Adaptation of Cancer Survivors’ Unmet Needs Measure into Turkish: A Validity and Reliability Study

Year 2023, , 264 - 272, 28.12.2023

Gülyeter Erdoğan Yüce , Gamze Muz , Ayser Döner

https://doi.org/10.31125/hunhemsire.1246068

Abstract

Aim: This study evaluates the psychometric properties of the Cancer Survivors’ Unmet Needs Measure (Tr-CaSUN), adapted into Turkish.
Material and Methods: This methodological study was conducted with 350 cancer survivors who were followed up in the oncology center of a university hospital. Data were collected between December 2020 and September 2021. A procedure including forward translation, synthesis, back translation, and expert evaluation was followed for the cross-cultural adaptation of CaSUN. The construct validity of the scale was evaluated by Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), criterion validity was assessed by Hospital Anxiety Depression Scale and The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and reliability was evaluated by internal consistency coefficient and test-retest method.
Results: The content validity index of the scale was determined as 0.96. While adapting the scale, some items were removed to obtain a stronger structure and improve the fit. A model consisting of five factors and 21 items explaining 78.5% of the variance was obtained with EFA. The model had a good fit based on CFA. The Cronbach's alpha coefficient for the overall scale was 0.93, and the test-retest reliability correlation coefficients were between 0.73 and 0.93. Tr-CaSUN showed moderate and significant correlations with anxiety, depression, and quality of life scales.
Conclusion: Tr-CaSUN is a valid and reliable tool that can be used to assess the unmet needs of cancer survivors.

Keywords

Cancer, cancer survivors, reliability, supportive care needs, unmet needs, validity

Kanserden Kurtulanların Karşılanmayan İhtiyaçları Ölçeğinin Türkçeye Uyarlanması: Geçerlik ve Güvenirlik Çalışması

Abstract

Amaç: Bu çalışma, Türkçeye uyarlanmış Kanserden Kurtulanların Karşılanmayan İhtiyaçları Ölçeği'nin (Tr-CaSUN) psikometrik özelliklerini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: Metodolojik tasarıma sahip bu çalışma bir üniversite hastanesinin onkoloji merkezinde ayaktan takip edilen 350 kanserden sağ kalan birey ile yürütülmüştür. Veriler Aralık 2020 ve Eylül 2021 tarihleri arasında toplanmıştır. CaSUN'un kültürler arası adaptasyonu için ileri çeviri, sentez, geri çeviri ve uzman değerlendirmesini içeren bir prosedür izlenmiştir. Ölçeğin yapı geçerliği Açımlayıcı Faktör Analizi (AFA) ve Doğrulayıcı Faktör Analizi (DFA), ölçüt geçerliği Hastane Anksiyete Depresyon Ölçeği ve Avrupa Kanser Araştırma ve Tedavi Örgütü Yaşam Kalitesi Ölçeği, güvenirliği ise, iç tutarlılık katsayısı ve test-tekrar test yöntemi ile değerlendirilmiştir.
Bulgular: Ölçeğin kapsam geçerlik indeksi 0.96 olarak belirlenmiştir. Ölçek uyarlanırken daha güçlü bir yapı elde etmek ve uyumu iyileştirmek için bazı maddeler çıkarılmıştır. AFA ile beş faktör ve 21 maddeden oluşan ve varyansın %78.5'ini açıklayan bir model elde edilmiştir. DFA ile modelin iyi bir uyuma sahip olduğu belirlenmiştir. Ölçeğin geneli için Cronbach alfa katsayısı 0.93 ve test-tekrar test güvenirliği korelasyon katsayıları 0.73 ile 0.93 arasında bulunmuştur. Ölçek, anksiyete, depresyon ve yaşam kalitesi ölçekleri ile orta düzeyde ve anlamlı korelasyon göstermiştir.
Sonuç: Tr-CaSUN'un, kanserden sağ kalanların karşılanmamış ihtiyaçlarını değerlendirmek için kullanılabilecek geçerli ve güvenilir bir araç olduğu belirlenmiştir.

Keywords

Destekleyici bakım ihtiyaçları, geçerlik, güvenirlik, kanser, kanserden kurtulanlar, karşılanmamış ihtiyaçlar

