育龄期癌症患者生育忧虑评估工具的系统评价

doi:10.3761/j.issn.1672-9234.2025.02.018

摘要/Abstract

摘要：

目的系统评价育龄期癌症患者生育忧虑评估工具的测量学属性及研究的方法学质量，为选择育龄期癌症患者生育忧虑量表提供参考。方法系统检索中国知网、中国生物医学文献数据库、万方数据库、维普期刊数据库、PubMed、Web of Science、CINAHL Ultimate、Embase数据库，获取建库至2024年3月17日，有关育龄期癌症患者生育忧虑评价量表测量学属性的文献。2名研究者独立提取资料，基于共识选择健康测量工具的标准（consensus-based standards for the selection of health measurement instruments，COSMIN）系统评价指南，对纳入的评估工具进行评价，并形成对于量表的最终推荐意见。结果共纳入16项研究，涉及12个育龄期癌症患者生育忧虑量表，均未报告校标效度、测量误差和反应度。癌症后生育忧虑量表（Reproductive Concerns After Cancer Scale，RCAC）等5个量表均存在具有高质量证据证明测量学属性“不充分”，被评为C级量表;其他量表被评为B级，其中，中文版RCAC有高等级证据表明其结构效度、内部一致性、假设检验和跨文化效度为“充分”，测量学属性报告更为全面。结论与其他量表相比，中文版RCAC的测量学属性得到了最为全面的评价，具有较好的信效度，可暂时被推荐使用。

关键词: 生育忧虑, 评估工具, 测量学属性, 系统评价

Abstract:

Objective To systematically evaluate the measurement properties and methodological quality of assessment tools for reproductive concerns in women of reproductive age with cancer，and provide recommendations for selecting an appropriate reproductive concerns scale. Methods A systematic search of the China National Knowledge Infrastructure，China Biology Medicine disc，Wanfang Data Knowledge Service Platform and China Science and Technology Journal Database，PubMed，Embase，the Web of Science，the CINAHL Ultimate database was conducted to obtain the literature on the measurement properties of the reproductive concerns measure for women of reproductive age with cancer，the time limit for the retrieval was up to March 17，2024. Two researchers independently extracted information based on consensus-based standards for the selection of health measurement instruments（COSMIN），evaluated the included evaluation tools and formed final recommendations for the measuring table. Results A total of 16 studies involving 12 reproductive concerns scales were included，none of which reported criterion validity，measurement error，or responsiveness. Five scales，including the Reproductive Concerns After Cancer Scale（RCAC），had high-quality evidence of “inadequate” measurement properties and were rated as C-level scales，and the others were rated as B-level scales. Among them，the Chinese version of the RCAC had high levels of evidence of “adequate” structural validity，internal consistency，hypothesis testing，and cross-cultural validity，and the measurement properties were reported more comprehensively. Conclusion Compared to other scales，the measurement properties of the Chinese version of the RCAC have been evaluated in the most comprehensive way，with a better reliability and validity，and can be recommended for use.

Key words: Reproductive concerns, Assessment tools, Measurement properties, Systematic reviews

沈淑洁, 刘洪秀, 李龙田, 魏思琪. 育龄期癌症患者生育忧虑评估工具的系统评价[J]. 中华护理教育, 2025, 22(2): 238-246.

SHEN Shujie, LIU Hongxiu, LI Longtian, WEI Siqi. A systematic review of the reproductive concerns assessment tool for women of reproductive age with cancer[J]. Chinese Journal of Nursing Education, 2025, 22(2): 238-246.

