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Original Article

Validity and Reliability Test of the Korean Version of the Oncology Patients' Perception of the Quality of Nursing Care Scale

Jiyoung Kang1, Heiyoung Kang2, Nanyeon Kim2, Mijung Lee2, Youjine Kim2, Juhyeon Kim2, Sujeong Yeo2, Yunye Seo3, E. Eunyoung Suh4
Korean Journal of Adult Nursing 2016;28(2):191-201.
Published online: April 30, 2016

1College of Nursing, Seoul National University, Seoul

2Department of Nursing, Seoul National University Hospital, Seoul

3Health Insurance Review & Assessment Service, Wonju

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Corresponding author: Suh, E, Eunyoung College of Nursing, Seoul National University, 103 Jonro-gu, Dehack-ro, Seoul 03080, Korea. Tel: +82-2-740-8484, Fax: +82-2-740-8484, E-mail: esuh@snu.ac.kr
• Received: February 6, 2016   • Accepted: April 19, 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this methodological study was to examine the validity and reliability of a translated Korean version of The Oncology Patients’ Perception of the Quality of Nursing Care Scale.
  • Methods
    The translated scale was pilot tested and then administered to 360 patients with cancer. Exploratory and confirmatory factor analyses were utilized to assess the factor structure. Internal consistency reliability was determined using coefficient ⍺.
  • Results
    Two of the 40 items were deleted with a principal component method of exploratory factor analysis because they did not meet the factor-loading criterion. The 38 items were again analyzed and, four factors were validated (KMO=.96, Bartlett x2=10809.81, df=780, p<.001). The four factors accounted for 60.9% of the variance. Factor loadings of the scale on the four subscales ranged from .65 to .91. The scale showed reliable internal consistency with a Cronbach's ⍺, total 38 items (⍺=.96) in four subscales: individualization (18 items, ⍺=.96), proficiency (10, .91), responsiveness (7, .90), and coordination (3, .80).
  • Conclusion
    The findings of this study demonstrate that the scale has satisfactory construct validity and reliability to measure quality of cancer nursing care from the patient's perspective in Korea.
  • Key Words: Patient-centered care; Oncology nursing; Quality of health care; Validity and reliability; Measures
Table 1.
General Characteristics of the Participants (N=360)
Characteristics Categories n (%) or M±SD
Cancer type Breast cancer 223 (61.9)
Thyroid cancer 137 (38.1)
Age (year) (Range: 25~75)   51.4±9.9
20~29 18 (5.0)
30~39 42 (11.7)
40~49 117 (32.5)
50~59 114 (31.7)
60~69 57 (15.8)
≥70 12 (3.3)
Marital status Single 13 (3.6)
Married 315 (87.5)
Divorced 14 (3.9)
Others 18 (5.0)
Number of children 0 56 (15.6)
1 80 (22.2)
2 175 (48.6)
≥3 49 (13.6)
Religion Christian 116 (32.2)
Catholic 69 (19.2)
Buddhist 73 (20.3)
Others (none include) 102 (28.3)
Education ≤Middle school 77 (21.4)
High school 132 (36.7)
College 143 (39.7)
≥Graduate school 8 (2.2)
Perceived economic status Good 13 (3.6)
Fair 262 (72.8)
Poor 31 (8.6)
Non response 54 (15.0)
Table 2.
Item Analysis and Factor Analysis of the OPPQNCS-K (N=360)
Item
The nurses		 M±SD A B C Factor loadings Com. EV (%)
1 2 3 4
Individualization 18 items 5.26±0.75 　 　 .96 　 　 　 　 　 47.9
personalized my care to my particular needs. 5.29±0.93 .73 .96 .96 .74
knew how to help me when things were bothering me. 5.36±0.94 .78 .96 .85 .76
discussed care options with me. 4.90±1.36 .68 .96 .85 .63
encouraged me to actively participate in my care. 5.28±1.02 .79 .96 .82 .74
knew how I was coping. 5.22±0.99 .78 .96 .78 .73
spent time with me when I needed them. 4.86±1.30 .70 .96 .77 .63
knew how I was feeling. 5.06±1.02 .77 .96 .76 .70
helped me get the information I wanted. 5.40±0.88 .67 .96 .70 .56
correctly anticipated problems I might have because of my conditions. 5.18±0.99 .74 .96 .67 .63
made it easy to establish the relationship I wanted with them. 5.15±1.03 .73 .96 .67 .63
tried to help when I was having a difficult time. 5.31±1.02 .74 .96 .60 .64
remembered things about me. 5.32±0.94 .70 .96 .60 .56
knew what I had been through. 5.20±1.06 .70 .96 .60 .56
did what they could to make me comfortable. 5.50±0.80 .72 .96 .56 .65
arranged for the same nurses to care for me regularly. 5.41±0.95 .59 .96 .54 .51
gave me support I needed. 5.56±0.72 .67 .96 .52 .58
knew how to help me in ways that I liked. 5.38±0.82 .71 .96 .50 .61
comforted me when I needed it. 5.35±0.88 .68 .96 .46 .52
Proficiency 10 items 5.64±0.46     .91 　   　 　   6.4 　
were skillful. 5.74±0.53 .52 .96 .78 .55
knew how to care for someone with my condition. 5.62±0.61 .54 .96 .78 .58
gave me accurate explanations about my care. 5.70±0.56 .52 .96 .74 .54
took time to answer my questions. 5.73±0.54 .56 .96 .73 .55
knew how to help me. 5.66±0.59 .60 .96 .67 .59
knew what they were doing. 5.76±0.53 .56 .96 .65 .57
knew made sure I had what I needed. 5.47±0.73 .64 .96 .57 .55
checked on me often enough. 5.49±0.75 .65 .96 .56 .59
addressed my needs promptly. 5.62±0.69 .59 .96 .46 .48
respected my dignity. 5.59±0.67 .72 .96 .43 .68
Responsiveness 7 items 5.56±0.59     .90 　 　 　 　 　 3.7 　
were kind to me. 5.74±0.56 .65 .96 .77 .67
made me feel like I mattered. 5.32±0.95 .71 .96 .64 .67
were gentle with me. 5.70±0.59 .68 .96 .63 .65
reacted quickly when something important happened. 5.65±0.65 .66 .96 .59 .58
came when I needed them. 5.64±0.64 .60 .96 .55 .56
took my concerns seriously. 5.36±0.99 .76 .96 .53 .69
paid attention to what I said. 5.52±0.78 .69 .96 .52 .63
Coordination 3 items 3.90±1.61     .80 　 　 　 　 　 2.9 　
told me which nurse was primarily responsible for coordinating my care. 3.92±1.88 .55 .96 .83 .81
showed me they cared about my family and friends. 3.78±1.95 .31 .96 .81 .59
told me which nurse was taking over when they were not there. 4.01±1.85 .62 .96 .71 .74
Total 38 items 5.31±0.62     .96           60.9

