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Kang SJ, An HJ, Hwang WY, Lee H, Kim Y. Translation and psychometric evaluation of the Korean version of the Reproductive Concerns After Cancer Scale (RCAC). BMC Nurs 2024; 23:518. [PMID: 39075411 PMCID: PMC11287844 DOI: 10.1186/s12912-024-02171-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 07/11/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Improving cancer survival rates highlights post-treatment fertility implications for reproductive-aged women. To provide fertility care for cancer survivors, nurses need instruments to assess and communicate reproductive concerns with cancer survivors and healthcare providers. This study aimed to translate the Reproductive Concerns after Cancer Scale (RCAC) into Korean and examine its psychometric properties in young female cancer survivors in South Korea. METHODS The RCAC was translated into Korean, involving expert bilingual translators for initial translation and reverse translation for cultural and semantic accuracy. In detail, the RCAC was translated into Korean and evaluated in a preliminary study involving 10 cancer survivors. Subsequently, a revised version of the instrument was administered to 182 cancer survivors and a psychometric evaluation was conducted. The process included verifying content validity, and then assessing construct validity using exploratory factor analysis and criterion validity. The reliability of the instrument was quantified by measuring its internal consistency using Cronbach's alpha. RESULTS The translated RCAC demonstrated an item-level content validity index of 1.0 and a scale-level index of 1.0. The content was finalized based on preliminary survey findings, which revealed that all participants thought the instrument was clear. The Korean version of the RCAC demonstrated a satisfactory level of validity per exploratory factor analysis, which resulted in a 14-item instrument consisting of three subscales: "fertility potential" (six items), "health problem" (five items), and "acceptance" (three items). The items and subscales explained 57.6% of the variance. Criterion validity was confirmed through an analysis of the correlation between the Korean version of the RCAC and both the FACT-G (r = -0.36, p < .001) and PHQ-9 (r = 0.38, p < .001). Cronbach's alpha coefficient of the Korean version of the RCAC was 0.83. CONCLUSIONS The Korean version of the RCAC is a valid and reliable instrument for assessing reproductive concerns in female cancer survivors. Thus, this instrument can be used to provide tailored care to female cancer survivors of reproductive age by clarifying and assess their reproductive concerns. This may support the development of guidelines or policies to provide care for those with reproductive concerns who require nursing care.
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Affiliation(s)
- Sook Jung Kang
- College of Nursing, Ewha Womans University, #203-2 Hellen Hall, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, 03760, Republic of Korea
| | - Hae Jeong An
- College of Nursing, Ewha Womans University, #203-2 Hellen Hall, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, 03760, Republic of Korea
| | - Woon Young Hwang
- College of Nursing, Ewha Womans University, #203-2 Hellen Hall, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, 03760, Republic of Korea
| | - Hyerim Lee
- College of Nursing, Ewha Womans University, #203-2 Hellen Hall, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, 03760, Republic of Korea
| | - Yoonjung Kim
- College of Nursing, Konyang University Medical Campus, #209, 158, Gwanjeodong-Ro, Seo-Gu, Daejeon, 35365, Korea.
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He X, Wu Y, Zhou Y, Chen Q, Li X, Fan X, Xia C, Ma J, Han J, Han X. Reproductive concerns and its correlation with fear of recurrence and level of family support in patients of childbearing age with gynecologic malignancies. Reprod Health 2024; 21:86. [PMID: 38886725 PMCID: PMC11181552 DOI: 10.1186/s12978-024-01827-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 06/12/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND To discuss the current status of reproductive concerns and its correlation with fear of recurrence and level of family support in patients of childbearing age with gynecologic malignancies. METHODS A convenient sampling method was used to enroll 188 patients with gynecologic malignancies in Nanjing Maternity and Child Health Care Hospital, Nanjing Drum Tower Hospital, General Hospital of Ningxia Medical University, and Haian Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from September 2022 to April 2023. Patients were assessed using general information questionnaire, Reproductive Concerns After Cancer Scale (RCAC), Fear of Cancer Recurrence Inventory (FCRI) questionnaire, and Perceived Social Support-Family (PSS-FA) Scale. RESULTS Among patients of childbearing age with gynecologic malignancies, the total RCAC score was (54.35 ± 7.52), indicating a moderate level of reproductive concerns. Patients scored (20.98 ± 4.51) on FCRI, implying a moderate level of fear of recurrence. The PSS-FA score was (9.57 ± 2.76), denoting a moderate level of family support. The total score and each dimensional score of RCAC were positively correlated with FCRI total score (P < 0.05), and negatively correlated with PSS-FA total score (P < 0.05). Fear of recurrence, family support level, number of children, educational background, treatment modality, and fertility intention were influencing factors for reproductive concerns in patients of childbearing age with gynecologic malignancies (all P < 0.05). CONCLUSION The reproductive concerns, fear of recurrence and family support are all at moderate levels in patients of childbearing age with gynecologic malignancies, and reproductive concerns are positively correlated with fear of recurrence and negatively correlated with family support.