References

• 1. Stewart B, Wild CP. World Cancer Report 2014 [Internet]. 2014 [Erişim Tarihi 10 Mart 2022]. Erişim adresi: http://publications.iarc.fr/Non-Series-Publications/World-Cancer-Reports/World-Cancer-Report-2014
• 2. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49.
• 3. National Cancer Institute. NCI Dictionary of Cancer Terms, Survivor [Internet]. 2022 [Erişim Tarihi 10 Nisan 2023]. Erişim adresi: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/survivor
• 4. National Cancer Institute. NCI Dictionary of Cancer Terms, Survivorship [Internet]. 2022 [Erişim Tarihi 10 Mart 2022]. Erişim adresi: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/survivorship
• 5. A Duijts SF, van Egmond MP, Spelten E, van Muijen P, Anema JR, van der Beek AJ. Physical and psychosocial problems in cancer survivors beyond return to work: a systematic review. Psycho‐oncology. 2014;23(5):481-92.
• 6. Mullen E, Mistry H. Managing Cancer Survivorship Issues. J Nurse Pract. 2018;14(4):337–43.
• 7. Pongthavornkamol K, Lekdamrongkul P, Pinsuntorn P, Molassiotis A. Physical Symptoms, Unmet Needs, and Quality of Life in Thai Cancer Survivors after the Completion of Primary Treatment. Asia-Pacific J Oncol Nurs. 2019;6(4):363.
• 8. Geller BM, Vacek PM, Flynn BS, Lord K, Cranmer D. What are cancer survivors’ needs and how well are they being met? J Fam Pract. 2014;63(10):7-16.
• 9. Şengün İnan F, Üstün B. Experiences of Turkish survivors of breast cancer: Neuman systems model perspective. Japan J Nurs Sci. 2016;13(4):466–77.
• 10. Ness S, Kokal J, Fee-Schroeder K, Novotny P, Satele D, Barton D. Concerns across the survivorship trajectory: results from a survey of cancer survivors. Oncol Nurs Forum [Internet]. 2013;40(1):35–42.
• 11. Cheng KKF, Wong WH, Koh C. Unmet needs mediate the relationship between symptoms and quality of life in breast cancer survivors. Support Care Cancer. 2016;24(5):2025–33.
• 12. Molassiotis A, Yates P, Li Q, So WKW, Pongthavornkamol K, Pittayapan P, et al. Mapping unmet supportive care needs, quality-of-life perceptions and current symptoms in cancer survivors across the Asia-Pacific region: results from the International STEP Study. Ann Oncol. 2017;28(10):2552–8.
• 13. Miroševič Š, Prins JB, Selič P, Zaletel Kragelj L, Klemenc Ketiš Z. Prevalence and factors associated with unmet needs in post-treatment cancer survivors: A systematic review. Eur J Cancer Care (Engl). 2019;28(3):e13060.
• 14. Lisy K, Langdon L, Piper A, Jefford M. Identifying the most prevalent unmet needs of cancer survivors in Australia: A systematic review. Asia Pac J Clin Oncol. 2019;15(5):68-78.
• 15. Jiao M, Hall AE, Nolte L, Piper A, Lisy K, Jefford M. A rapid review of needs assessment tools for post-treatment cancer survivors. Eur J Cancer Care (Engl). 2018;27(2):e12764.
• 16. Komatsu H, Yagasaki K, Sato Y, Arao H, Yamamoto S, Hayashida T. Evaluation of the Japanese Version of the Cancer Survivors’ Unmet Needs Scale. Asia-Pacific J Oncol Nurs. 2020;7(2):167–73.
• 17. Keeman MC, Bolman CAW, Mesters I, Willems RA, Kanera IM, Lechner L. Psychometric properties of the Dutch extended Cancer Survivors’ Unmet Needs measure (CaSUN-NL). Eur J Cancer Care (Engl). 2018;27(2):e12807.
• 18. Hodgkinson K, Butow P, Hunt GE, Pendlebury S, Hobbs KM, Lo SK, et al. The development and evaluation of a measure to assess cancer survivors’ unmet supportive care needs: the CaSUN (Cancer Survivors’ Unmet Needs measure). Psychooncology. 2007;16(9):796–804.
• 19. Martínez P, Andreu Y, Conchado A. Psychometric Properties of the Spanish Version of the Cancer Survivors’ Unmet Needs (CaSUN-S) Measure in Breast Cancer. Psicothema. 2021;33(1):155–63.
• 20. Li Q, Xu Y, Lin Y, Li J, Huang W, Chen Y. Psychometric properties of the Chinese version of the cancer survivors’ unmet needs measure. Eur J Oncol Nurs. 2020;46:101772.
• 21. Fang SY, Cheng HR, Lin CY. Validation of the modified Chinese Cancer Survivor’s Unmet Needs (CaSUN-C) for women with breast cancer. Psychooncology. 2018;27(1):236–42.
• 22. Kang D, Lee G, Kim S, Nam H, Kong S, Shim S, et al. Psychometric Validation of the Korean Version of the Cancer Survivors’ Unmet Needs (CaSUN) Scale Among Korean Non-Small Cell Lung Cancer (NSCLC) Survivors. Cancer Res Treat. 2023;55(1):61-72.
