Development and Psychometric Evaluation of a Pulmonary Rehabilitation Information Needs Scale for Patients with...

This study aimed to develop and validate a pulmonary rehabilitation information needs scale for patients with chronic obstructive pulmonary disease (COPD) using both classical test theory (CTT) and item response theory (IRT).

Guided by Alderfer's ERG theory and Kochen's information needs theory, the initial item pool was developed through a literature review and semi-structured interviews with 12 COPD patients undergoing pulmonary rehabilitation. Using the Delphi method, 35 experts were consulted to refine the questionnaire into its first draft. A pilot test with 20 COPD patients was then conducted to revise item wording. Data were collected from a convenience sample of 300 COPD patients from February to December 2024 at five hospitals in Changsha, China. Participants had a mean age of 71.01±9.38 years, and 85.3% were male. Validity and reliability were evaluated using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), internal consistency, and item analysis based on CTT and IRT.

The final questionnaire contains a total of 6 dimensions and 39 items. EFA identified six factors, with all items having factor loadings greater than 0.40 within their respective factors. CFA supported the proposed six-factor structure, with all standardized factor loadings at acceptable levels and the model demonstrating an acceptable fit to the data (χ²/df = 1.804, CFI = 0.984, TLI = 0.983, RMSEA = 0.052, SRMR = 0.065). The content validity index (S-CVI) was 0.935 and the Cronbach's α coefficient of the scale was 0.936. IRT analysis showed that all items had good discrimination parameters (a > 1.0) and threshold parameters within an appropriate range (b = -4 to 4).

To our knowledge, the scale is the first tool designed to assess pulmonary rehabilitation-specific information needs in COPD. It demonstrated acceptable validity and reliability for assessing the information needs of patients with COPD who are preparing to participate in or are undergoing pulmonary rehabilitation. The instrument may provide a useful and feasible instrument for supporting clinical assessment and the planning of individualized pulmonary rehabilitation education and support.