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Development and Validation of an Instrument for Measuring Attitudes and Beliefs about Complementary and Alternative Medicine (CAM) Use among Cancer Patients.

Mao JJ, Palmer SC, Desai K, Li SQ, Armstrong K, Xie SX - Evid Based Complement Alternat Med (2012)

Bottom Line: These domains had Eigenvalues of 4.79, 2.37, and 1.43, and together explained over 57.2% of the variance.The 4-item expected benefits, 7-item perceived barriers, and 4-item subjective norms domain scores, each had an acceptable internal consistency (Cronbach's alpha) of 0.91, 0.76, and 0.75, respectively.As expected, CAM users had higher expected benefits, lower perceived barriers, and more positive subjective norms (all P < 0.001) than those who did not use CAM.

View Article: PubMed Central - PubMed

Affiliation: Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia, PA 19104, USA.

ABSTRACT
Despite cancer patients' extensive use of complementary and alternative medicine (CAM), validated instruments to measure attitudes, and beliefs predictive of CAM use are lacking. We aimed at developing and validating an instrument, attitudes and beliefs about CAM (ABCAM). The 15-item instrument was developed using the theory of planned behavior (TPB) as a framework. The literature review, qualitative interviews, expert content review, and cognitive interviews were used to develop the instrument, which was then administered to 317 outpatient oncology patients. The ABCAM was best represented as a 3-factor structure: expected benefits, perceived barriers, and subjective norms related to CAM use by cancer patients. These domains had Eigenvalues of 4.79, 2.37, and 1.43, and together explained over 57.2% of the variance. The 4-item expected benefits, 7-item perceived barriers, and 4-item subjective norms domain scores, each had an acceptable internal consistency (Cronbach's alpha) of 0.91, 0.76, and 0.75, respectively. As expected, CAM users had higher expected benefits, lower perceived barriers, and more positive subjective norms (all P < 0.001) than those who did not use CAM. Our study provides the initial evidence that the ABCAM instrument produced reliable and valid scores that measured attitudes and beliefs related to CAM use among cancer patients.

No MeSH data available.


Related in: MedlinePlus

Distribution of domain scores of the ABCAM.
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fig1: Distribution of domain scores of the ABCAM.

Mentions: Of the 25 items included in the initial instrument, one item, “reduce stress,” had missing data greater than 5% and was excluded from analysis. The remaining 24 items had missing data ranging from 1.5% to 4.4% with no apparent ceiling or flooring effects. Through iterative factor analysis, we removed items that cross-loaded to multiple domains as well as items that had low correlation coefficients to the intended domains. For example, “boost my immune system,” “my family encourages me to use CAM,” and “my friend asks me to try CAM” cross-loaded to both expected benefits and social norms. Our final scale consisted of 15 items with a 3-factor structure: expected benefits, perceived barriers, and subjective norms (see Table 1). These three domains had Eigenvalues of 4.79, 2.37, and 1.43, and, together, explained over 57.2% of the variance in items. The component scores were then calculated by summing the individual items and normalizing to a value between 0 and 100 for each of the domains (see Table 2 and Figure 1 for distribution of domain scores).


Development and Validation of an Instrument for Measuring Attitudes and Beliefs about Complementary and Alternative Medicine (CAM) Use among Cancer Patients.

Mao JJ, Palmer SC, Desai K, Li SQ, Armstrong K, Xie SX - Evid Based Complement Alternat Med (2012)

Distribution of domain scores of the ABCAM.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369496&req=5

fig1: Distribution of domain scores of the ABCAM.
Mentions: Of the 25 items included in the initial instrument, one item, “reduce stress,” had missing data greater than 5% and was excluded from analysis. The remaining 24 items had missing data ranging from 1.5% to 4.4% with no apparent ceiling or flooring effects. Through iterative factor analysis, we removed items that cross-loaded to multiple domains as well as items that had low correlation coefficients to the intended domains. For example, “boost my immune system,” “my family encourages me to use CAM,” and “my friend asks me to try CAM” cross-loaded to both expected benefits and social norms. Our final scale consisted of 15 items with a 3-factor structure: expected benefits, perceived barriers, and subjective norms (see Table 1). These three domains had Eigenvalues of 4.79, 2.37, and 1.43, and, together, explained over 57.2% of the variance in items. The component scores were then calculated by summing the individual items and normalizing to a value between 0 and 100 for each of the domains (see Table 2 and Figure 1 for distribution of domain scores).

Bottom Line: These domains had Eigenvalues of 4.79, 2.37, and 1.43, and together explained over 57.2% of the variance.The 4-item expected benefits, 7-item perceived barriers, and 4-item subjective norms domain scores, each had an acceptable internal consistency (Cronbach's alpha) of 0.91, 0.76, and 0.75, respectively.As expected, CAM users had higher expected benefits, lower perceived barriers, and more positive subjective norms (all P < 0.001) than those who did not use CAM.

View Article: PubMed Central - PubMed

Affiliation: Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia, PA 19104, USA.

ABSTRACT
Despite cancer patients' extensive use of complementary and alternative medicine (CAM), validated instruments to measure attitudes, and beliefs predictive of CAM use are lacking. We aimed at developing and validating an instrument, attitudes and beliefs about CAM (ABCAM). The 15-item instrument was developed using the theory of planned behavior (TPB) as a framework. The literature review, qualitative interviews, expert content review, and cognitive interviews were used to develop the instrument, which was then administered to 317 outpatient oncology patients. The ABCAM was best represented as a 3-factor structure: expected benefits, perceived barriers, and subjective norms related to CAM use by cancer patients. These domains had Eigenvalues of 4.79, 2.37, and 1.43, and together explained over 57.2% of the variance. The 4-item expected benefits, 7-item perceived barriers, and 4-item subjective norms domain scores, each had an acceptable internal consistency (Cronbach's alpha) of 0.91, 0.76, and 0.75, respectively. As expected, CAM users had higher expected benefits, lower perceived barriers, and more positive subjective norms (all P < 0.001) than those who did not use CAM. Our study provides the initial evidence that the ABCAM instrument produced reliable and valid scores that measured attitudes and beliefs related to CAM use among cancer patients.

No MeSH data available.


Related in: MedlinePlus