Development and psychometric properties of the social adjustment scale for youth cancer survivors in South Korea

Sumi Oh; Hyejung Lee; Sue Kim; Sanghee Kim; Chuhl Joo Lyu; Chang Gi Park; Hyoung Jin Kang

doi:10.1016/j.apjon.2023.100241

Development and psychometric properties of the social adjustment scale for youth cancer survivors in South Korea

Asia Pac J Oncol Nurs. 2023 May 11;10(7):100241. doi: 10.1016/j.apjon.2023.100241. eCollection 2023 Jul.

Authors

Sumi Oh¹, Hyejung Lee², Sue Kim², Sanghee Kim², Chuhl Joo Lyu³, Chang Gi Park⁴, Hyoung Jin Kang⁵

Affiliations

¹ College of Nursing, Health and Nursing Research Institute, Jeju National University, Jeju Special Self-Governing Province, South Korea.
² College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea.
³ Division of Pediatric Hemato-oncology, Yonsei University Health System, College of Medicine, Yonsei University, Seoul, South Korea.
⁴ Department of Population Health Nursing Science, College of Nursing, University of Illinois, Chicago, USA.
⁵ Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Children's Hospital, Seoul, South Korea.

Abstract

Objective: We developed a new scale-the Social Adjustment Scale for Youth Cancer Survivors-and examined its psychometric properties.

Methods: In the scale's development stage, preliminary items were constructed based on the results of a concept analysis of the hybrid model, literature review, and interviews. These items were then reviewed through content validity and cognitive interviews. In the validation stage, 136 survivors were recruited from two children's cancer centers in Seoul, South Korea. An exploratory factor analysis was performed to identify a set of constructs, and validity and reliability were tested.

Results: Starting with 70 items constructed through literature review and interviews with youth survivors, the final scale comprised 32 items. The exploratory factor analysis identified four domains-namely, role achievement in one's present position, harmony in relationships, disclosure and acceptance of cancer history, and preparation and expectation for future roles. Correlations with quality of life indicated good convergent validity (r = 0.82, P < 0.001). The Cronbach's α of the overall scale was 0.95, indicating excellent internal consistency; and the intraclass correlation coefficient was 0.94 (P < 0.001), suggesting high test-retest reliability.

Conclusions: The Social Adjustment Scale for Youth Cancer Survivors exhibited acceptable psychometric properties in measuring the social adjustment of youth cancer survivors. It can be used to identify youths facing difficulty in adjusting to society after treatment and to investigate the effect of interventions implemented to promote social adjustment among youth cancer survivors. Future research is needed to examine the applicability of the scale in patients across diverse cultural backgrounds and healthcare systems.

Keywords: Adolescent; Cancer survivor; Oncology nursing; Scale development; Social adjustment; Young adult.