# Translation and psychometric evaluation of the Korean version of the Reproductive Concerns After Cancer Scale (RCAC)

## TL;DR

This study translated and validated a Korean version of a scale to assess reproductive concerns in female cancer survivors, ensuring it is reliable and useful for healthcare.

## Contribution

The study provides a culturally adapted and psychometrically validated Korean version of the Reproductive Concerns After Cancer Scale.

## Key findings

- The Korean RCAC demonstrated excellent content validity with item-level and scale-level indices of 1.0.
- The final 14-item Korean RCAC had three subscales explaining 57.6% of the variance.
- The instrument showed strong criterion validity and reliability with a Cronbach’s alpha of 0.83.

## Abstract

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.

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.

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.

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.