癌症兒童主要照顧者資訊需求量表之發展與測試

本研究目的在建立並測試「癌症兒童主要照顧者資訊需求量表」，研究分兩階段進行，第一階段是建構量表內容；研究者查證與癌症兒童及主要照顧者資訊需求相關文獻，並訪問臨床有經驗的癌症兒童主要照顧者、小兒血液腫瘤專科醫師、護理人員及資深兒科護理教師，經彙整上述人員之意見後，再加上本身的臨床經驗來發展量表之項目(item)，並由五位專家及十位癌症兒童主要照顧者審閱確立量表的內容效度，初建立之量表涵蓋五個層面：疾病與治療相關知識（17題）、生理照顧相關知識（12題）、心理支持相關資訊（六題）、病童的發展未來規劃（三題）、相關醫療與社會福利資源（五題），全量表共42題。第二階段是測試量表的信效度；本研究信度方面以內在一致性信度及兩週後再測信度來檢定，效度方面以建構效度、效標關聯效度、聚斂與分殊效度及區辨效度來檢定。以立意取樣方式在三家醫學中心進行收案，共得210位癌症兒童主要照顧者為量表測試對象。研究結果顯示；在信度方面，全量表的Cronbach’s α係數為 .97，折半信度係數為 .86，兩週後再測其類組內相關係數為 .93。在建構效度方面，經因素分析萃取出五個因素共計四十一題，歸類重組後命名分別為：疾病與治療相關知識（十題）、生理照顧相關知識（12題）、心理支持相關資訊（五題）、居家照護及複診相關知識（六題）及醫療與社會福利資源相關資訊（八題），此五個因素可解釋的變異量為61.01%。另外，以焦慮測試效標效度，顯示有顯著相關( r = .42 ; p < .01)，量表之聚斂效度係數介於 .83至 .95達顯著相關( p < .01)，且分殊效度良好。在區辨效度方面，顯示不同治療階段病童主要照顧者之資訊需求有顯著差異(F(3, 206 ) = 7.70 ; p < .01)。本研究發展之「癌症兒童主要照顧者資訊需求量表」，可作為臨床及研究中評估癌症兒童主要照顧資訊需求的工具。此外，研究結果可作為介入措施之參考依據。

關鍵字

兒童癌症；量表建立；資訊需求；主要照顧者

並列摘要

The purpose of this study was to develop and to test an instrument for measuring information needs of family caregivers who took care of children with cancer. The study was conducted in two phases, developing the instrument and testing validity and reliability. In the phase one, the researcher reviewed the literature about children with cancer and information needs of caregivers, discussed with oncology pediatrician, clinical nurse specialists and caregivers of children with cancer, and wrote down personal experiences as sources for item derivation. Five experts and ten caregivers of children with cancer reviewed the instrument for content validity. The instrument, Scale of Information Needs for Caregivers with Cancer Children (SINCCC), includes 42 items which belong to five dimensions: knowledge about disease and treatment (17-item), knowledge about physical care (12-item), information related to psychosocial support (6-item), futurity and development of children (3-item), and resources related to health and social welfare (5-item). In phase two, the psychometrics properties of SINCCC were examined. Reliability was shown by coefficient of internal consistency (Cronbach’sα) and test-retest reliability. The dimensionality of SINCCC was examined by factor analysis, and other examinations for the validity of instrument included criterion related validity, convergent validity, divergent validity, and discriminate analysis. A convenience sample that consisted of 210 caregivers were recruited from three medical centers hospitals located in northern and southern Taiwan. The Cronbach’sαof SINCCC were 0.97, split-half reliability were 0.86, and the intraclasses correlation coefficient for test-retest reliability were 0.93. The constructed validity of SINCCC was examined by factor analysis. 41 items were divided to five factors: knowledge about pathphysiology and treatments (10-item), knowledge about physical care(12-item), information related to psychosocial support (5-item), knowledge of home care and follow up (6-item), information related to health and social welfare resources (8-item). Five factors accounted for 61.01% of the total variance. In addition, the criterion related validity were significant (r = .42; p < .01), the convergent validity and divergent validity were fine. Besides, the discriminate analysis with the stage of treatment were significant (F (3, 206 ) = 7.70 ; p < .01). The SINCCC can be used as a tool to assess information needs among caregivers of children with cancer. Besides, the results can be used as a guide for developing more sensitive intervention programs.