The Patient Care Monitor-Neutropenia Index: development, reliability, and validity of a measure for chemotherapy-induced neutropenia

Oncol Nurs Forum. 2011 May;38(3):360-7. doi: 10.1188/11.ONF.360-367.

Abstract

Purpose/objectives: To provide an initial evaluation of the psychometric properties of the Patient Care Monitor 1.0 Revised-Neutropenia Index (PCM-N), a symptom-based assessment tool designed to measure health-related quality-of-life (HRQOL) changes associated with chemotherapy-induced neutropenia.

Design: Known-groups methodology and self-report instrument validation.

Setting: A large community oncology practice in Memphis, TN.

Sample: 424 patients with cancer in four samples.

Methods: All patients in the first three samples were assessed at baseline of chemotherapy administration and at a point analogous to midcycle. The fourth sample underwent a cross-sectional evaluation of the ability of the PCM-N to distinguish patients with febrile neutropenia, severe afebrile neutropenia, and no neutropenia.

Main research variables: PCM-N score, grade of neutropenia, and febrile status.

Findings: Internal consistency reliability and factor analysis supported the single additive scale structure of the 13 items of the PCM-N. The PCM-N demonstrated good known-groups validity and was able to distinguish patients with grades 3-4 neutropenia from those with grades 0-2. The tool also was able to distinguish patients with febrile neutropenia, severe afebrile neutropenia, and no neutropenia. Receiver operating characteristic analyses provided a psychometrically based threshold score.

Conclusions: The PCM-N is a reliable and valid instrument sensitive to changes in HRQOL associated with moderate-to-severe chemotherapy-induced neutropenia.

Implications for nursing: Nurses can use the PCM-N as a rapid and cost-effective tool for monitoring symptoms of neutropenia in patients with cancer.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects*
  • Drug Monitoring* / methods
  • Drug Monitoring* / nursing
  • Drug Monitoring* / standards
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Neoplasms / nursing*
  • Neutropenia / chemically induced*
  • Neutropenia / nursing
  • Oncology Nursing / methods*
  • Psychometrics / standards
  • Quality of Life
  • ROC Curve
  • Reproducibility of Results

Substances

  • Antineoplastic Agents