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参考文献 29

[1]	Li WZ, Liang HR, Wang W, et al. Global cancer statistics for adolescents and young adults:population based study[J]. J Hematol Oncol, 2024, 17(1):99.
[2]	Bright CJ, Reulen RC, Winter DL, et al. Risk of subsequent primary neoplasms in survivors of adolescent and young adult cancer(Teenage and Young Adult Cancer Survivor Study):a population-based,cohort study[J]. Lancet Oncol, 2019, 20(4):531-545. doi: S1470-2045(18)30903-3 pmid: 30797674
[3]	Wenzel L, Dogan-Ates A, Habbal R, et al. Defining and mea-suring reproductive concerns of female cancer survivors[J]. J Natl Cancer Inst Monogr, 2005(34):94-98.
[4]	Gorman JR, Su HI, Pierce JP, et al. A multidimensional scale to measure the reproductive concerns of young adult female cancer survivors[J]. J Cancer Surviv, 2014, 8(2):218-228. doi: 10.1007/s11764-013-0333-3 pmid: 24352870
[5]	朱飞, 路潜, 刘春蕾, 等. 癌症患者生育忧虑概念分析[J]. 医学研究与教育, 2021, 38(5):51-58. doi: 10.3969/j.issn.1674-490X.2021.05.008
	Zhu F, Lu Q, Liu CL, et al. Concept analysis of reproductive concerns among cancer patients[J]. Med Res Educ, 2021, 38(5):51-58. doi: 10.3969/j.issn.1674-490X.2021.05.008
[6]	Bártolo A, Santos IM, Valério E, et al. Depression and health-related quality of life among young adult breast cancer patients:the mediating role of reproductive concerns[J]. J Adolesc Young Adult Oncol, 2020, 9(3):431-435.
[7]	乔婷婷, 颜萍, 由淑萍, 等. 年轻女性癌症患者生育忧虑与抑郁的相关性研究:以乌鲁木齐市某三级甲等医院为例[J]. 现代预防医学, 2019, 46(17):3134-3138.
	Qiao TT, Yan P, You SP, et al. Correlation between reproduc-tive apprehension and depression in young female cancer pa-tients:a Grade Ⅲ-a hospital in Urumqi[J]. Mod Prev Med, 2019, 46(17):3134-3138.
[8]	乔婷婷, 陈丹丹, 郑蔚, 等. 年轻女性癌症患者生育忧虑现状及其影响因素分析[J]. 现代预防医学, 2017, 44(1):64-68.
	Qiao TT, Chen DD, Zheng W, et al. Reproductive concerns and its influencing factors in young female cancer patients[J]. Mod Prev Med, 2017, 44(1):64-68.
[9]	Prinsen CAC, Mokkink LB, Bouter LM, et al. COSMIN guideline for systematic reviews of patient-reported outcome measures[J]. Qual Life Res, 2018, 27(5):1147-1157. doi: 10.1007/s11136-018-1798-3 pmid: 29435801
[10]	Mokkink LB, de Vet HCW, Prinsen CAC, et al. COSMIN risk of bias checklist for systematic reviews of patient-reported outcome measures[J]. Qual Life Res, 2018, 27(5):1171-1179. doi: 10.1007/s11136-017-1765-4 pmid: 29260445
[11]	Terwee CB, Prinsen CAC, Chiarotto A, et al. COSMIN methodo-logy for evaluating the content validity of patient-reported outcome measures:a Delphi study[J]. Qual Life Res, 2018, 27(5):1159-1170. doi: 10.1007/s11136-018-1829-0 pmid: 29550964
[12]	Alhazzani W, Guyatt G. An overview of the GRADE approach and a peek at the future[J]. Med J Aust, 2018, 209(7):291-292. pmid: 30257627
[13]	Garvelink MM ter Kuile MM, Louwé LA, et al. Validation of a Dutch version of the reproductive concerns scale(RCS) in three populations of women[J]. Health Care Women Int, 2015, 36(10):1143-1159. doi: 10.1080/07399332.2014.993036 pmid: 25562531
[14]	Cherven B, Meacham L, Williamson Lewis R, et al. Evaluation of the modified reproductive concerns scale among emerging adult cancer survivors[J]. J Adolesc Young Adult Oncol, 2021, 10(6):661-667.