KMO=.996; Bartlett x2=108099.81;df=780;; p＜.00

A=corrected item-total correlation; B=Cronbach's ⍺ if item deleted; C=Cronbach's ⍺; Com.=communality; EV=explained variance; OPPQNCS-K=Korean Version of the Oncology Patients' Perception of the Quality of Nursing Care Scale; Factor 1=Individualization; Factor 2=Proficiency; Factor 3=Responsiveness; Factor 4=Coordination.

Table 3.
Model Fit Indices for OPPQNCS-K
Variables x2 df p RMSEA
OPPQNCS-K 1,905.31 659 ＜.001 .07
Table 4.
Convergent Validity of OPPQNCS-K
Variables Path Standardized estimates (β) SE CR p Average variance extracted Construct reliability
Quality of nursing care → Individualization .90 .01 8.08 ＜.001 .69 .89
→ Proficiency .83 .01 10.69 ＜.001
→ Responsiveness .91 .01 7.51 ＜.001
→ Coordination .65      
Criteria ＞.50   ＞1.96   ＞.50 ＞.70
Result yes   yes   yes yes

CR=critical ratio.

Table 5.
Discriminant Validity of OPPQNCS-K
  Individualization Proficiency Responsiveness Coordination
Individualization .58†     .52†
Proficiency .54‡ .73†  
Responsiveness .66‡ .64‡ .72†
Coordination .27‡ .12‡ .18‡
Criteria AVE＞Ф2 Criteria

†Average Variance Extracted (AVE);

‡Square of Correlation Coefficient= (r2)=Ф2

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    Validity and Reliability Test of the Korean Version of the Oncology Patients' Perception of the Quality of Nursing Care Scale
    Korean J Adult Nurs. 2016;28(2):191-201.   Published online April 30, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.2.191
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    Validity and Reliability Test of the Korean Version of the Oncology Patients' Perception of the Quality of Nursing Care Scale
    Korean J Adult Nurs. 2016;28(2):191-201.   Published online April 30, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.2.191
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    Validity and Reliability Test of the Korean Version of the Oncology Patients' Perception of the Quality of Nursing Care Scale
    Validity and Reliability Test of the Korean Version of the Oncology Patients' Perception of the Quality of Nursing Care Scale

    General Characteristics of the Participants (N=360)

    Characteristics Categories n (%) or M±SD
    Cancer type Breast cancer 223 (61.9)
    Thyroid cancer 137 (38.1)
    Age (year) (Range: 25~75)   51.4±9.9
    20~29 18 (5.0)
    30~39 42 (11.7)
    40~49 117 (32.5)
    50~59 114 (31.7)
    60~69 57 (15.8)
    ≥70 12 (3.3)
    Marital status Single 13 (3.6)
    Married 315 (87.5)
    Divorced 14 (3.9)
    Others 18 (5.0)
    Number of children 0 56 (15.6)
    1 80 (22.2)
    2 175 (48.6)
    ≥3 49 (13.6)
    Religion Christian 116 (32.2)
    Catholic 69 (19.2)
    Buddhist 73 (20.3)
    Others (none include) 102 (28.3)
    Education ≤Middle school 77 (21.4)
    High school 132 (36.7)
    College 143 (39.7)
    ≥Graduate school 8 (2.2)
    Perceived economic status Good 13 (3.6)
    Fair 262 (72.8)
    Poor 31 (8.6)
    Non response 54 (15.0)

