Development of a Self-Care Performance Scale for Patients with Stomach Cancer after Gastrectomy

Min Kyung Jeon; Geum Ja Park

doi:10.5388/aon.2016.16.2.67

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Jeon and Park: Development of a Self-Care Performance Scale for Patients with Stomach Cancer after Gastrectomy

Original Article

Asian Oncology Nursing 2016; 16(2): 67-74.

Published online: 30 June 2016

DOI: https://doi.org/10.5388/aon.2016.16.2.67

Development of a Self-Care Performance Scale for Patients with Stomach Cancer after Gastrectomy

Min Kyung Jeon¹, Geum Ja Park²

¹Department of Nursing, Kaya University, Kimhae, Korea.

²College of Nursing, Kosin University, Busan, Korea.

Address reprint requests to: Park, Geum Ja. College of Nursing, Kosin University, 262 Gamcheon-ro, Seo-gu, Busan 49267, Korea. Tel: +82-51-990-3974, Fax: +82-51-990-3970, gjpark@kosin.ac.kr

Received 13 May 2016 Revised 9 June 2016 Accepted 22 June 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was to develop a valid and reliable self-care performance scale for stomach cancer patients with gastrectomies.

Methods

The initial items for the self-care performance scale were derived by a literature review and in-depth interviews with stomach cancer patients with gastrectomies and a conceptual framework based on Orem's theory was used. The identified items were evaluated for content validity by experts. The main survey with refined items was performed with a sample of 232 patients. The data were analyzed using item analysis, Pearson correlation coefficients, Cronbach's alpha and factor analysis.

Results

A 22 item instrument with 7 factors was developed and the total variance explained was 66.9%. The factors were 'manage dietary restriction', 'avoid hazards', 'rest and elimination', 'manage social support and stress', 'regulation diet', 'meal portion control' and 'seek information and follow-up care'. The internal consistency, Cronbach's alpha was .86 and reliability of the subscale ranged from .65 to .82.

Conclusion

This study suggested that the self-care performance scale is a reliable and valid instrument to measure self-care performance for patients with stomach cancer after gastrectomy.

Keywords: Stomach Neoplasms, Gastrectomy, Self-Care, Scales

Figures and Tables

Table 1

Socio-demographic and Clinical Characteristics of Participants (N=232)

Characteristics	Categories	n (%)
Gender	Male	156 (67.2)
Gender	Female	76 (32.8)
Age (year)	<40	8 (3.5)
	40~49	27 (11.6)
	50~59	80 (34.5)
	60~69	68 (29.3)
	≥70	49 (21.1)
Marital status	Unmarried	12 (5.2)
	Married	190 (81.9)
	Widowed/divorced	30 (12.9)
Religion	No	76 (32.8)
Religion	Yes	156 (67.2)
Educational level	≤Elementary school	54 (23.3)
	Middle school	53 (22.8)
	High school	88 (37.9)
	College or University	37 (16.0)
Job	Yes	119 (51.3)
Job	No	113 (48.7)
Main caregiver	Spouse	152 (65.5)
	Sons and daughters	49 (21.1)
	Others	31 (13.4)
Stage	0	115 (49.6)
	I	48 (20.7)
	II	29 (12.5)
	III	34 (14.6)
	IV	6 (2.6)
Duration since diagnosis (year)	<1	109 (47.0)
	1~2	70 (30.2)
	≤3	53 (22.8)

Table 2

Results of Factor Analyses

Factor	Items	Factor loading							Comm.
Manage dietary restriction	4. Do not eat spicy or salty foods	.81	.04	.01	.12	.06	.18	.06	.69
	3. Avoid fatty foods	.78	.11	-.01	.16	.14	.02	.14	.70
	5. Avoid instant foods	.73	.26	.05	.30	.20	.05	-.05	.65
	6. Avoid too cold or hot foods	.73	.10	.28	.14	.04	.14	.03	.66
Avoid hazards	15. Do not smoke	-.01	.86	.03	.06	.07	.09	.01	.68
	14. Do not drink alcohol.	.21	.82	.20	.05	-.03	.01	-.01	.75
	24. Do not eat raw fish or raw meat.	.26	.76	.06	.02	.08	-.03	.10	.64
Rest and elimination	38. Get enough sleep	.09	.02	.75	-.02	.21	.10	.03	.76
	40. Take a short break during Often at work or from housework.	.15	.13	.68	.20	.10	.17	.04	.75
	37. Have a regular bowel movement.	-.01	.15	.68	-.02	.26	.14	.05	.67
	39. Check the color and condition of stool, urine and vomitus	.05	.02	.58	.24	.08	-.04	.31	.57
Manage social support and stress	26. Express your feelings to others, when you are feeling anxious about the disease progress.	.17	.06	.01	.83	.05	.13	-.05	.63
	8. Take to others about your painful events or internal conflicts.	.15	.04	.14	.78	.12	-.08	.00	.50
	35. Ask for help to family when you think it is necessary for your health	.07	.02	.11	.72	.21	.18	.16	.59
Regulation diet	33. Eat balanced diet	.13	.16	.13	.23	.69	.17	.14	.58
	1. Eat right amount of foods frequently in a day.	.04	-.22	.14	.01	.69	.19	.00	.64
	9. Eat meals regularly	.11	.19	.11	.08	.69	.08	.01	.54
	32. Keep plan for health	.38	.03	.18	.26	.57	-.05	.18	.61
Meal portion control	29. Control foods portions when you eat out.	.10	.01	.18	.09	.15	.85	.07	.82
Meal portion control	27. Do not overeat.	.16	.07	.15	.10	.20	.84	.09	.80
Seek information and follow-up care	25. Consult with a doctor about your schedule.	.08	.02	.17	.02	.11	-.09	.84	.76
Seek information and follow-up care	28. Inquire of upir doctor about test results	.08	.06	.08	.05	.09	.33	.79	.75

Factor	Eigen value	Proportion of variances (%)	Cumulative variances (%)
Manage dietary restriction	5.69	12.5	12.5
Avoid hazards	2.16	110.5	22.7
Rest and elimination	1.78	9.8	32.5
Manage social support and stress	1.45	9.7	42.2
Regulation diet	1.33	9.5	51.7
Meal portion control	1.19	8.1	59.8
Seek information and follow-up care	1.13	7.1	66.9

Comm.= Communality.

Table 3

Correlation of Factors

Variables	Factor 1	Factor 2	Factor 3	Factor 4	Factor 5	Factor 6	Factor 7
Variables	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
Factor 1	1.00
Factor 2	.34 (<.001)	1.00
Factor 3	.35 (<.001)	.15 (.026)	1.00
Factor 4	.27 (<.001)	.29 (<.001)	.25 (<.001)	1.00
Factor 5	.41 (<.001)	.39 (<.001)	.19 (.004)	.42 (<.001)	1.00
Factor 6	.29 (<.001)	.25 (<.001)	.13 (.052)	.37 (<.001)	.40 (<.001)	1.00
Factor 7	.20 (.002)	.17 (.011)	.12 (073)	.33 (<.001)	.27 (<.001)	.26 (<.001)	1.00

Table 4

Internal Consistency of Developmental Instrument

Sub-scales	Final items	Cronbach's α
Manage dietary restriction	4	.82
Avoid hazards	3	.80
Rest and elimination	3	.69
Manage social support and stress	4	.76
Regulation diet	4	.71
Meal portion control	2	.81
Seek information and follow-up care	2	.65
Total	22	.86

Notes

This manuscript is a condensed form of the first author's doctoral thesis from Kosin University.

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