Development and Validation of the Social Adjustment Scale for Adolescent Cancer Survivors

Abstract

Purpose: This study aimed to develop and validate a measurement tool for social adjustment in adolescent cancer survivors.Design and

Methods: The Social Adjustment Scale-Adolescent Cancer Survivors (SAS-ACS) was developed in three stages. In the first stage, the attributes of social adjustment in adolescent cancer survivors were identified through a literature review and qualitative interviews with adolescent cancer survivors. In the second stage, initial scale items were constructed based on the literature review and interviews. These items were then reviewed through content validity tests and cognitive interviews. In the third stage, 136 participants were recruited from two children’s cancer centers in Seoul, South Korea. Exploratory factor analysis was performed, and criterion validity and test-retest reliability were tested.

Results: The results of Kaiser-Meyer-Olkin (.893) and Bartlett's test of sphericity (χ 2 =2876.432, p <.001) indicated suitability for factor analysis. The final 32 item-scale includes four domains: role achievement in one’s present position, harmony in relationships, disclosure and acceptance of cancer history, and preparation and expectation for future roles. The Cronbach's α of the overall scale was 0.95, and the intraclass correlation coefficient (ICC) and test-retest coefficient were .93 and .88, respectively, indicating high reliability. Correlation/ICC analysis confirmed good criterion-related validity.

Conclusions: The SAS-ACS is a standardized, reliable, and valid instrument to assess social adjustment in adolescent cancer survivors.

Practice Implications:  This scale can be used as a clinical and research tool for developing and implementing interventions to promote social adjustment among adolescent cancer survivors.

Note:
Funding Information: This work was supported by a grant from the Yonsei University College of Nursing Mo-Im Kim Nursing Research Institute in 2017.

Conflict of Interests: The authors declare that there is no conflict of interest.

Ethical Approval: The research plan of this study was approved by the IRB of the two medical institutions (IRB No. 4-2017-0923, 1801-094-916). The consent procedure for the parents of participants aged below 19 was performed at the recommendation of the Institutional Review Board (IRB) of each institution.

Keywords: Social adjustment, Cancer survivors, Adolescents, Questionnaire, Psychometrics