The Development and Validation of the Cancer Patient Self-Advocacy Scale

Self-advocacy is essential for cancer patients to obtain high-quality care. However, existing self-advocacy assessment tools-developed by Western scholars-are poorly aligned with the cultural and healthcare context of China.

The study aimed to develop and validate a new self-advocacy scale tailored to Chinese cancer patients.

In phase I, an item pool was formulated through a literature review, qualitative interviews with 14 cancer patients, and focus group discussions. In phase II, the scale's domains and items were revised based on feedback from two rounds of Delphi consultation involving 16 experts. In phase III, a cross-sectional survey was administered to a convenient sample of 257 cancer patients, and item analysis and exploratory factor analysis were used to explore the scale's structure. In Phase IV, the scale's validity and reliability were comprehensively evaluated using data from a convenience sample of 311 cancer patients. Finally, the Cancer Patient Self-Advocacy Scale (CPSAS) was developed.

The newly developed scale comprised 21 items across four dimensions: information seeking, autonomous decision-making, active communication, and informational support. The scale demonstrated adequate convergent and discriminant validity supported by average variance extracted and composite reliability, good criterion validity through significant correlations with quality of life and treatment adherence, and excellent internal consistency and split-half reliability.

The CPSAS is a valid, reliable, and efficient tool for assessing self-advocacy in Chinese cancer patients, suitable for both outpatient and inpatient settings. Additional research is necessary to evaluate the psychometric properties of the scale.