Preliminary development and validation of a perioperative patient-reported experience measure for gynaecological tumours: three rounds of survey development

Abstract Objectives To develop a patient-reported questionnaire for perioperative experience in gynaecological tumors, and preliminarily verify its reliability, validity, and discriminative ability. Study setting and design Cross-sectional, national multicenter study. Data sources and analytic sample The Perioperative Patient-reported Experience Measure for Gynaecological Tumors (PREMs-GTP) was developed through a rigorous multi-phase methodological framework. The initial item bank was generated from a scoping review and qualitative interviews with patients and clinical experts. The item pool was further refined through two rounds of Delphi expert consultation and a pilot investigation. Three sequential field surveys were then administered across three hospitals to screen items and explore the underlying construct of the scale. Psychometric assessments were performed stepwise. variability analysis and exploratory factor analysis (EFA) were applied to eliminate redundant items, while confirmatory factor analysis (CFA) was subsequently used to verify the structural validity of the finalized scale. Principal findings A conceptual model established in the preliminary analysis covered six domains: information delivery, environmental awareness, communication and interaction, service experience, care and support, symptom care. The original scale contained 129 candidate items, and a total of 1,020 patients with gynaecological tumors were recruited across three sequential survey waves. After pilot testing and expert consultation, the item pool was trimmed to 106 entries. The first survey wave ( n = 153) further narrowed the scale down to 60 items, and exploratory factor analysis performed on data from the second wave ( n = 326) refined the instrument into a 33-item scale with a stable factor structure. The third wave ( n = 541) comprehensively examined the full psychometric characteristics of this 33-item scale. The finalized PREMs-GTP consists of 33 items distributed across six dimensions, with satisfactory internal reliability, construct validity, discriminant validity, and model fit indices. Conclusions This study developed a dedicated measurement tool for evaluating perioperative care experiences among patients with gynaecological tumors. The PREMs-GTP exhibited strong reliability and sound construct validity within the Chinese healthcare setting. As a practical instrument, it facilitates routine clinical assessment of nursing quality, enable the identification of issues, and supports targeted quality improvement interventions. Furthermore, the present findings lay a rigorous empirical foundation for nationwide programs focused on elevating care standards and patient-reported experiences in gynaecological oncology.