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Development and psychometric properties of Health-Promoting Lifestyle Scale in Colorectal Cancer Survivors
Elahe Ramezanzade Tabriz1, Monir Ramezani2,3, Abbas Heydari4
1Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
BMC Cancer
|October 3, 2023
Summary
A new 80-item scale, the Health-Promoting Lifestyle Scale in Colorectal Cancer Survivors (HPLS-CRCS), has been developed and validated. This tool helps healthcare providers assess and manage the lifestyles of colorectal cancer survivors post-treatment.
Area of Science:
- Oncology
- Lifestyle Medicine
- Psychometrics
Background:
- Assessing health-promoting lifestyles in colorectal cancer (CRC) survivors is crucial for managing complications, preventing recurrence, and improving survival.
- No specialized tool currently exists to measure the lifestyle of CRC survivors.
- This study aimed to develop and validate the Health-Promoting Lifestyle Scale in CRC Survivors (HPLS-CRCS).
Purpose of the Study:
- To develop a psychometrically sound instrument for assessing health-promoting lifestyles in colorectal cancer survivors.
- To establish the validity and reliability of the HPLS-CRCS.
- To provide a tool for healthcare providers to evaluate and guide lifestyle modifications in CRC survivors.
Main Methods:
- A mixed-methods exploratory sequential design was employed in two phases.
- Phase 1 involved concept analysis using Schwartz-Barcott and Kim's hybrid model to generate scale items.
- Phase 2 focused on psychometric evaluation, including face, content, and construct validity (Confirmatory Factor Analysis), and reliability (internal consistency, stability).
Main Results:
- An initial 211-item scale was refined to 89 items after face validity and reduced to 80 items in the final scale.
- Confirmatory Factor Analysis (CFA) on 500 survivors identified six dimensions: activity and rest, spiritual growth, health responsibility, nutrition, interpersonal relationships, and psychological management.
- The HPLS-CRCS demonstrated strong reliability (Cronbach's alpha: 0.865–0.928) and validity, with specific metrics for measurement error and change (ICC: 0.896, SEM: 3.36, MIC: 13.86, SDC: 19.87).
Conclusions:
- The 80-item HPLS-CRCS is a valid and reliable scale for assessing the health-promoting lifestyle of colorectal cancer survivors.
- This scale can aid healthcare providers in identifying lifestyle deficiencies among CRC survivors.
- The HPLS-CRCS facilitates the planning of tailored lifestyle interventions for CRC survivors during the post-treatment phase.
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