<p>Sample characteristics by research phase.</p>

Background
Patient engagement in cancer care is increasingly recognized as essential for improving clinical outcomes. Nurses play a crucial role in fostering patient engagement, yet there is a lack of validated instruments to assess which nursing behaviors are most effective in promoting engagement from the patient’s perspective.
Objective
This study aimed to develop and test the psychometric characteristics of the Nurses’ Behavioral Engagement Scale, a tool designed to measure nursing behaviors that support patient engagement in oncology settings, from patients’ point of view.
Methods
The study followed a three-phase exploratory sequential mixed-methods design. In the first phase, 53 items were generated based on findings from a previous qualitative study and a systematic review of the literature. In the second phase, the items underwent content validation through a modified e-Delphi procedure with 19 experts in oncology nursing, patient engagement, tool development, and linguistics. Forty-eight items were deemed relevant and tested in the third phase with a sample of 250 cancer patients to evaluate construct validity, internal consistency, and convergent validity.
Results
Exploratory Factor Analysis revealed a four-factor structure, collectively explaining 70.0% of the total variance: Factor 1 – Acknowledgment of Patient’s Uniqueness, Factor 2 – Meeting Patient’s Knowledge Expectations, Factor 3 – Fostering Patient’s Motivation, and Factor 4 – Valuing Patient’s Informal Caregivers. The final Nurses’ Behavioral Engagement Scale comprises 29 items. Internal consistency was excellent, with Cronbach’s alpha coefficients of 0.953, 0.890, 0.942, and 0.920 for the four factors, respectively. The Nurses’ Behavioral Engagement Scale demonstrated significant and meaningful correlations with the Health Care Climate Questionnaire and items assessing satisfaction with nursing care, supporting its convergent validity.
Conclusion
The Nurses’ Behavioral Engagement Scale provides a psychometrically sound measure of nursing behaviors that promote patient engagement in oncology care. This tool has the potential to inform targeted interventions and quality improvement initiatives, ultimately enhancing patient-centered care and improving health outcomes in cancer patients.

背景
患者参与癌症护理日益被视为改善临床结局的关键要素。护士在促进患者参与方面发挥着至关重要的作用，但目前仍缺乏经过验证的测评工具，能够从患者视角评估哪些护理行为最能有效提升患者参与度。
研究目的
本研究旨在开发并检验《护士行为参与量表》（Nurses’ Behavioral Engagement Scale）的心理测量学特征，该工具旨在从患者视角出发，测评肿瘤科环境中支持患者参与的护理行为。
研究方法
本研究采用三阶段探索性序贯混合方法设计。第一阶段，基于既往一项质性研究的结果与系统文献综述，生成了53个条目。第二阶段，通过改良电子德尔菲（e-Delphi）程序开展内容效度检验，共邀请19名肿瘤科护理、患者参与、工具开发及语言学领域的专家参与。最终保留48个相关条目，并在第三阶段纳入250名癌症患者样本进行测试，以评估结构效度、内部一致性与聚合效度。
研究结果
探索性因子分析揭示了四因子结构，累计解释总方差的70.0%：因子1——认可患者独特性（Acknowledgment of Patient’s Uniqueness），因子2——满足患者知识预期（Meeting Patient’s Knowledge Expectations），因子3——激发患者动机（Fostering Patient’s Motivation），因子4——重视患者非正式照护者（Valuing Patient’s Informal Caregivers）。最终版《护士行为参与量表》共包含29个条目。内部一致性表现优异，四个因子的克朗巴赫α系数（Cronbach’s alpha）分别为0.953、0.890、0.942与0.920。该量表与医疗照护氛围问卷（Health Care Climate Questionnaire）及护理满意度测评条目均呈现显著且具有临床意义的相关性，验证了其聚合效度。
结论
《护士行为参与量表》是一款心理测量学性能优良的测评工具，可用于评估肿瘤科护理中促进患者参与的护理行为。该工具有望为针对性干预与质量改进项目提供依据，最终推动以患者为中心的照护，并改善癌症患者的健康结局。