Development and Factorial Structure of the Surgical Patient’s Anxious Condition Assessment Scale (SPAC)

Development and Factorial Structure of the Surgical Patient’s Anxious Condition Assessment Scale (SPAC) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Development and Factorial Structure of the Surgical Patient’s Anxious Condition Assessment Scale (SPAC) Wei Li, jie Yang, li jun wang, li zhou, fengjiao xu, hui xiong, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9202055/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Objective: The objective was to develop the Surgical Patient’s Anxious Condition Assessment Scale (SPAC) to provide evidence supporting clinical non-pharmacological interventions. Methods: 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). Results: The finalized SPAC Assessment Scale included three dimensions: medical provider, process and effect, and hospital environment, comprising a total of ten items. The overall Cronbach’s alpha coefficient was 0.893. The EFA revealed a Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy of 0.892 and a Bartlett’s Test of Sphericity, which yielded a chi-square value of 2886.217, df = 45, p < 0.001. Principal Component Analysis (PCA) identified three common factors, accounting for 63.20% of the cumulative variance. The rotated factor structure was distinct, with each item demonstrating high loadings (> 0.7) on its respective factor and minimal cross-loading. The CFA results indicated a chi-square/degrees of freedom ratio of 2.87, a Comparative Fit Index (CFI) of 0.942, a Tucker-Lewis Index (TLI) of 0.928, a Root Mean Square Error of Approximation (RMSEA) of 0.078, and a Standardized Root Mean Square Residual (SRMR) of 0.048, confirming a very good fit of the three-factor model to the data. Conclusion: The SPAC assessment scale exhibits excellent factorial validity and internal consistency. It provides a reliable clinical tool for identifying and addressing anxiety among surgical patients, facilitating standardized perioperative psychological management. Psychometrics Anxiety Surgical Procedures Operative Reproducibility of Results Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 04 Apr, 2026 Reviewers invited by journal 02 Apr, 2026 Editor assigned by journal 02 Apr, 2026 Submission checks completed at journal 29 Mar, 2026 First submitted to journal 29 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9202055","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":617607054,"identity":"edfc468c-b92a-48aa-9528-dad9a772b6ae","order_by":0,"name":"Wei Li","email":"","orcid":"","institution":"People's Hospital of Leshan","correspondingAuthor":false,"prefix":"","firstName":"Wei","middleName":"","lastName":"Li","suffix":""},{"id":617607059,"identity":"efbe577d-cfa4-4dfb-853b-15c1bff5c549","order_by":1,"name":"jie Yang","email":"","orcid":"","institution":"People's Hospital of 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(SPAC)","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"discpsy","sideBox":"Learn more about [Discover Psychology](https://www.springer.com/44202)","snPcode":"","submissionUrl":"","title":"Discover Psychology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Psychometrics, Anxiety, Surgical Procedures, Operative, Reproducibility of Results","lastPublishedDoi":"10.21203/rs.3.rs-9202055/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9202055/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective:\u003c/h2\u003e \u003cp\u003eThe objective was to develop the Surgical Patient\u0026rsquo;s Anxious Condition Assessment Scale (SPAC) to provide evidence supporting clinical non-pharmacological interventions.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eA qualitative study was conducted at Leshan People\u0026rsquo;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\u0026thinsp;=\u0026thinsp;16) and a pilot test (N\u0026thinsp;=\u0026thinsp;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\u0026thinsp;=\u0026thinsp;376). A confirmatory factor analysis (CFA) was conducted on a second sample (N\u0026thinsp;=\u0026thinsp;386).\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eThe finalized SPAC Assessment Scale included three dimensions: medical provider, process and effect, and hospital environment, comprising a total of ten items. The overall Cronbach\u0026rsquo;s alpha coefficient was 0.893. The EFA revealed a Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy of 0.892 and a Bartlett\u0026rsquo;s Test of Sphericity, which yielded a chi-square value of 2886.217, df\u0026thinsp;=\u0026thinsp;45, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001. Principal Component Analysis (PCA) identified three common factors, accounting for 63.20% of the cumulative variance. The rotated factor structure was distinct, with each item demonstrating high loadings (\u0026gt;\u0026thinsp;0.7) on its respective factor and minimal cross-loading. The CFA results indicated a chi-square/degrees of freedom ratio of 2.87, a Comparative Fit Index (CFI) of 0.942, a Tucker-Lewis Index (TLI) of 0.928, a Root Mean Square Error of Approximation (RMSEA) of 0.078, and a Standardized Root Mean Square Residual (SRMR) of 0.048, confirming a very good fit of the three-factor model to the data.\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e \u003cp\u003eThe SPAC assessment scale exhibits excellent factorial validity and internal consistency. It provides a reliable clinical tool for identifying and addressing anxiety among surgical patients, facilitating standardized perioperative psychological management.\u003c/p\u003e","manuscriptTitle":"Development and Factorial Structure of the Surgical Patient’s Anxious Condition Assessment Scale (SPAC)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-07 18:02:31","doi":"10.21203/rs.3.rs-9202055/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"323235273383288244195895851046005886714","date":"2026-04-04T17:08:39+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-02T05:12:44+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-02T04:35:33+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-29T08:46:57+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Psychology","date":"2026-03-29T08:42:39+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"discpsy","sideBox":"Learn more about [Discover Psychology](https://www.springer.com/44202)","snPcode":"","submissionUrl":"","title":"Discover Psychology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c506707c-bb8f-477f-aedd-3b2a19de4e14","owner":[],"postedDate":"April 7th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-07T18:02:31+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-07 18:02:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9202055","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9202055","identity":"rs-9202055","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}