“老年认知衰退患者癌症疼痛评估困难”（CPAD-CD）量表的开发与验证：一种心理测量学评估

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing Pub Date : 2025-04-10 DOI:10.1016/j.apjon.2025.100696

Nami Sakuraba , Hisao Imai , Kunihiko Kobayashi

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引用次数: 0

摘要

本研究旨在开发和验证老年认知衰退患者癌症疼痛评估困难（cad - cd）量表，旨在评估护士在管理老年认知衰退患者癌症疼痛时面临的挑战。方法量表的编制采用三个阶段的流程：(1)通过文献查阅和专家输入生成项目；(2)通过专家评审和试点研究进行内容验证；(3)进行心理测量评估，包括探索性因子分析、验证性因子分析和信度检验。该量表对199名在日本肿瘤和姑息治疗机构工作的护士进行了调查。使用Cronbach's alpha评估内部一致性，使用类内相关系数（ICCs）确定重测信度。已知组效度测试基于护士的信心水平和多年的癌症护理经验。结果最终的CPAD-CD量表包含5个因素共32个条目，内部一致性系数≥0.80，表明内部一致性较强。因子负荷范围为0.430 ~ 0.859。重测信度ICC为0.797，信度中等。已知组效度分析显示，基于护士信心和经验水平的总量表和因子得分存在显著差异(P <；0.05)。结论CPAD-CD量表是评估老年认知衰退患者护理人员癌症疼痛管理困难程度的有效、可靠的工具。它可以作为评估培训需求和指导干预措施的有价值的工具，以提高疼痛管理的护理能力。建议在不同的文化和临床背景下进一步验证。

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Development and validation of the “cancer pain assessment difficulties in older patients with cognitive decline” (CPAD-CD) scale: A psychometric evaluation

Objective

This study aimed to develop and validate the Cancer Pain Assessment Difficulties in Older Patients with Cognitive Decline (CPAD-CD) scale, designed to assess the challenges nurses face in managing cancer pain for older patients with cognitive decline.

Methods

A three-phase process was used for scale development: (1) item generation through literature review and expert input, (2) content validation via expert review and a pilot study, and (3) psychometric evaluation, including exploratory factor analysis, confirmatory factor analysis, and reliability testing. The scale was administered to 199 nurses working in oncology and palliative care settings in Japan. Internal consistency was assessed using Cronbach's alpha, and test-retest reliability was determined using intraclass correlation coefficients (ICCs). Known-groups validity was tested based on nurses' confidence levels and years of cancer nursing experience.

Results

The final CPAD-CD scale comprised 32 items across five factors, and the internal consistency coefficients were ≥ 0.80, indicating strong internal consistency. Factor loadings ranged from 0.430 to 0.859. The test-retest reliability ICC was 0.797, demonstrating moderate reliability. Known-groups validity analyses showed significant differences in total scale and factor scores based on nurses’ confidence and experience levels (P < 0.05).

Conclusions

The CPAD-CD scale is a valid and reliable instrument for assessing difficulties in cancer pain management among nurses caring for older patients with cognitive decline. It can serve as a valuable tool for evaluating training needs and guiding interventions to enhance nursing competency in pain management. Further validation in diverse cultural and clinical contexts is recommended.

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