# Structural Validity and Reliability of a Tool for Clinical Rehabilitation Staff to Evaluate Life-Goal-Setting Practice for Cancer Survivors

## TL;DR

This study developed a 14-item tool to help rehabilitation staff evaluate how well they support cancer survivors in setting life goals, improving patient-centered care.

## Contribution

The study presents a validated and reliable 14-item assessment tool for evaluating life-goal-setting practices in oncology rehabilitation.

## Key findings

- The ReGAT-C was refined from 21 to 14 items with a three-category response scale through Rasch analysis.
- The revised tool demonstrated satisfactory structural validity and reliability for clinical use.
- The tool can help staff identify gaps in their practice and improve rehabilitation policies.

## Abstract

Cancer survivors often set meaningful life goals with clinical rehabilitation staff, but until now, there has been no valid and reliable tool to evaluate how well staff support this process. This study tested and refined an assessment tool to ensure it accurately measures life goal setting practices. After careful analysis and revisions, the final version contains 14 clear items that clinical rehabilitation staff can use to reflect on their practice. This tool can help identify areas where professionals may need to improve and guide the development of support systems. In the future, it may contribute to improving the quality of rehabilitation services for cancer survivors, inform rehabilitation policies on patient-centered care, and inspire further research into how life goal setting affects recovery and well-being. By strengthening professionals’ ability to support life goal setting, this tool has the potential to improve outcomes for people living with cancer.

Background: There is a need for an assessment tool for clinical rehabilitation staff to evaluate their life-goal-setting practice, especially in oncology rehabilitation. This study aimed to confirm the structural validity and reliability of the 21-item Reengagement life Goal Assessment Tool for Cancer survivors (ReGAT-C) with a five-category response scale. Methods: Participants were clinical rehabilitation staff who worked at designated cancer care hospitals in Japan and had experience in setting life-goals with cancer survivors hospitalized during the non-terminal phase. The ReGAT-C was mailed to participants twice, and Rasch analysis was repeated on the scores of the first ReGAT-C to test structural validity and reliability. The test–retest reliability was also examined using the scores of the first and second ReGAT-Cs after revising it according to the Rasch analysis results. Results: A total of 121 participants completed the first ReGAT-C, and 70 participants completed the second ReGAT-C. Following three Rasch analyses, the ReGAT-C was revised to contain 14 items with a three-category response scale. The revised scale showed satisfactory psychometric properties. Conclusions: The 14-item ReGAT-C with a three-category response scale could help staff to identify elements that are lacking in their practice and adjust their policies based on the items’ difficulty.