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Development and psychometric evaluation of the Symptom Self-Management Behaviors Tool for adolescents/young adults with cancer

Published online by Cambridge University Press:  30 June 2023

Kristin Stegenga Open the ORCID record for Kristin Stegenga [Opens in a new window] ,
Jeanne M. Erickson ,
Lauri Linder ,
Catherine Fiona Macpherson ,
R.K. Elswick Jr.  and
Suzanne Ameringer
Kristin Stegenga*
Affiliation:
Children’s Mercy Hospital, Division of Hematology/Oncology and BMT, Kansas City, MO, USA
Jeanne M. Erickson
Affiliation:
College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
Lauri Linder
Affiliation:
University of Utah College of Nursing and Primary Children’s Hospital, Center for Cancer and Blood Disorders, Salt Lake City, UT, USA
Catherine Fiona Macpherson
Affiliation:
Seattle Children’s Hospital, Center for Cancer and Blood Disorders, Seattle, WA, USA
R.K. Elswick Jr.
Affiliation:
School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
Suzanne Ameringer
Affiliation:
School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
*
Corresponding author: Kristin Stegenga; Email: kstegenga@cmh.edu
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Abstract

Objectives

Adolescents and Young Adults (AYAs) with cancer experience symptoms related to disease and treatment. To manage these symptoms, they need to develop self-management behaviors, yet no tool exists to assess these behaviors. The Symptom Self-Management Behaviors Tool (SSMBT) was developed to meet this need.

Methods

The study consisted of 2 phases. Phase 1 evaluated content validity, and Phase 2 evaluated reliability and validity. The SSMBT initially contained 14 items with 2 dimensions: (1) behaviors used to Manage Symptoms and (2) behaviors used to communicate with providers regarding symptoms. Four oncology professionals and 5 AYAs with cancer assessed the content validity. Evaluation of reliability and validity involved 61 AYAs with cancer. Reliability was evaluated using Cronbach’s alpha. Construct validity was assessed with factor analysis. Discriminant validity was assessed using associations with symptom severity and distress.

Results

Content validity evaluation supported the importance of the items. Factor analysis supported a two-factor structure: Manage Symptoms (8 items) and Communicate with Healthcare Providers (4 items) subscales. Internal consistency reliability for the total SSMBT was acceptable with Cronbach’s alpha = 0.74. Cronbach’s alpha value for the Manage Symptoms subscale was α = 0.69 and for the Communicate with Healthcare Providers subscale was α = 0.78. The SSMBT total and the Manage Symptoms subscale scores were moderately correlated with symptom severity (r = 0.35, p = 0.014; r = 0.44, p = 0.002, respectively), partially supporting discriminant validity.

Significance of results

Systematic assessment of behaviors AYAs use is critical for clinical practice and evaluate interventions to improve self-management. The SSMBT demonstrates initial reliability and validity but requires further evaluation for clinical interpretation and future use.

Keywords

Symptom self-managementPsychometricsValidityInternal consistencyAYA
Type
Original Article
Information
Palliative & Supportive Care , Volume 22 , Issue 2 , April 2024 , pp. 274 - 280
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Copyright
© The Author(s), 2023. Published by Cambridge University Press.

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