• 23. Lekdamrongkul P, Pongthavornkamol K, Molassiotis A, Dechpichai P, Pinsuntorn P. Translation and psychometric testing of the Thai version of cancer survivors’ unmet needs measure among cancer survivors. Asia Pac J Oncol Nurs. 2022;9(9):100083.
• 24. Xing W, So WKW, Choi KC, Wong CL, Tong M, Choy YP, et al. Translation and psychometric testing of Cancer Survivors’ Unmet Needs, Chinese version. Asia Pac J Clin Oncol. 2019;15(5):42–6.
• 25. Sütsünbüloğlu E. Kolorektal Kanserli Hastalarda Perioperatif Hemşire Danışmanlığının Hasta Sonuçlarına Etkisi [Doktora tezi]. İzmir: Dokuz Eylül Üniversitesi; 2021.
• 26. Miroševič Š, Selič-Zupančič P, Prins J, Homar V, Klemenc-Ketiš Z. Psychometric properties of the Slovenian version of the Cancer Survivors’ Unmet Needs (CaSUN-SL) measure in post-treatment cancer survivors. BMC Psychol. 2022;10(1):175.
• 27. Kıyak M, Özkaraman A. Kanser Sonrası Yaşam: Sağ Kalanların Gereksinimleri. İzmir Katip Çelebi Üniversitesi Sağlık Bilim Fakültesi Derg. 2022;7(1):99–104.
• 28. Akkuzu G, Kurt G, Guvenc G, Kok G, Simsek S, Dogrusoy S, et al. Learning Needs of Gynecologic Cancer Survivors. J Cancer Educ. 2018;33(3):544–50
• 29. Kline RS. Principles and practice of structural equation modeling. NewYork: The Guilford Press; 2011.
• 30. Field A. Discovering statistics using SPSS. Thousand Oaks, CA: Sage; 2009.
• 31. Arifin WN. Sample size calculator [Internet]. 2023 [Erişim Tarihi 10 Nisan 2023]. Erişim adresi:http://wnarifin.github.io
• 32. Fayers P, Aaronson N, Bjordal K, Groenvold D, Curran A. Bottomley, on behalf of the EORTC Quality of Life Group EORTC QLQ-C30 Scoring Manual. 3rd edition. Brussels: EORTC; 2001.
• 33. Cankurtaran ES, Ozalp E, Soygur H, Ozer S, Akbiyik DI, Bottomley A. Understanding the reliability and validity of the EORTC QLQ-C30 in Turkish cancer patients. Eur J Cancer Care (Engl). 2008;17(1):98–104.
• 34. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.
• 35. Aydemir O, Küey L, Kültür S. Hastane anksiyete ve depresyon ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Turk Psikiyatr Derg. 1997;8(4):187–280.
• 36. Acemoğlu H, Aktürk Z. Reliability and validity in medical research. Dicle Tıp Dergisi. 2012; 39(2):316-319.
• 37. Çapık C, Gözüm S, Aksayan S. Intercultural Scale Adaptation Stages, Language and Culture Adaptation: Updated Guideline. FNJN Florence Nightingale Journal of Nursing. 2018;26(3):199-210.
• 38. Davis LL. Instrument review: Getting the most from a panel of experts. Appl Nurs Res. 1992;5(4):194–7.
• 39. Polit DF, Beck CT, Owen S V. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007;30(4):459–67.
• 40. Alpar R. Uygulamalı çok değişkenli istatistiksel yöntemler. Ankara: Delta Yayıncılık; 2016.
• 41. Kaiser HF. A computational starting point for Rao’s canonical factor analysis: Implications for computerized procedures. Educ Psychol Meas. 1974;34(3):691-2.
• 42. Bartlett MS. A note on the multiplying factors for various χ 2 approximations. Journal of the Royal Statistical Society: Series B (Methodological). 1954;16(2):296–8.
• 43. Güriş S, Astar M. Bilimsel araştırmalarda SPSS ile istatistik. İstanbul: Der Yayınları; 2015.
• 44. Costello AB, Osborne J. Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis, Practical Assessment, Research, and Evaluation. 2005;10(7):1-10.
• 45. Tabachnick BG, Fidell LS. Çok değişkenli istatistiklerin kullanımı. Ankara: Nobel Akademik Yayıncılık; 2015.
• 46. Hooper D, Coughlan J, Mullen M. Structural equation modeling: guidelines for determining model fit. Electron J Bus Res Methods. 2008;6(1):53–60.
• 47. De Vet H, Terwee C, Mokkink L, Knol D. Measurement in medicine, practical guides to biostatistics and epidemiology. Cambridge. New York; 2011.
• 48. Polit D, Beck C. Nursing research: generating and assessing evidence for nursing practice. Eleventh e. Philadelphia: Wolters Kluwer; 2021.
• 49. Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016;15(2):155-63.
• 50. Rusticus S. Content Validity. Encycl Qual Life Well-Being Res. 2014;1261–2.
• 51. Özdamar K. Paket programlar ile istatistiksel veri analizi-1: SPSS-MINITAB. Eskişehir: Nisan Kitapevi; 2013.