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Affiliation(s)
- Xinying He
- Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210004, Jiangsu, China
| | - Ying Wu
- Hai'an Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nantong, 226600, Jiangsu, China
| | - Yaqing Zhou
- Department of Critical Care Medicine, Hai'an People's Hospital, Nantong City, 226600, Jiangsu Province, China
| | - Qin Chen
- Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210004, Jiangsu, China
| | - Xuping Li
- General Hospital of Ningxia Medical University, Hui Autonomous Region, Xingqing District, Yinchuan, 750001, Ningxia, China
| | - Xuemei Fan
- Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210004, Jiangsu, China
| | - Chengjun Xia
- Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210004, Jiangsu, China
| | - Jiao Ma
- Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210004, Jiangsu, China
| | - Jing Han
- Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210004, Jiangsu, China
| | - Xue Han
- Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210004, Jiangsu, China.
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Wu X, Zhang W, Liu A, Zhang M. Factors associated with reproductive concerns among young female patients with colorectal cancer: A cross-sectional study. J Clin Nurs 2023. [PMID: 37127929 DOI: 10.1111/jocn.16736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 03/04/2023] [Accepted: 04/05/2023] [Indexed: 05/03/2023]
Abstract
AIMS AND OBJECTIVES The aim of this study was to describe the prevalence of reproductive concerns among young female patients with colorectal cancer and explore the associated factors. BACKGROUND With the trend of longer survival and younger age at diagnosis of colorectal cancer patients, reproductive concerns have become increasingly prevalent among young female colorectal cancer patients. DESIGN Cross-sectional design. METHODS The study included 150 young female patients with colorectal cancer who completed cancer treatment at 2 hospitals in Guangzhou, China, between November 2020 and December 2021 completed an investigation comprising A general questionnaire, The Reproductive Concerns After Cancer scale, The Family Adaptation and Cohesion Evaluation Scale II and unmet fertility information needs questionnaire. Multivariable linear regression analysis was performed in order to identify factors that influence reproductive concerns. This study was prepared and is reported according to the STROBE checklist. RESULTS The mean (SD) score on the Reproductive Concerns After Cancer scale was 54.78 ± 8.97. The highest score was for the children's health subscale (3.84 ± .92) and the lowest was for acceptance (2.24 ± .70). Multiple regression analysis showed that patients with fewer children, female children, lower education level (less than undergraduate degree), earlier disease stage, lower family function and higher unmet need for fertility information had more reproductive concerns, which explained 26.9% of the total variation of the model. CONCLUSIONS The patients with fewer children, female children, low cultural degree (less than bachelor), early clinical patients, poorer family function and higher unmet fertility information needs had higher reproductive concerns. RELEVANCE TO CLINICAL PRACTICE These findings can guide the development of interventions to mitigate reproductive concerns, including understand and meet their fertility information needs, improve the level of family function. PATIENT OR PUBLIC CONTRIBUTION Survey questionnaires were completed by participants among young female with colorectal cancer in this study.
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Affiliation(s)
- Xiaoyu Wu
- Clinical Nursing Teaching and Research Section, The Second XiangYa Hospital of Central South University, Changsha, China
| | - Wenxia Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Aihong Liu
- Department of Nursing, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meifen Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Bártolo A, Santos IM, Guimarães R, Reis S, Monteiro S. Attentional Bias Toward Reproduction-Related Stimuli and Fertility Concerns Among Breast Cancer Survivors. Behav Med 2022; 48:273-283. [PMID: 33872117 DOI: 10.1080/08964289.2021.1879725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The current study examined whether an attentional bias exists for reproduction-related visual cues among breast cancer survivors and its relationship with fertility concerns and emotional distress. Breast cancer survivors (n = 38) aged 18-40 were compared to 37 healthy women recruited from the general population. Attentional bias was investigated using a visual dot-probe task and response times (RT) were measured. Participants also completed several questionnaires, including the Reproductive Concerns After Cancer Scale (RCACS) and the Hospital Anxiety and Depression Scale (HADS). Biased cognitive processing toward reproduction-related stimuli was observed for all young women. However, attentional bias was a significant predictor of concerns about partner disclosure of fertility status, with higher bias scores associated with higher levels of concern only for breast cancer survivors. The desire to have a (or another) biological child was also a significant predictor of higher concerns related with fertility potential for all young women. Higher vigilance regarding reproduction-related cues seems to lead to higher concerns among women with breast cancer history whose fertility is threatened. This result may have important research and clinical implications. Interventions focused on goal-oriented attention self-regulation and problem-solving can help to manage fertility concerns and distress in the course of the disease.
