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| Establishment and test of reliability and validity of knowledge-attitude-practice scale for prevention of upper limb lymphedema in patients after breast cancer surgery |
| SHI Bohui1 LIN Zihan2 MA Xiaoxia1 HAO Na1 QI Jing1 CHEN Yao1 WANG Lian3▲#br# |
1.Department of Breast Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi Province, Xi’an 710061, China;
2.School of Medicine, Xi’an Jiaotong University, Shaanxi Province, Xi’an 710061, China;
3.Ward Two, Department of Orthopaedic, Shaanxi Provincial Hospital of Chinese Medicine, Shaanxi Province, Xi’an 710100, China |
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Abstract Objective To develop a scale of knowledge-attitude-practice of preventing the upper limb lymphedema for breast cancer patients after surgery and test its reliability and validity. Methods Based on the knowledge- attitude-practice theory, the first draft of the scale was constructed on the basis of evidence and combined with brainstorming method. The Delphi method was used to consult experts for further revision. After the pre-survey, a total of 200 breast cancer patients who were hospitalized in the First Affiliated Hospital of Xi’an Jiaotong University from September to November 2021 were selected by convenience sampling for questionnaire survey to test the reliability and validity of the scale. Results The knowledge-attitude-practice scale for preventing upper limb lymphedema in patients after breast cancer surgery includes three dimensions, knowledge-attitude-practice, with a total of 23 items. The positive coefficients of the two rounds of expert consultation were 1.00 and 0.93, the authoritative coefficients were 0.90 and 0.89, and the coordination coefficients were 0.387 and 0.287. Thirty valid questionnaires were collected in the pre-survey with an effective recovery rate of 100%. The recovered scale was revised again according to the patient’s feedback, and a total of four items were modified. A total of 162 valid questionnaires were recovered from the formal investigation, with an effective recovery rate of 81%. The correlation coefficient between the total scale and each item was 0.414-0.787, the content validity of the total scale was 0.938, the content validity index of each item level was 0.857-1.000, the Cronbach’s α coefficient of the scale was 0.931, the split half coefficient was 0.875, and the test-retest coefficient was 0.916. Exploratory factor analysis was used to extract three common factors, which could explain 62.843% of the total variables, and confirmatory factor analysis showed that the model had a good fit. Conclusion The knowledge-attitude-practice scale for preventing upper limb lymphedema in patients after breast cancer surgery has good reliability and validity, and can be used as an assessment tool for patients’ knowledge- attitude-practice of lymphedema prevention.
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