P-CAS tool updated for gauging constipation in pediatric cancer patients
NEW ORLEANS—A phase 1 study has reviewed and updated the content contained in the Pediatric Constipation Assessment Scale (P-CAS) to make it more accurate and relevant overall, according to research presented at the Oncology Nursing Society 37th Annual Congress.
Children receiving active treatment for cancer or palliative care are at risk for constipation. Management requires accurate assessment, but few pediatric measures are available. The P-CAS, a 20-question self-report tool for gauging the severity of constipation in pediatric patients with cancer, was adapted from an adult instrument to addresses this gap.
During the first of several series of evaluations, Myra Woolery, MN, RN, CPON, Nursing and Patient Care Services, National Institutes of Health, Baltimore, MD, and Deborah McGuire, PhD, RN, FAAN, Organizational Systems and Adult Health, University of Maryland Baltimore School of Nursing, Baltimore, MD, measured psychometic properties of the instrument.
The research team developed and tested the P-CAS with guidance from the Model for Constipation Across the Lifespan, developed by the lead author. During the evaluation, 12 health care professionals (pediatric oncology nurses, oncologists, gastroenterologists) and 12 children with cancer aged 8 to 17 years completed a standardized questionnaire regarding the questions that was accompanied by an appropriately leveled explanation of their role and detailed instructions.
Statistical analyses included descriptive characteristics, content validity index estimated at the item-level (I-CVI) and scale-level (S-CVI), and qualitative analysis according to Knafl and colleagues. The research was commensurate with the symptom-related research agendas of the Oncology Nursing Society, National Institute of Nursing Research, and National Cancer Institute.
Health care professionals had no difficulty completing the questionnaire, and most children were able to rate the relevancy of the questions and offer suggestions for revisions or deletions.
Analyses revealed that the I-CVI ranged from 0.25-1.0 for professional experts, 0.58-1.0 for children, and 0.50-1.0 for the combined sample. Quantitative and qualitative comments were used to determine disposition of items, with 14 retained, 4 revised, and 6 deleted. The S-CVI-average was 0.76 for professionals, 0.84 for children, and 0.80 combined. After 6 items were deleted, the S-CVI-average increased to 0.83 for professionals, 0.91 for children, and 0.87 combined.
“Results demonstrate evidence for content validity and provide a foundation for phase 2 in which the revised P-CAS will be tested,” the authors concluded.
This study received funding from the American Cancer Society Doctoral Scholarship.