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Affiliation(s)
- Ana Bártolo
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Isabel M Santos
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Raquel Guimarães
- Breast Center, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Salomé Reis
- Department of Gynecology and Obstetrics, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sara Monteiro
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
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Bártolo A, Santos IM, Guimarães R, Reis S, Monteiro S. Reproduction-related cognitive processing and distress among young adult women: the role of personal breast cancer history. Cogn Process 2021; 22:569-578. [PMID: 33797684 DOI: 10.1007/s10339-021-01026-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/12/2021] [Indexed: 11/28/2022]
Abstract
Breast cancer diagnosis can threaten fertility and biological motherhood in women of reproductive age due to the gonadotoxic effects of treatments. Much evidence documents these women fertility-related concerns and distress, but no study has attempted to understand how implicit cognitive processes can contribute to this maladjustment. In this research, we explored whether reproduction-related stimuli interfere with cognition among cancer survivors with infertility risk using an emotional Stroop task. Furthermore, we investigated the relationship between reproduction-related cognitive processing and psychological morbidity. Young cancer survivors aged 18-40 years who received anticancer treatments and an age-matched non-cancer control group without known fertility problems were compared. Color-naming times and error rates were assessed. Participants in both groups were slower naming the color of reproduction-related words in comparison to unrelated negative valence words. Although in the same direction, this difference did not reach statistical significance for positive and neutral unrelated word lists. Further analysis suggested that biased attention toward reproduction-related information was associated with higher depression levels in young women with personal breast cancer history, but not in healthy women. These findings suggest that biased processing of reproduction-related cues might be a vulnerability factor after a breast cancer diagnosis. Additionally, this study puts in evidence the potential usefulness of using experimental tasks to investigate attentional bias in a context where fertility is at risk.
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Affiliation(s)
- Ana Bártolo
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal.
| | - Isabel M Santos
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Raquel Guimarães
- Breast Center, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Salomé Reis
- Department of Gynecology and Obstetrics, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sara Monteiro
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
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Anandavadivelan P, Wiklander M, Eriksson LE, Wettergren L, Lampic C. Cultural adaptation and psychometric evaluation of the Swedish version of the Reproductive Concerns After Cancer (RCAC) scale. Health Qual Life Outcomes 2020; 18:273. [PMID: 32762775 PMCID: PMC7412787 DOI: 10.1186/s12955-020-01520-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/29/2020] [Indexed: 01/01/2023] Open
Abstract
Background Reproductive concerns are common among young cancer survivors and include worries related to different aspects of fertility and parenthood. The Reproductive Concerns After Cancer (RCAC) scale is an 18-item scale with six dimensions, developed to capture a variety of such concerns. The aim of the present study was to describe the cultural adaptation of the RCAC scale into Swedish and evaluate its psychometric properties among young women who have undergone treatment for cancer. Methods The RCAC was forward translated from English into Swedish and assessed for cultural adaptation based on a two-panel approach followed by cognitive interviews with the target group. For the psychometric evaluation, a Swedish cohort of 181 female young adult breast cancer survivors completed a survey including the RCAC scale approximately 1.5 years post-diagnosis. Psychometric properties were examined by analyses of construct validity (confirmatory factor analysis and convergent validity), data quality (score distribution, floor and ceiling effects), reliability and known-groups validity. Results The confirmatory factor analysis yielded an acceptable fit (RMSEA 0.08, SRMR 0.09, CFI 0.92). Convergent validity was demonstrated by a negative correlation of moderate size (− 0.36) between the RCAC total score and the emotional function scale of the EORTC QLQ-C30. Reliability measured with Revelle Ω total was satisfactory (0.73–0.92) for five of the dimensions, and poor for the dimension Becoming pregnant (Revelle Ω total = 0.60); Cronbach’s alpha showed a similar pattern. Known-groups validity was indicated by significant RCAC mean score differences (MD), reflecting more concerns among women with a certain (MD 4.56 [95% CI 3.13 to 5.99]) or uncertain (MD 3.41 [95% CI 1.68 to 5.14]) child wish compared to those with no wish for (additional) children. Conclusion The translation and cultural adaptation of the Swedish RCAC has resulted in a scale demonstrating construct and known-groups validity, and satisfactory reliability for five of six dimensions. The dimension Becoming pregnant showed non-optimal internal consistency and should undergo further evaluation. The Swedish RCAC is recommended to be used in research settings for measurement of concerns related to fertility and parenthood in young women with cancer.
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Affiliation(s)
| | - Maria Wiklander
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Lars E Eriksson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,School of Health Sciences, City, University of London, London, UK.,Department of Infectious Diseases, Karolinska University Hospital, Huddinge, Sweden
| | - Lena Wettergren
- Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden
| | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Fertility under uncertainty: exploring differences in fertility-related concerns and psychosocial aspects between breast cancer survivors and non-cancer infertile women. Breast Cancer 2020; 27:1177-1186. [DOI: 10.1007/s12282-020-01124-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/14/2020] [Indexed: 12/27/2022]
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