Rationale, Aims, and Objectives: A needs assessment tool considering the cultural background of mainland China has not been reported. This study developed a Needs Self-rating Questionnaire for Breast Cancer (NSQ-BC) based on Maslow's hierarchy of needs for mainland Chinese patients.
Methods:The Delphi technique and pilot cross-sectional surveys (two rounds) were performed for item selection. In the Delphi technique, items were selected according to the experts' perspective on the item's significance (ie, 1-5 Likert-scale ratings of importance; mean > 4.0 and coefficients of variation <0.25). In the pilot crosssectional surveys, items were selected according to internal consistency reliability (Cronbach's α ≥ 0.70), discriminant validity (stronger correlations of the item with the hypothesized subscale than for other subscales), and convergent validity (hypothesized item-subscale correlations ≥0.40). All decisions were made based on the results of statistical analyses, recommendations of the experts, and in-depth discussion among research team members.Results: Following the two evaluation rounds, the revised NSQ-BC comprised 26 items across five subscales of needs: physical, psychological, respect/self-esteem, information, and rehabilitation. Item ratings from the expert panellists met the aforementioned criteria (ie, Kendall's W = 0.329, P < 0.001). Except for the "respect/self-esteem needs" subscale, Cronbach's α for all subscales exceeded 0.70. All items had acceptable discriminant and convergent validity. Additionally, two new items-good environment/facilities and economic support-were added to the NSQ-BC, as recommended by the experts.
Conclusions:The NSQ-BC was developed fully via the comprehensive use of Delphi technique and pilot cross-sectional surveys. It provides evidence of a proper instrument for needs assessment and evaluation among women with breast cancer in mainland China.