The Leuven questionnaire for Patient Self-care during Chemotherapy (L-PaSC): instrument development and psychometric evaluation.
OBJECTIVE
Since 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.


METHODS
First, 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.


RESULTS
We 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.


CONCLUSIONS
The 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.
Department of Oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. annemarie.coolbrandt@uzleuven.be
Annemarie
A
Coolbrandt
Koen
K
Van den Heede
Kathleen
K
Clemens
Koen
K
Milisen
Annouschka
A
Laenen
Hans
H
Wildiers
Chris
C
Verslype
D000328:Adult; D000553:Ambulatory Care / Q000379:methods; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001530:Belgium; D004358:Drug Therapy / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D011594:Psychometrics; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods / Q000523:psychology*; D011795:Surveys and Questionnaires
D000970:Antineoplastic Agents