Development and validation of a symptom cluster assessment scale for patients with lumbar degenerative disease after unilateral biportal endoscopy surgery based on the symptom experience model.

BACKGROUND

There is a lack of specific tools to assess the complex symptom clusters experienced by patients after unilateral biportal endoscopy (UBE) surgery for lumbar degenerative disease (LDD), particularly from the multidimensional perspective of the Symptom Experience Model.

AIMS: This study aimed to develop and validate a new symptom cluster assessment scale for LDD patients following UBE surgery, based on the Symptom Experience Model.

METHODS

The initial scale items were developed through a systematic literature review, Delphi expert consultation, and patient cognitive interviews. Convenience sampling recruited 163 patients with LDD who had undergone UBE surgery from a tertiary hospital in Guangzhou, China, between April and September 2025. Item refinement was performed through item analysis and exploratory factor analysis (EFA). The scale's reliability and validity were then evaluated.

RESULTS

The final scale consisted of 15 items across five dimensions. Exploratory factor analysis indicated that these dimensions explained 61.62% of the total variance. The scale-level content validity index for universal agreement (S-CVI/UA) was 0.83, and the average scale-level content validity index (S-CVI/Ave) was 0.90. The total scale score showed a positive correlation with the Oswestry Disability Index (ODI) (r = 0.486, P < 0.01). The overall scale demonstrated good internal consistency, with a Cronbach's alpha coefficient of 0.823. Split-half reliability coefficients ranged from 0.725 to 0.790.

CONCLUSION

The newly developed symptom cluster assessment scale demonstrates robust reliability and validity. It shows promise as a clinically useful tool for assessing symptom burden in patients with LDD during the postoperative period following UBE surgery.