Development and initial validation of a questionnaire to assess patients’ perception of protective isolation following haematopoietic stem cell transplantation

Abstract

The aim of this study was to develop and psychometrically test a questionnaire assessing patients’ perception of protective isolation following haematopoietic stem cell transplantation (HSCT). The conceptual framework for developing the questionnaire was a three‐dimensional model that emerged from a metasynthesis: isolation‐related suffering, relationship with oneself and relationship with others. Item selection was performed through a focus group, comparison with the findings of two phenomenological studies, and content validity with 22 experts. Cognitive interviews with five patients were used to verify face validity. A validation study was conducted in 10 Italian centres, all members of the Italian Group of stem cell transplant (GITMO). Patients completed the questionnaires between 7 and 9 days post‐transplant. Dimensionality was tested through exploratory factor analysis (EFA). A total of 17 items yielded a content validity index (CVI) of 0.88. Participants included 186 adult patients receiving autologous (48%) or allogeneic (52%) HSCT in protective isolation. The EFA yielded a three‐factor solution, explaining 55% of the variance. The scale showed adequate psychometric properties, with the exception of three items, which were eliminated. Future studies should test the psychometric properties of the questionnaire through confirmatory factor analysis and verify its transcultural validity.

Living with cancer in the COVID‐19 pandemic: An Italian survey on self‐isolation at home

“…Participants reported substantial problems in relating to significant others, as shelter at home prevented them from being close to non-cohabitant loved ones, and increased their feelings of detachment, in the same way as does protective isolation (Biagioli et al, 2019a). Compared to the latter situation, the participants felt more cut off from the world and more imprisoned, and they experienced less serenity and less of an advantage in looking at life from a new perspective (Biagioli et al, 2019a). The patients who experienced greater problems in their relationship with others were those with a lower level of education, in line with previous studies underlining the buffering role of education in fostering social cognitive activities while isolated (Biagioli et al, 2019b).…”

“…Perceived isolation was measured using the ISOLA scale (Biagioli et al, 2019a). This is a 14‐item self‐reported questionnaire to assess the perception of being in protective isolation.…”

“…It was originally developed to collect the isolation experiences of patients with haematological malignancies undergoing haematopoietic stem cell transplantation (HSCT). Its construct validity has been tested through exploratory factor analysis (EFA), and three dimensions have been found: isolation‐related suffering (F1), problems in relationships with others (F2) and difficulties in one's relationship with oneself (F3) (Biagioli et al, 2019a). Participants are asked to indicate the extent to which they feel isolated, on a scale ranging from 1 (not at all) to 5 (completely).…”

“…The study variables were described using descriptive statistics (frequency, percentage, range, median, mean and standard deviation [ SD ]). The construct validity of the ISOLA scale in the context of being isolated at home, which was hypothesised to be similar to the original version (Biagioli et al, 2019a), was tested through confirmatory factorial analysis (CFA) using a robust estimator (MLr). To evaluate the fit of the model, the following indices were considered: chi‐square ( χ 2 ), the root mean square error of approximation (RMSEA; values ≤0.06 indicate a good fit), the comparative fit index (CFI; values ≥0.90 indicate a good fit), the Tucker and Lewis index (TLI; values ≥0.90 indicate a good fit) and the standardised root mean square residual (SRMR; values ≤0.08 indicate a good fit) (Muthén & Muthén, 1998‐2017).…”

Factors influencing the perception of protective isolation in patients undergoing haematopoietic stem cell transplantation: A multicentre prospective study

“…Perception of protective isolation was measured using the ISOLA scale (Biagioli et al, ). This is a 14‐item self‐report questionnaire assessing three dimensions: isolation‐related suffering, relationship with oneself and relationship with others.…”