# Psychometric Properties of the Persian Self‐Advocacy in Cancer Survivorship Scale (SACS‐P) in Iran

## TL;DR

This study evaluates the reliability and validity of a Persian version of a self-advocacy scale for cancer patients in Iran.

## Contribution

The study provides a culturally adapted and validated tool for measuring self-advocacy in Iranian cancer patients.

## Key findings

- The Persian version of the SACS (SACS-P) has 24 items grouped into three dimensions with strong validity and reliability.
- The three-factor model was confirmed through exploratory and confirmatory factor analysis.
- The SACS-P showed moderate convergent validity with another patient self-advocacy scale.

## Abstract

Self‐advocacy is crucial for cancer patients, as it allows them to express their needs and engage in treatment decisions. This skill enhances the quality of care and life satisfaction. Accurately measuring self‐advocacy and supporting patients with lower skills is essential to improving treatment outcomes and promoting patient‐centered care. Accurate measurement of self‐advocacy is vital for identifying patients with lower skills and providing support to enhance treatment outcomes and patient‐centered care. This study aimed to investigate the psychometric properties of the Persian version of the Self‐Advocacy Scale in Cancer Patients (SACS).

This methodological study used a cross‐sectional design with 339 cancer patients selected through convenience sampling. It examined the scale's face, content, construct validity, and reliability after translation and cultural adaptation.

The original English version of the Self‐Advocacy in Cancer Survivorship Scale (SACS) consisted of 29 items, five of which were removed based on content validity results. This reduction resulted in the Persian version (SACS‐P) containing 24 items. These items were grouped into three dimensions: informed decision‐making, effective communication with healthcare providers, and connected strength. The scale showed satisfactory validity, with exploratory factor analysis (EFA) revealing three latent factors that accounted for 52.85% of the total variance. Confirmatory factor analysis (CFA) confirmed the adequacy of the three‐factor model. The overall Cronbach's alpha was 0.89, and the intraclass correlation coefficient (ICC) was 0.75 with a 95% confidence interval. Convergent validity was supported by a moderate correlation (r = 0.49) with the Persian version of the Patient Self‐Advocacy Scale for chronic illnesses (PSAS‐P).

The SACS‐P (24‐item) is a reliable and valid instrument for assessing self‐advocacy in cancer patients in Iran, suitable for use in both research and clinical settings.