Development and validation of a marital anxiety scale for married patients with breast cancer of childbearing age.
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OBJECTIVE: This study aimed to develop and develop and preliminarily validate a scale for assessing marital anxiety among patients with breast cancer. METHODS: Guided by Social Ecological Theory, we employed an exploratory sequential design within a mixed-methods research framework. The initial draft of the scale was developed through a systematic literature review, in-depth qualitative interviews, and expert consultations. A convenience sample of 509 patients with breast cancer was recruited for this study. Participants were randomly divided into two independent sub-samples for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). RESULTS: A total of 509 valid questionnaires were collected. The final scale comprised three first-level dimensions, nine second-level dimensions, and 25 items. The Cronbach's α coefficient for the entire scale was 0.865, with test-retest reliability of 0.902 and split-half reliability of 0.780. The item-level content validity index (I-CVI) for individual items ranged from 0.88 to 1.00; scale-level content validity index (S-CVI)/Ave = 0.987, and S-CVI/Universal Agreement (UA) = 0.81. Convergent validity was confirmed by average variance extracted values exceeding 0.5 and composite reliability values exceeding 0.7 across all dimensions. Several CFA fit indices met acceptable criteria; however, RMSEA and GFI suggested marginal fit, indicating that further validation is needed. CONCLUSIONS: The scale demonstrated preliminary reliability and validity after preliminary verification and can provide a reference tool for assessing marital anxiety among married patients with breast cancer who are of childbearing age. Nevertheless, follow-up studies need to verify its structural stability and applicability to a wider population.