evidence on the psychometric properties of these tools. The lack of evidence regarding measurement error and responsiveness might limit their value in measuring change over time.

• Implications for Rehabilitation

• The ABILOCO-Kids, 1-Minute Walk Test, Timed Up and Go Test, Gillette Functional Assessment Questionnaire, Functional Mobility Scale can be performed within 5?min with limited equipment, and do not require examiner training for measuring of walking ability in children and adolescents with cerebral palsy.

• The clinicians should use these measurement tools carefully when assessing change over time as the available evidence on measurement error and responsiveness is limited.

• When clinicians use these measurement tools, the psychometric properties reported in this systematic review should be considered in the selection of tools and subsequent interpretation of results.

     

Comparative Responsiveness of the PROMIS Pain Interference Short Forms With Legacy Pain Measures: Results From Three Randomized Clinical Trials

The Patient-Reported Outcomes Measurement Information System Pain Interference (PROMIS-PI) scales are reliable and publicly accessible; however, little is known about how responsive they are to detect change in clinical trials and how their responsiveness compares with legacy measures. The study purpose was to evaluate responsiveness for the PROMIS-PI scales and to compare their responsiveness with legacy pain measures. We used data from 3 clinical trials totaling 759 participants. The clinical trials included patients with chronic low back pain (n = 261), chronic back or osteoarthritis pain (n = 240), and a history of stroke (n = 258). At both baseline and follow-up, participants completed PROMIS-PI scales and legacy pain measures (Brief Pain Inventory Interference scale; Pain, Enjoyment, General Activity scale; 36-Item Short Form Survey (SF-36) Bodily Pain scale; and Roland-Morris Disability Questionnaire). We measured global ratings of pain change, both prospectively and retrospectively, as anchors to identify patients as improved, unchanged, or worsened. Responsiveness was assessed with standardized response means, statistical tests comparing change groups, and area under the curve analysis. The PROMIS-PI scales had largely comparable responsiveness with the Brief Pain Inventory Interference and Pain, Enjoyment, General Activity scales. The 4 PROMIS-PI short forms had comparable responsiveness. For all pain questionnaires, responsiveness varied based on the study population and whether pain improved or worsened.PerspectiveThis article presents 1) how responsive the PROMIS-PI scales were to detect change over time in the context of 3 clinical trials and 2) how their responsiveness compared with legacy pain measures. The findings can help researchers and clinicians choose between different patient-reported pain outcome measures.     

Benefit finding in adult cancer populations: Psychometric properties and performance of existing instruments

PurposeTo analyse the psychometric properties and performance of existing instruments that aim to measure benefit finding in adult cancer populations.MethodsFour electronic databases were searched. The focus was to identify English language, peer-reviewed journal articles where benefit finding is assessed with adult cancer populations. The terms ‘benefit finding’, ‘cancer’, ‘instruments’, ‘scales’, and ‘adult’ were used in various combinations. The instruments were rated against established criteria for instrument construction, reliability, validity, and interpretability.ResultsSeventeen benefit finding instruments were reviewed. The instruments present a multifarious conceptualisation of the construct. Instrument structure is diverse. Several instruments (n = 4) reported on all the psychometric properties, but not interpretability. One instrument, the Stress-Related Growth Scale – Revised, additionally reported correlation statistics with another benefit finding instrument. Based on the information provided, the psychometric rigour of a number of instruments is yet to be established.ConclusionsOne instrument reported validation statistics for all the identified criteria. While existing instruments provide a range of operationalisations of the benefit finding concept and have been more or less used in previous research, a majority are in the early stages of development and require further validation work in adult cancer populations. Given the increasing interest in the role benefit finding in clinical practice, researchers are urged to use these instruments further and to report relevant validation statistics when using them.     

