Development and Validation of a Scale to Measure Preoperative Anxiety in Patients with Breast Cancer

Universal anxiety questionnaires such as the State-Trait Anxiety Inventory and the Visual Analog Scale for Anxiety are widely used to measure preoperative anxiety. There is currently major interest in developing a surgery-specific preoperative anxiety assessment tool. This study aimed to develop and validate a preoperative anxiety scale for breast cancer patients. Based on a literature review and semi-structured interviews, a draft assessment scale was constructed. The scale was revised after two rounds of Delphi consultations, and a pilot test was performed to evaluate the reliability and validity of the scale. The final scale consisted of 33 items and a global rating score with an item-level content validity of 0.765–0.941. The scale-level content validity was 0.964. Exploratory factor analysis identified four principal factors, and the cumulative contribution of variance was 62.49%. The load value of the common factors of each item was > 0.5. Confirmatory factor analysis showed a chi-square test of the goodness of fit (𝜒2/df) = 1.617. The root mean square error of approximation was 0.042, the goodness of fit index was 0.886, the comparative fit index was 0.956, and the normal fit index was 0.894. The total and dimension scores were positively correlated (r = 0.513–0.767, p < 0.001) with the Hospital Anxiety and Depression Scale-Anxiety scores. The scale developed in this study has good reliability and validity and can be easily used to objectively assess preoperative anxiety.