Psychometric Evaluation of the Ostomy Adjustment Scale in Chinese Cancer Patients with Colostomies

Background: The Ostomy Adjustment Scale (OAS) has been widely used to measure the adjustment to an ostomy. Although the instrument had been used among subjects from various backgrounds, psychometric properties had never been evaluated. Objectives: The primary aim of this study was to test the psychometric properties of the OAS among Chinese colostomy patients, and the secondary aim was to examine the predictors of colostomy adjustment. Methods: The translated OAS was tested using a convenience sample of 207 colostomy patients from a university-affiliated cancer center in China. Results: The content validity of the OAS was 0.91. Four items were removed during the process of validity and reliability testing. The final Chinese version of the OAS consisted of 30 items (OAS-C-30) with 4 subscales as follows: negative affect, normal functioning, therapy attitude, and life worry. The Cronbach's α, the intraclass correlation, and a split-half Spearman-Brown coefficient for the total scale were 0.915, 0.902 and 0.871, respectively. Multiple linear regression analysis showed that stoma self-efficacy, stoma acceptance, excessive aerofluxus, constipation, family relationship, and body image loss were the predictors of adjustment among Chinese colostomy patients. Conclusion: The OAS-C-30 has been proven to be a valid and reliable measure to assess the adjustment among colostomy patients. Implications for Practice: The OAS-C-30 is a useful instrument to assess and monitor the level of adjustment among patients with permanent colostomies. The identified predictor variables for adjustment also provide insights to clinicians to assist them in planning interventions to facilitate the adjustment of colostomy patients.