Development and validation of the comprehensive assessment scale for chemotherapy-induced peripheral neuropathy in survivors of cancer
Development and validation of the comprehensive assessment scale for chemotherapy-induced peripheral neuropathy in survivors of cancer
复制标题
DOI：
10.1186/s12885-019-6113-3
复制
发表时间：
2019-09-10
期刊：
影响因子：
3.8
通讯作者：
Lee, B.
中科院分区：
文献类型：
--
作者：
Kanda, K.;Fujimoto, K.;Lee, B.
背景：化疗引起的周围神经病变（CIPN）是一种无法缓解的难治性症状，是癌症患者痛苦的原因之一，对其进行适当的评估是必不可少的。然而，医务人员的客观评估容易低估CIPN在癌症幸存者中的症状和影响。因此，对癌症幸存者的主观评价出现偏差是一个重大问题。因此，迫切需要开发一种反映癌症患者体验的、准确性高、适用性强的主观量表。我们制定了一套癌症幸存者化疗诱导周围神经病变综合评估量表，命名为癌症幸存者化疗诱导周围神经病变综合评估量表（CAS-CIPN），并对其信度和效度进行了验证。方法在日本癌症患者周围神经病变定性研究和文献回顾的基础上编制问卷。12位癌症专家确认了问卷的内容效度。一个包含40个项目的草案是通过对100个科目进行试点测试最后确定的。本研究的参与者是327名日本癌症幸存者。构念效度采用因子分析，内部效度采用确认因子分析和Cronbach’s alpha。结果因子分析显示，该结构包括“负面情绪对日常生活干扰的威胁”、“手部精细运动技能受损”、“治疗/管理选择的信心”和“手掌和脚底感觉障碍”四个维度的15个项目。CAS-CIPN内部一致性信度为0.826，采用Spearman-Brown公式[q = 2r/(1 + r)]计算的信度系数为0.713，具有较高的内部一致性和稳定性。该量表得分与妇科肿瘤组神经毒性评分呈强相关（r = 0.714, p < 0.01），证实了其标准相关的效度。结论CAS-CIPN是一种高信度和效度的评估工具，可全面评估癌症幸存者的CIPN。CAS-CIPN使用简单，可由医疗专业人员用于适当的情景评估和干预。
Background Appropriate assessment is essential for the management of chemotherapy-induced peripheral neuropathy (CIPN), an intractable symptom that cannot yet be palliated, which is high on the list of causes of distress for cancer patients. However, objective assessment by medical staff makes it easy to underestimate the symptoms and effects of CIPN in cancer survivors. As a result, divergence from subjective evaluation of cancer survivors is a significant problem. Therefore, there is an urgent need to develop a subjective scale with high accuracy and applicability that reflects the experiences of cancer patients. We developed a comprehensive assessment scale for CIPN in cancer survivors, named the Comprehensive Assessment Scale for Chemotherapy-Induced Peripheral Neuropathy in Survivors of Cancer (CAS-CIPN), and demonstrated its reliability and validity. Methods We developed a questionnaire based on qualitative studies of peripheral neuropathy in Japanese cancer patients and literature review. Twelve cancer experts confirmed the content validity of the questionnaire. A draft version comprising 40 items was finalized by a pilot test on 100 subjects. The participants in the present study were 327 Japanese cancer survivors. Construct validity was determined by factor analysis, and internal validity by confirmation factor analysis and Cronbach's alpha. Results Factor analysis showed that the structure consisted of 15 items in four dimensions: "Threatened interference in daily life by negative feelings", "Impaired hand fine motor skills", "Confidence in choice of treatment/management," and "Dysesthesia of the palms and soles." The CAS-CIPN internal consistency reliability was 0.826, and the reliability coefficient calculated using the Spearman-Brown formula [q = 2r/(1 + r)] was 0.713, confirming high internal consistency and stability. Scores on this scale were strongly correlated with Gynecologic Oncology Group-Neurotoxicity scores (r = 0.714, p < 0.01), confirming its criterion-related validity. Conclusions The CAS-CIPN is an assessment tool with high reliability and validity for the comprehensive evaluation of CIPN in cancer survivors. The CAS-CIPN is simple to use, and can be used by medical professionals for appropriate situational assessment and intervention.