Developing the parenting concerns scale for cancer survivors and assessment of its validity and reliability in China

Parenting concerns impose a substantial psychological burden on cancer survivors, who must cope not only with concerns related to disease treatment but also with worries about the healthy development of their minor children. However, the early identification and assessment of this complex psychological burden remain insufficiently addressed owing to the lack of a valid and reliable assessment instrument. Therefore, this study aims to provide a scientifically valid and reliable assessment tool for evaluating parenting concerns among cancer survivors.

1. An initial item pool was constructed through a literature review, Delphi expert consultation, and patient cognitive interviews to develop the preliminary pre-test version of the scale. 2. A total of 165 cancer survivors with minor children were recruited to conduct the initial item screening of the pre-test version using the critical ratio method, item-total correlation analysis, and exploratory factor analysis, thereby establishing the formal test version of the scale. Subsequently, an additional 200 eligible cancer survivors were recruited to evaluate the scale's reliability and validity.

1. The item pool of the preliminary scale was revised through expert consultation and patient cognitive interviews and ultimately consisted of 3 dimensions and 25 items. The Kendall's W coefficients for the two rounds of expert consultation were 0.217 and 0.232, respectively, indicating good consistency among expert opinions. 2. The Kaiser-Meyer-Olkin (KMO) value for the first exploratory factor analysis was 0.890, and Bartlett's test of sphericity yielded χ²=2370.625(P < 0.001). The cumulative variance explained was 57.427%. Therefore, the scale retained 3 dimensions and 21 items. In the second exploratory factor analysis, all item factor loadings exceeded 0.50, and no cross-loadings were observed. The cumulative variance explained reached 61.629%. 3. Regarding the reliability and validity results, the item-level content validity index (I-CVI) and scale-level content validity index (S-CVI) were both 1.00. Confirmatory factor analysis demonstrated acceptable structural validity, with χ²/df=1.940, RMSEA=0.069, and CFI, TLI, and IFI values of 0.939, 0.929, and 0.940, respectively. The Cronbach's α coefficient of the scale was 0.906, the split-half reliability was 0.704, and the test-retest reliability was 0.821.

The scale was developed in accordance with scientific principles and demonstrated good reliability and validity, making it an optimized tool for assessing parenting concerns among cancer survivors.