Developing a test of knowledge of surgical options for breast cancer

Because many women now have a choice regarding the type of surgery they prefer for early stage breast cancer, it is important for clinicians to provide comprehensive information about these options and to determine whether patients have understood this information. The purpose of this study was to develop a short, easily administered, valid and reliable test of women's knowledge of surgical treatment options for early stage breast cancer. Instrument development was carried out in two phases: (a) content domains were established and items were generated and examined for content validity and clarity; and (b) the known-groups technique was used to determine construct validity and to generate data for reliability testing. The test was administered to 44 student nurses, 21 women with breast cancer, and 24 practicing nurses. An 18-item test--the BCIT-R (Breast Cancer Information Test-Revised)--with modest internal consistency and very good construct validity resulted from these steps. Nurses scored significantly better than either students or patients. The instrument is discussed in terms of psychometric issues and clinical use.