[15]	Gorman JR, Pan-Weisz TM, Drizin JH, et al. Revisiting the Re-productive Concerns After Cancer(RCAC) scale[J]. Psychoon-cology, 2019, 28(7):1544-1550.
[16]	乔婷婷, 陈丹丹, 郑蔚, 等. 癌症后生育忧虑量表的汉化及信效度研究[J]. 中华护理杂志, 2016, 51(12):1509-1514.
	Qiao TT, Chen DD, Zheng W, et al. Translation and reliability and validity of the Chinese version of the Reproductive Concerns After Cancer scale(RCAC)[J]. Chin J Nurs, 2016, 51(12):1509-1514.
[17]	Qiao TT, Zheng W, Xing W, et al. Psychometric properties of the Chinese version of the Reproductive Concerns After Cancer Scale(RCAC) for young female cancer survivors[J]. Support Care Cancer, 2017, 25(4):1263-1270.
[18]	乔婷婷, 裴华莲, 颜萍, 等. 中文版癌症后生育忧虑量表跨癌症类型的测量不变性[J]. 现代预防医学, 2021, 48(9):1600-1603,1608.
	Qiao TT, Pei HL, Yan P, et al. Testing measurement invarian-ce of the Chinese version of the reproductive concerns after cancer scaleacross cancer types[J]. Mod Prev Med, 2021, 48(9):1600-1603,1608.
[19]	Anandavadivelan P, Wiklander M, Eriksson LE, et al. Cultural adaptation and psychometric evaluation of the Swedish version of the Reproductive Concerns After Cancer(RCAC) scale[J]. Health Qual Life Outcomes, 2020, 18(1):273.
[20]	Bártolo A, Santos IM, Valério E, et al. The European Portu-guese version of the Reproductive Concerns After Cancer Scale(RCACS):a psychometric validation for young adult female cancer survivors[J]. Eur J Oncol Nurs, 2020, 47:101781.
[21]	Gorman JR, Drizin JH, Malcarne VL, et al. Measuring the mul-tidimensional reproductive concerns of young adult male cancer survivors[J]. J Adolesc Young Adult Oncol, 2020, 9(6):613-620.
[22]	刘洁, 陶莉, 顾静, 等. 育龄期男性癌后生育忧虑量表的汉化及信效度研究[J]. 护理学杂志, 2023, 38(3):86-89.
	Liu J, Tao L, Gu J, et al. Translation of the Reproductive Concerns After Cancer Scale-Male:reliability and validity testing of the Chinese version[J]. J Nurs Sci, 2023, 38(3):86-89.
[23]	Li CC, Huang SM, Lai JC, et al. Development and validation of a fertility intention scale in breast cancer survivors[J]. J Nurs Res, 2018, 26(3):177-184.
[24]	Zhu F, Liu CL, Qi J, et al. Psychometric properties of the fertility intention scale among patients with breast cancer of childbearing age in mainland China[J]. Asia Pac J Oncol Nurs, 2022, 9(8):100100.
[25]	Zhu F, Liu CL, Chen QT, et al. Revision and psychometric evaluation of a fertility intention scale for young women with breast cancer in Chinese Mainland[J]. Asia Pac J Oncol Nurs, 2023, 10(9):100264.
[26]	张娜, 明月, 张小杰. 乳腺癌幸存者生育意愿量表的修订及信效度检验[J]. 护理学杂志, 2023, 38(6):11-14.
	Zhang N, Ming Y, Zhang XJ. Revision of the Fertility Inten-tion Scale for Breast Cancer Survivors:reliability and validity[J]. J Nurs Sci, 2023, 38(6):11-14.
[27]	Gagnier JJ, Lai JY, Mokkink LB, et al. COSMIN reporting guideline for studies on measurement properties of patient-reported outcome measures[J]. Qual Life Res, 2021, 30(8):2197-2218. doi: 10.1007/s11136-021-02822-4 pmid: 33818733
[28]	Lee J, Lee EH, Moon SH. Systematic review of the measure-ment properties of the Depression Anxiety Stress Scales-21 by applying updated COSMIN methodology[J]. Qual Life Res, 2019, 28(9):2325-2339.
[29]	柳青. 医学量表研制步骤及统计方法[J]. 听力学及言语疾病杂志, 2024, 32(2):97-99.