Zhongguo quanke yixue (May 2023)
Development of a Treatment Burden Scale for Elderly Patients with Coexisting Chronic Diseases
Abstract
Background The treatment burden of elderly patients with coexisting chronic diseases is high. Accurate and effective evaluation of the treatment burden provides a crucial assessment tool for the development of individualized intervention protocol and evaluation of intervention effects. However, there is no localized treatment burden scale for elderly patients with coexisting chronic diseases. Objective To develop and test the reliability and validity of the treatment burden scale for elderly patients with coexisting chronic diseases, and provide a suitable assessment tool for scientific evaluation of the effectiveness of interventions for elderly patients with coexisting chronic diseases. Methods The item pool for the scale was constructed through literature analysis and patient interviews, and the initial scale was developed through expert consultation. The semantics and best presentation formats of the initial scale items were modified by pretesting. From September to November in 2021, 294 elderly patients with coexisting chronic diseases were selected using convenience sampling method, and items of the initial scale were screened using item analysis and exploratory factor analysis to form a test version of the scale. From November to January in 2022, 316 elderly patients with coexisting chronic diseases were selected using convenience sampling method, and the test version of the scale was scientifically evaluated using reliability, validity, and feasibility to finally form the official version of the scale. Results The official version of the treatment burden scale for elderly patients with coexisting chronic diseases included 33 items in 7 dimensions, including economic burden, burden of self-management, burden of access to healthcare, burden of medication management, burden of adverse drug reactions, burden of sociability, and psychological burden. The results of the confirmatory factor analysis showed that χ2/df=1.506, comparative fit index (CFI) =0.933, Tucker-Lewis index (TLI) =0.925, standardized residual mean root (SRMR) =0.054, and root-mean-square error of approximation (RMSEA) =0.040. The Cronbach's α coefficient for the total scale was 0.895, the split-half reliability was 0.938, and the retest reliability was 0.939 (P<0.01). The item-level content validity index (I-CVI) was 0.833~1.000, the scale-level content validity index (S-CVI/Ave) was 0.939, the correlation coefficient between the scale items and each dimension ranged from 0.522 to 0.897 (P<0.01). The results of the feasibility test showed that the recovery rate of the scale was 95.8%, the completion rate was 100.0%, and the completion time was 10-15 minutes. Conclusion The treatment burden scale for elderly patients with coexisting chronic diseases developed in this study has good reliability and validity, which is suitable for assessing the treatment burden of elderly patients with coexisting chronic diseases in China.
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