    Item Analysis and Factor Analysis of the OPPQNCS-K (N=360)

    Item
    The nurses    		 M±SD A B C Factor loadings Com. EV (%)
    1 2 3 4
    Individualization 18 items 5.26±0.75 　 　 .96 　 　 　 　 　 47.9
    personalized my care to my particular needs. 5.29±0.93 .73 .96 .96 .74
    knew how to help me when things were bothering me. 5.36±0.94 .78 .96 .85 .76
    discussed care options with me. 4.90±1.36 .68 .96 .85 .63
    encouraged me to actively participate in my care. 5.28±1.02 .79 .96 .82 .74
    knew how I was coping. 5.22±0.99 .78 .96 .78 .73
    spent time with me when I needed them. 4.86±1.30 .70 .96 .77 .63
    knew how I was feeling. 5.06±1.02 .77 .96 .76 .70
    helped me get the information I wanted. 5.40±0.88 .67 .96 .70 .56
    correctly anticipated problems I might have because of my conditions. 5.18±0.99 .74 .96 .67 .63
    made it easy to establish the relationship I wanted with them. 5.15±1.03 .73 .96 .67 .63
    tried to help when I was having a difficult time. 5.31±1.02 .74 .96 .60 .64
    remembered things about me. 5.32±0.94 .70 .96 .60 .56
    knew what I had been through. 5.20±1.06 .70 .96 .60 .56
    did what they could to make me comfortable. 5.50±0.80 .72 .96 .56 .65
    arranged for the same nurses to care for me regularly. 5.41±0.95 .59 .96 .54 .51
    gave me support I needed. 5.56±0.72 .67 .96 .52 .58
    knew how to help me in ways that I liked. 5.38±0.82 .71 .96 .50 .61
    comforted me when I needed it. 5.35±0.88 .68 .96 .46 .52
    Proficiency 10 items 5.64±0.46     .91 　   　 　   6.4 　
    were skillful. 5.74±0.53 .52 .96 .78 .55
    knew how to care for someone with my condition. 5.62±0.61 .54 .96 .78 .58
    gave me accurate explanations about my care. 5.70±0.56 .52 .96 .74 .54
    took time to answer my questions. 5.73±0.54 .56 .96 .73 .55
    knew how to help me. 5.66±0.59 .60 .96 .67 .59
    knew what they were doing. 5.76±0.53 .56 .96 .65 .57
    knew made sure I had what I needed. 5.47±0.73 .64 .96 .57 .55
    checked on me often enough. 5.49±0.75 .65 .96 .56 .59
    addressed my needs promptly. 5.62±0.69 .59 .96 .46 .48
    respected my dignity. 5.59±0.67 .72 .96 .43 .68
    Responsiveness 7 items 5.56±0.59     .90 　 　 　 　 　 3.7 　
    were kind to me. 5.74±0.56 .65 .96 .77 .67
    made me feel like I mattered. 5.32±0.95 .71 .96 .64 .67
    were gentle with me. 5.70±0.59 .68 .96 .63 .65
    reacted quickly when something important happened. 5.65±0.65 .66 .96 .59 .58
    came when I needed them. 5.64±0.64 .60 .96 .55 .56
    took my concerns seriously. 5.36±0.99 .76 .96 .53 .69
    paid attention to what I said. 5.52±0.78 .69 .96 .52 .63
    Coordination 3 items 3.90±1.61     .80 　 　 　 　 　 2.9 　
    told me which nurse was primarily responsible for coordinating my care. 3.92±1.88 .55 .96 .83 .81
    showed me they cared about my family and friends. 3.78±1.95 .31 .96 .81 .59
    told me which nurse was taking over when they were not there. 4.01±1.85 .62 .96 .71 .74
    Total 38 items 5.31±0.62     .96           60.9

