Development Of Health Literacy Questionnaire For Patients With Prostate Cancer And Its Reliability And Validity

Objective:To develop the health literacy questionnaire for patients with prostate cancer and verify its reliability and validity.Methods: The questionnaire dimensions and item pool were developed through literature analysis and semi-structured interview,The purpose of semi-structured interview was to verify and improve the dimensions and items of the questionnaire.after the development of the tool,a panel of experts were consulted to modify the items and conduct a content validity assessment.Ten patients diagnosed with prostate cancer were recruited for language adjustment.By using convenience sampling method,a total of 188 eligible patients with prostate cancer completed the study questionnaire in the Department of Urology,First Affiliated Hospital of China Medical University.The critical ratio method,total question correlation method and Cronbach’s α coefficient method were used to screen items,and exploratory factor analysis was used to analyze the structural validity of the questionnaire.The Pearson correlation coefficient between the total score of the final questionnaire and the total score of NVS was used to analyze the calibration correlation validity,and the content validity adopted the item content validity index(I-CVI)and the scale content validity index(S-CVI/Ave),Internal consistency and split-half reliability analyze the reliability of the questionnaire.Results: 1.Questionnaire item pool:(1)Based on literature analysis and interview results,a pool of 34 items in 7 dimensions was determined.The 7 dimensions were literacy and counting ability,disease knowledge reserve,health attitude and behavior,the ability to communication with medical staff,the ability to use health information,the ability to perceive the services of the medical system,and to obtain social support.(2)Three themes were extracted based on the interview data.Theme 1: There were differences in attitudes and abilities in health information seeking behaviors,which are consistent with the questionnaire dimensions "literacy and counting ability" and "healthy attitudes and behaviors";theme two : There was a difference in communication behavior between patients and medical staff,which was compatible with the two dimensions of "communication ability with medical staff" and "ability to perceive medical system services";theme three: social support obtained,this theme made the original dimension content increase.2.Item selection: two rounds of expert consultations deleted 2 items,added 4 items,split1 item,and modified language and content of 10 items,and finally retained 37 items;14items were deleted after project analysis,And finally retain 23 items.3.Questionnaire validity: 23 items and 5 dimensions were finally retained after exploratory factor analysis,namely "acquisition and understanding ability","assessment and application ability","communication and interaction ability","healthy behavior and attitude" and "reading" Ability",which explained 58.219% of the total variance,the school-standard association validity was r=0.652(P < 0.05),the content validity S-CVI/Ave was 0.963,only one item I-CVI was 0.67,and the remaining items I-CVI were 0.83～1;4.Questionnaire reliability: the total Cronbach alpha coefficient of the questionnaire was0.898,the total score half-reliability of the questionnaire was 0.636,the Cronbach alpha of acquisition and understanding ability,evaluation and application ability,communication and interaction ability,healthy behavior and attitude,and reading ability were respectively 0.823,0.807,0.769,0.387 and 0.744,indicating that the questionnaire has acceptable reliability.Conclusion: The health literacy questionnaire compiled for prostate cancer patients has acceptable reliability and validity,and follow-up research needs to be further revised and improved.