The Surgical Patient’s Anxious Condition Assessment Scale demonstrates good factorial structure

The objective was to develop the Surgical Patient’s Anxious Condition Assessment Scale (SPAC) to provide evidence supporting clinical non-pharmacological interventions. A qualitative study was conducted at Leshan People’s Hospital in Sichuan Province, China. Semi-structured interviews were carried out with 11 patients to create an item pool for the scale. This was followed by a Delphi expert inquiry ( N = 16) and a pilot test ( N = 30), with subsequent adjustments to the scale based on patient feedback. Surgical inpatients from the same hospital were surveyed using the scale, and an exploratory factor analysis (EFA) was performed on a random sample ( N = 376). A confirmatory factor analysis (CFA) was conducted on a second sample ( N = 386).Reliability and validity were assessed using convergent validity (correlation analysis between SPAC and STAI-S, n = 57). The final version of the SPAC consists of 10 items. The Cronbach’s alpha coefficient for the total scale was 0.893. Results from exploratory factor analysis (EFA) showed a Kaiser-Meyer-Olkin(KMO) measure of sampling adequacy of 0.937 and an approximate chi-square value of 2144.652 for Bartlett’s sphericity test (df = 45, p < 0.001), indicating that the data were highly suitable for factor analysis. Since the items were in a three-point Likert scale format and thus constituted an ordinal categorical variable, the analysis was based on a polychoric correlation matrix, and principal axis factor analysis (PAF) was used to extract factors. Based on the criterion of eigenvalues greater than 1, a single common factor was extracted, accounting for 62.3% of the cumulative variance. The factor loadings for each item ranged from 0.71 to 0.82, all exceeding the acceptance criterion of 0.40.The CFA results indicated a chi-square of freedom ratio of 4.080, a Comparative Fit Index (CFI) of 0.942, a Tucker-Lewis Index (TLI) of 0.926, a Root Mean Square Error of Approximation (RMSEA) of 0.058, and a Standardized Root Mean Square Residual (SRMR) of 0.067, Convergent validity test (correlation between SPAC and STAI-S: r = 0.424, p = 0.001).The scale demonstrates good construct validity and internal consistency. Overall, the SPAC shows satisfactory psychometric properties and may serve as a screening measure for surgery-related cognitive worry. Nevertheless, its clinical utility is preliminary and awaits validation of predictive validity and cut-off scores. For now, the scale should be used mainly for research purposes.