Development and validation of the axillary web syndrome classification scale

Abstract

• Objective: To develop and validate a clinical scale for the classification of axillary web syndrome (EC-SRA). Methods: This
  is an exploratory, methodological development research with a quantitative approach. The study included 23 women
  undergoing surgical treatment for breast cancer who received axillary approaches and were treated at the physiotherapy
  outpatient clinic of the Mastology Service of Hospital das Clínicas (Cora/HC), and signed the informed consent form.
  Women with alterations or impairment of the shoulder ipsilateral to the breast operated prior to surgical treatment were
  excluded. The methodology for constructing the instrument was divided into stages: 1. Establishment of the conceptual
  structure; 2. Construction and structuring of EC-SRA items; 3. Content validation (by seven experts); 4. Assessment of
  usability and refinement of the instrument; and 5. Analysis of results. The research was conducted between April 2020 and
  August 2021. Results: The calculated content validity index was 0.97, indicating a high level of agreement among experts,
  since values of at least 0.80 are considered acceptable. The reliability of the instrument, verified through internal consistency measured by calculating Cronbach’s alpha among evaluators, was 0.8, a value considered ideal. The overall internal
  consistency of the instrument was considered satisfactory. The analysis of agreement of the instrument measured by the
  evaluators showed a general correlation coefficient of 0.986, with a p<0.001. Conclusion: Based on the usability assessment, it is possible to conclude that the EC-SRA is capable of measuring the cord and reproducing consistent, stable, and
  accurate results, presenting reliability. The EC-SRA, therefore, has the potential to be widely used and avoid the merely
  subjective assessment of the SRA, which is the current clinical reality.