Revisiting the Reproductive Concerns After Cancer (RCAC) scale

Abstract

Objective The aims of this study were to examine the factor structure and reliability of the multidimensional Reproductive Concerns After Cancer (RCAC) scale in a sample of female cancer survivors during their reproductive years, younger than age 45. Methods Female reproductive‐aged survivors (N = 238; current age, 18 to 44 y) with a variety of cancer diagnoses completed a web‐based survey that included the RCAC scale. Three structural models were examined via confirmatory factor analysis: (a) one‐factor, (b) higher‐order with one second‐order factor and six first‐order factors, and (c) oblique six‐factor. Reliability was examined using omega total and Revelle omega total. Results Only the oblique six‐factor model of the RCAC scale fits well. Omega total and Revelle omega total estimates for all of the six three‐item subscales were in the nearly satisfactory to good range (.66 to.87). Conclusions The RCAC scale was found to have satisfactory factor structure and reliability when measuring a range of reproductive concerns experienced by female reproductive‐aged survivors. The RCAC scale is a multidimensional measure of varying aspects of reproductive concerns, and results suggest that the scale may be best represented as a profile of subscale scores. The subscale scores would be useful for tailoring recommendations and interventions to more effectively address the diverse reproductive concerns of female reproductive‐aged survivors.

Cultural adaptation and psychometric evaluation of the Swedish version of the Reproductive Concerns After Cancer (RCAC) scale

“…The results of the reliability measure of four of the six dimensions were above the acceptable range, in line with recent results for young female cancer survivors in the US (10). In our study the reliability for the subscale Personal health was nearly in the satisfactory range.…”

“…This subscale had the lowest Cronbach's alpha of the six subscales in the original study where the RCAC scale was developed (9) and again recently when analysed for psychometric properties (10). Although the Cronbach's α for the Becoming pregnant dimension was below the acceptable range in our study, which was not the case in the other studies, it is noteworthy that the subscale performed similarly in two other populations with different demographics (9,10). The results suggest that it may be likely that this dimension is more difficult to comprehend than the other dimensions.…”

“…To capture the full range of reproductive concerns following cancer the multidimensional Reproductive Concerns After Cancer (RCAC) scale was developed for use in young adult female survivors (9). The scale has shown satisfactory construct validity and internal consistency among women aged 18-44 treated for different types of cancer in the United States (9,10). Outside the US context, the RCAC scale was recently translated and culturally adapted into Chinese and demonstrated suitable psychometric properties for evaluation of reproductive concerns in young female patients with cancer (11).…”

Cultural adaptation and psychometric evaluation of the Swedish version of the Reproductive Concerns After Cancer (RCAC) scale

“…Thus, in comparison to previous studies of the RCAC that included lower percentages of breast cancer survivors (7,9,11), more women in our cohort may have had reason to be concerned about a genetic cancer risk for their children.…”

“…The differences with regard to the strength of the model t indices and convergent validity may be attributed to differences in the sampling techniques between the studies. In the studies describing the original RCAC, participants were recruited via social media outreach and fertility preservation programs (7,9) and the study of the Portuguese RCAC used convenience sampling (11). This may have resulted in an overrepresentation of female cancer survivors interested in having children, as also pointed out by some of the researchers.…”