    KMO=.996; Bartlett x2=108099.81;df=780;; p＜.00

    A=corrected item-total correlation; B=Cronbach's ⍺ if item deleted; C=Cronbach's ⍺; Com.=communality; EV=explained variance; OPPQNCS-K=Korean Version of the Oncology Patients' Perception of the Quality of Nursing Care Scale; Factor 1=Individualization; Factor 2=Proficiency; Factor 3=Responsiveness; Factor 4=Coordination.

    Model Fit Indices for OPPQNCS-K

    Variables x2 df p RMSEA
    OPPQNCS-K 1,905.31 659 ＜.001 .07

    Convergent Validity of OPPQNCS-K

    Variables Path Standardized estimates (β) SE CR p Average variance extracted Construct reliability
    Quality of nursing care → Individualization .90 .01 8.08 ＜.001 .69 .89
    → Proficiency .83 .01 10.69 ＜.001
    → Responsiveness .91 .01 7.51 ＜.001
    → Coordination .65      
    Criteria ＞.50   ＞1.96   ＞.50 ＞.70
    Result yes   yes   yes yes

    CR=critical ratio.

    Discriminant Validity of OPPQNCS-K

      Individualization Proficiency Responsiveness Coordination
    Individualization .58†     .52†
    Proficiency .54‡ .73†  
    Responsiveness .66‡ .64‡ .72†
    Coordination .27‡ .12‡ .18‡
    Criteria AVE＞Ф2 Criteria

    †Average Variance Extracted (AVE);

    ‡Square of Correlation Coefficient= (r2)=Ф2
    Table 1. General Characteristics of the Participants (N=360)

    Table 2. Item Analysis and Factor Analysis of the OPPQNCS-K (N=360)

    KMO=.996; Bartlett x2=108099.81;df=780;; p＜.00

    A=corrected item-total correlation; B=Cronbach's ⍺ if item deleted; C=Cronbach's ⍺; Com.=communality; EV=explained variance; OPPQNCS-K=Korean Version of the Oncology Patients' Perception of the Quality of Nursing Care Scale; Factor 1=Individualization; Factor 2=Proficiency; Factor 3=Responsiveness; Factor 4=Coordination.

    Table 3. Model Fit Indices for OPPQNCS-K

    Table 4. Convergent Validity of OPPQNCS-K

    CR=critical ratio.

    Table 5. Discriminant Validity of OPPQNCS-K

    Average Variance Extracted (AVE);

    Square of Correlation Coefficient= (r2)=Ф2

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

    Korean J Adult Nurs : Korean Journal of Adult Nursing

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