# Face and content validity of a holistic assessment questionnaire to assess cancer-related fatigue after breast cancer

## TL;DR

This study validates a new questionnaire to assess cancer-related fatigue in breast cancer survivors, showing it is clear, relevant, and user-friendly.

## Contribution

The study confirms the face and content validity of the Holistic Assessment of CRF (HA-CRF) questionnaire for breast cancer survivors.

## Key findings

- Breast cancer survivors found the HA-CRF questionnaire helpful and easy to use, with minor suggestions for improvement.
- Healthcare professionals rated 71% of items as very clear and 92% as relevant, indicating strong content validity.
- The HA-CRF questionnaire took an average of 18 minutes to complete and provided a sense of openness and self-awareness.

## Abstract

Cancer-related fatigue (CRF) affects the quality of life after breast cancer. In a previous study, we developed a 72-item questionnaire that assesses CRF from a holistic point of view; named the Holistic Assessment of CRF (HA-CRF) questionnaire. The current study assessed the face and content validity of the HA-CRF questionnaire.

Using a mixed-method approach, ten breast cancer survivors (BCS) did a cognitive walkthrough of the HA-CRF via an app followed by a semi-structured interview about relevancy and essentiality (qualitative). In addition, ten health care professionals (HCPs) assessed the relevancy, clarity, and essentiality of each item via a questionnaire (quantitative).

BCS indicated minor textual improvement for four items and six items were not completely clear. The app was considered easy to use and the HC-CRF was on average completed in 18 minutes. The HA-CRF questionnaire provided openness about fatigue and gave the feeling of being heard. The items were helpful and induced self-awareness. HCPs indicated 71% of items being very clear or minor revisions proposed by the minority, with 64% of items being essential and 92% considered relevant.

The HA-CRF showed good face and excellent content validity. Further research is needed to assess its ability to monitor in daily life.