肺がん患者用生活調整尺度の開発

Development of Life Adjustment Scale for Patient with Lung Cancer (L-LAS)

要旨

　目的：肺がん患者用生活調整尺度（L-LAS）を作成し、その信頼性と妥当性の検討をすることを目的とする。

　方法：文献検討に基づき肺がん患者用生活調整尺度原案を作成した。内容妥当性の検討から尺度原案を修正し、50項目の肺がん患者用生活調整尺度原案の修正版を作成した。肺がん患者480名を対象に質問紙調査を実施し、尺度の信頼性と妥当性を検討した。

　結果：質問紙回収数は238件（回収率49.6％）であり、有効回答147件を分析対象とした。項目分析および因子分析の結果、最終的に22項目5因子が精選され、「社会関係の維持」「自分らしさの発揮」「負担の軽減」「最期の過ごし方の決定」「症状管理」と命名した。信頼性はCronbach's α係数（α＝0.85）と折半法のSpearman-Brownの信頼性係数（ρ＝0.79）で確認した。妥当性は、日本語版FACT-L（r＝0.64、p＜0.01）および日本語版MAC scale（r＝0.58、p＜0.01）との相関によって確認した。

　結論：L-LASは信頼性と妥当性が検証され、実用可能な尺度であると判断した。

Abstract

　Purpose: The purpose of this study was to develop Life Adjustment Scale for Patients with Lung Cancer (L-LAS) and to examine the reliability and validity of the scale.

　Methods: The original Life Adjustment Scale for Patients with Lung Cancer was developed based on a comprehensive review of the literature. A revised 50 items version was developed based an examination of the content validity of the original scale. Subsequently, the revised questionnaire was distributed to 480 lung cancer patients.

　Results: Two hundreds thirty-eight lung cancer patients returned answers by mail(49.6%), and 147 valid responses were analyzed. Statistically insignificant items were eliminated and factor analysis was conducted. Consequently, 22 items categorized into the following and 5 factors were selected:"Maintaining social relations," "Expressing individuality," "Reduction of load on mind and body," "Decision of how to spend terminal stage,"and "Symptom management." Reliability was confirmed using Cronbach's α coefficient(α=0.85) and Spearman-Brown's coefficient of reliability(ρ=0.79). The results were compared with those obtained using FACT-L scale(r=0.64, p＜0.01) and MAC scale(r=0.58, p＜0.01).

　Conclusion: The new scale(L-LAS)was found to be reliable, effective and practicable.