Stoma Acceptance and Valuable Actions Scale for Colorectal Cancer Patients With Permanent Stomas: A Reliability and Validity Study

AIMS: This study aimed to develop and evaluate the psychometric properties of the Stoma Acceptance and Valuable Actions Scale (SAVAS), which measures the degree of stoma acceptance and the extent of personal actions aligned with values among colorectal cancer (CRC) patients with permanent stomas. BACKGROUND: Acceptance of a stoma and the enactment of actions consistent with personal values are crucial for psychosocial adaptation following stoma formation. However, these aspects have not been adequately explored, largely due to the lack of valid and reliable measurement tools. DESIGN: This is an instrument development and validation study with a cross-sectional design. METHODS: Items were created through a literature review and guided by Acceptance and Commitment Therapy (ACT) theory. Content validity was evaluated using two rounds with a consensus panel of 12 experts. The psychometric properties of the SAVAS were tested using two separate convenience samples (Ns = 201 and 213). Key aspects assessed included content validity, internal consistency, test-retest reliability, convergent validity, discriminant validity and concurrent validity. RESULTS: The content validity of the SAVAS was high at 0.921, and a two-factor solution emerged from the final 12 items: stoma acceptance and valuable actions. The Cronbach's alpha for the overall scale and its factors was strong (0.888 for the total scale, 0.879 for stoma acceptance and 0.872 for valuable actions). Acceptable test-retest reliability was demonstrated, with values of 0.939, 0.872 and 0.864, respectively. The study also confirmed good convergent, concurrent and discriminant validity for the SAVAS. CONCLUSION: The SAVAS demonstrated good validity and reliability for assessing stoma acceptance and valuable actions among CRC patients with permanent stomas. Future observational and interventional studies are needed to further assess and refine the psychometric properties of the SAVAS.