Development and psychometric testing of a Chinese version of the Fatigue Scale-Children in Taiwan

Aims. The aim of this study was to develop and evaluate the psychometric properties of a Chinese version of the Fatigue Scale-Children (FS-C-C). Background. Cancer-related fatigue is one of the most distressing and prevalent symptoms reported by paediatric oncology patients during and after their cancer treatment. A reliable and valid instrument to measure fatigue is essential to the successful clinical care of paediatric oncology patients in Taiwan who experience this troubling symptom. Design and methods. A total of 108 paediatric oncology Taiwanese patients who were aged 7–12 years participated in this cross-sectional, instrumentation study. The FS-C was translated into Chinese by using an established translation/back-translation method. The psychometric testing of the FS-C-C included internal consistency, content validity, construct validity, convergent validity, criterion-related validity and known-group validity. Results. The FS-C-C achieved an acceptable internal consistency coefficient. Content validity was moderately high (content validity indices ranged from 83–100%). Confirmatory factor analysis supported the three-factor model as an acceptable model fit (the goodness-of-fit index and adjusted goodness-of-fit index both were greater than 0·9; normed fit index, 0·89; root-mean-square residual, 0·15). Although the results did not support the known-group hypothesis, the convergent validity, concurrent validity and predictive validity of the FS-C-C were supported by significant associations with the PedsQL Multidimensional Fatigue Scale, the Anxious/Depressed subscale of the Child Behaviour Checklist and the generic and disease-specific scores on the Quality of Life for Children with Cancer instrument, respectively. Conclusion. Our newly developed FS-C-C is a reliable and valid instrument for the measurement of cancer-related fatigue intensity in Taiwanese children. Relevance to clinical practice. The FS-C-C could provide useful information to guide clinical practice in assessing and managing cancer-related fatigue in childhood cancer patients in Taiwan.     

Validity and reliability of a pediatric hematology oncology patient acuity tool

Appropriate use of nursing resources in the pediatric hematology and oncology inpatient settings demands a patient acuity system that is easy to use and accurate, and that objectively measures nursing care needs of a specialized patient population. Structured survey of 13 comprehensive cancer centers and a review of the literature show no valid and reliable acuity tools for this pediatric population. The purpose of this project was to study the validity and reliability of a newly developed pediatric hematology and oncology acuity system designed to quantify patient care needs. A new acuity tool for this pediatric population was developed based on the patient classification tool used at Johns Hopkins Hospital Oncology Center (JHHOC). The levels of care from the JHHOC tool were adopted, with therapeutic indicators modified to reflect nursing diagnoses relevant to the pediatric inpatient. Nursing care hours required for each level of care were also identified. Validity was studied using a content validity index (CVI). Experts from the pediatric unit where the tool would be used were asked whether each therapeutic indicator was assigned to the correct level of care (1 thru 5) based on patient care hours. CVIs for items ranged from .5 to 1.0; the overall CVI for the tool was .93. Interrater reliability was studied using two raters from the unit. Data were collected for 150 patient observations on a 12-bed pediatric hematology and oncology inpatient and short-stay outpatient unit. The resulting Pearson correlation coefficient was r = .97 (P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)     

Scale Validation of the Mandarin-Language Supportive Care Needs Survey–Adolescent Form

ObjectivesTo (1) modify the Mandarin-language 34-item Supportive Care Needs Survey–Adult Form into the Adolescent Form and (2) examine the psychometric properties of the Adolescent Form.Data SourcesA multiphase, iterative scale validation process was used in this methodological study. Participants who were 13 to 18 years old and receiving cancer treatment in inpatient or outpatient settings, or receiving follow-up care in outpatient settings, were recruited using a convenience sampling method. Confirmatory factor analysis demonstrated good fitness of indices, and all factor loadings for the 18-item Adolescent Form were >0.50, which supported the scale's construct validity. The Adolescent Form score was significantly correlated with the symptom distress score (r = 0.56, P < .01) and quality of life score (r = −0.65, P < .01), which indicated the scale's convergent validity. The correlated item-total correlations (0.30–0.78), Cronbach's alpha (.93), and test-retest reliability coefficient (0.79) confirmed the scale's stability.ConclusionThis study successfully modified the 34-item Adult Form into the 18-item Adolescent Form. Given its adequate psychometric properties, this concise scale has great promise as a useful, feasible, and age-appropriate tool for evaluating care needs among adolescents with cancer who speak Mandarin.Implications for Nursing PracticeThis scale can screen for unmet care needs in busy pediatric oncology settings or large-scale clinical trials. It allows for cross-sectional comparison of unmet care needs between adolescent and adult populations and for longitudinal follow-up into how unmet care needs change from adolescence into adulthood.