Development And Preliminary Application Of The Chinese Version Of The Reproductive Concerns After Cancer Scale

Objectives1.To translate the Reproductive Concerns After Cancer scale(RCAC)into Chinese,and assess its reliability and validity in Chinese young female cancer survivors.2.Using Chinese version of the Reproductive Concerns After Cancer scale(RCAC)to investigate reproductive concerns of young female cancer patients,and analysis its influencing factors.Methods1.The Chinese version of the RCAC was developed using the standard Functional Assessment of Chronic Illness Therapy(FACIT)translation methodology.Then,a total of 380 patients were selected to fill in questionnaires including general information questionnaire,Patient Health Questionnaire-9,Functional Assessment of Cancer Therapy-General and Chinese version of the Reproductive Concerns After Cancer scale to assess reliability and validity of scale.All participants recruited to were young female cancer survivors who were diagnosed and treated at two tertiary hospitals in Zhengzhou between January 2014 and August 2015.We used Item-analysis to select items.The validity included content validity,exploratory factor analysis,confirmatory factor analysis and convergent validity.Reliability was assessed by using internal consistency and test-retest reliability.2.We recruited young female cancer survivors to study,they were diagnosed and treated at two tertiary hospitals in Zhengzhou between September 2015 and June 2016.A total of 200 patients were selected to fill in questionnaires including general information questionnaire and Chinese version of the Reproductive Concerns After Cancer scale.Results1.According to the results of the Item-analysis,all items of the Chinese version of the RCAC scale between high score group and low score group have statistical significance(P<0.05),what's more,the correlation coefficients between the items and total score of scale were 0.404 ~ 0.697(P< 0.05).The Scale-Content Validity Index(S-CVI)was 0.91,the Item-Content Validity Index(I-CVI)ranged from 0.80 to 1.00.Exploratory factor analysis extracted six factors,which could explain 71.118% of the total variance.The confirmatory factor analysis revealed a good fit model:?2/df =1.512;Comparative Fit Index(CFI)was 0.984;Goodness of Fit Index(GFI)was 0.975;Incremental Fit Index(IFI)was 0.984;Tucker-Lewis Index(TLI)was 0.979;Root Mean-square Residual(RMR)was 0.016;Root Mean Square Error of Approximation(RMSEA)was 0.025.The score of the Chinese version of RCAC was positively correlated with the score of the PHQ-9(r=0.547,P<0.001)and negatively correlated with the score of FACT-G(r=-0.519,P<0.001),which indicated acceptable convergent validity.The Cronbach's ? for the total scale was 0.792,the Cronbach's ? for six dimensions ranged from 0.720 to 0.864.The test-retest reliability was 0.956 for the overall scale,and 0.815~0.890 for the six dimensions.2.The overall reproductive concerns score for young female cancer patients was 57.30±7.82.Each dimension scores from high to low in turn were: children health(11.15±1.62),personal health(10.53±1.88),pregnancy ability(9.41±1.91),infertility acceptance(9.27±2.99),partner/spouse informed(9.08±3.06),pregnancy(8.03±2.31).Educational level,number of children,fertility desire and types of cancer entered the multiple regression equation and explained variance of 35.0%.Compared to breast cancer patients,thyroid cancer patients with lower level of reproductive concerns(?=-0.244,t=-2.886,P=0.004),while reproductive concerns scores of the colorectal cancer and gynecological cancer patients showed no difference.Conclusion1.The translation and cross-cultural adaption of the RCAC into Chinese was successful.The Chinese version of the RCAC has suitable factor structure and psychometric properties for reproductive concerns evaluation in young female cancer patients.Introduction of this scale would help medical staff to quickly identify cancer patients' psychological state,and provide the basis for intervention measures.2.Young female cancer patients have higher reproductive concerns,which is influenced by various factors.Educational level,number of children,fertility desire and types of cancer are major influence factors of reproductive concerns.Therefore,in order to promote patients' physical and mental health and improve the quality of life,health care workers should give patients fertility-associated information and adopt effective mental health improvement strategies.