| dc.description.abstract | Abstract:
Introduction: In adolescent chronic disease the task of care is gradually transferred from the healthcare system to the patient or family, and achieving this requires reviewing and meeting the patient's self-care needs. Cancer is one of the most common chronic diseases in adolescents that needs to be carefully examined and followed up to prevent complications. Therefore, the purpose of this study was to utilize the real experiences of adolescents cancer survivore to explain the concept of self-care needs, in order to become a tool for measuring the concept and psychometric evaluation.
Method: In the first stage of this mixed study with Exploratory Sequential Design, a qualitative study was conducted to explain the concept self care needs in adolescents of cancer survivors with a conventional content analysis approach. For this purpose, semi-structured interviews were conducted with 18 adolescents cancer survivor, 4 of their parents, 2 nurses, one physician, one teacher and one member of the Mahak charity were selected through purposeful sampling (n=27). Next, tool items were designed using findings of qualitative stage and a literature review. Then, face validity, content validity (determination of content validity ratio and content validity index), and exploratory factor analysis construct validity (n=287), discriminant validity (Kid-KINDL questionare), internal consistency, stability (20 adolescents cancer survivor) was evaluated. MAXQDA 10 sofware in qualitative section and SPSS 21 in quntitatve section was used.
Findings: Data analysis in the qualitative part led to the identification of two themes: "protection self-care needs" and "supportive self-care needs". After explaining the concept of self care needs in adolescents cancer survivor, tool draft with 64 items in the 5-point Likert scale was designed. After determining quantitative and qualitative face and content validity, content validity index for items and whole tool was calculated and finally the scale with 52 items were prepared for Factor analysis. The total variance of the instrument (72.42) in exploratory factor analysis indicated two dimensions that were referred to as "supportive self-care" with The percentage of variance 42.98 and "self protection" with the percentage of variance 57.09. Ten items were omitted during factor analysis and second internal consistency. The Cronbach's alpha coefficient of the final scale with 42 items, was calculated to be 0.946 and for demensions of supportive self-care needs and self protection was 0.940 and 0.764, respectively by using conveniance sampling. Intra class correlation coefficient for scale was 0.969.
Conclusion: Qualitative phase results showed that adolescents’ cancer survivors based on their severity and amount of perceived vulnerability felt the need for physical and psychological protection, but if they are unable to meet the protective self-care needs, they will need support in self-care, who needs to receive support from their families and close relatives, health care providers, governmental and non-governmental institutions. Quantitative phase results also showed that the instrument was valid for psychometric criteria (validity and reliability) and could be used in education, management and nursing services. | en_US |
