Development and pilot testing of four desired health outcomes scales.

PURPOSE/OBJECTIVES To develop and pilot test scales to measure desired health outcomes hypothesized to result from high-quality cancer nursing care: Fortitude Scale, Trust in Nurses Scale, Cancer Patient Optimism Scale, and Authentic Self-Representation Scale. DESIGN Instrument development. SETTING Community cancer support organization. SAMPLE 66 recently treated patients with cancer who attended a cancer support organization workshop. The sample was predominately white, middle-aged, well-educated females. METHODS Items for each scale were generated from qualitative data and the literature. The scales properties were evaluated using expert panel assessment of content validity, cognitive interviews of patients with cancer, and reliability and validity testing of each scale with the Multitrait/Multi-Item Analysis Program Revised (MAP-R) statistical program. FINDINGS Participant responses to the four scales did not include the lowest possible score. Responses yielded evidence of adequate Cronbachs alpha internal consistency reliability for each scale: 0.81 for the Fortitude Scale; 0.81 for Trust in Nurses Scale, 0.75 for Cancer Patient Optimism Scale, and 0.71 for Authentic Self-Representation Scale. The MAP-R statistics yielded evidence of acceptable convergent validity and discriminant validity. CONCLUSIONS The data provided preliminary evidence of acceptable psychometric properties for four scales designed to measure desired outcomes of cancer nursing care. Support was found for careful use of scales. Further psychometric testing with large samples is recommended. IMPLICATIONS FOR NURSING These scales represent an initial effort toward providing measures of the desired health outcomes that patients with cancer attributed to high-quality cancer nursing care.