Development and Psychometric Assessment of a Measurement Instrument for Functioning and Function-Affecting Factors in Women With Breast Cancer: A Rasch Analysis Approach.
12 affiliations
- 1Department of Occupational Therapy, School of Allied Medical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran.
- 2School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario. Roth McFarlane Hand and Upper Limb Center, St. Joseph's Hospital, London, Ontario, Canada, Department of Occupational therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
- 3Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
- 4Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
- 5Department of Hematology Oncology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
- 6Department of Internal Medicine, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
- 7Department of Hematology and Medical Oncology, Cancer Research Center, Cancer Institute of Iran, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
- 8Department of Medical Oncology, Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
- 9Department of Hematology and Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
- 10Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran.
- 11Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.
- 12Department of Psychology, Faculty of Humanities and Social Sciences, Istinye University, Istanbul, Türkiye.
Abstract
Purpose
To develop and psychometrically evaluate an instrument for assessing functioning and function-affecting factors in women with breast cancer, based on the International Classification of Functioning, Disability and Health (ICF) Core Set for Breast Cancer.Methods
This methodological study combined a systematic literature review, qualitative interviews with women with breast cancer, and expert consultation to develop the questionnaire. Face validity was assessed in 10 women with breast cancer, content validity by 10 experts, and structural validity and reliability in 305 women with breast cancer. Rasch analysis was performed using dichotomized item responses, and confirmatory factor analysis (CFA) was conducted in R using the WLSMV estimator for ordered categorical variables. Internal consistency was evaluated using McDonald's Omega.Results
Following content validation, the preliminary questionnaire contained 70 items (40 functioning and 30 function-affecting factors). Rasch analysis identified misfitting items and resulted in a final 55-item instrument comprising 32 functioning items and 23 function-affecting items. CFA supported the proposed multidimensional structure after theoretically justified model refinement. The functioning section demonstrated satisfactory model fit (CFI = 0.976, TLI = 0.974, RMSEA = 0.040, 90% CI = 0.034-0.046), while the function-affecting factors section also demonstrated acceptable fit (CFI = 0.979, TLI = 0.977, RMSEA = 0.054, 90% CI = 0.046-0.062). Although several items showed relatively low standardized factor loadings, they were retained because of acceptable Rasch fit, satisfactory content validity, and conceptual importance. McDonald's Omega indicated acceptable internal consistency across the retained subscales.Conclusion
The findings provide preliminary evidence supporting the reliability and structural validity of this ICF-based instrument for assessing functioning and function-affecting factors in women with breast cancer. Further validation in independent populations is recommended before broader clinical implementation.
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BibTeX
@article{jamshidihosseinabadi2026development,
title = {{Development and Psychometric Assessment of a Measurement Instrument for Functioning and Function-Affecting Factors in Women With Breast Cancer: A Rasch Analysis Approach.}},
author = {Farkhondeh Jamshidihosseinabadi and Maryam Farzad and Enayatollah Bakhshi and Seyed Ali Hosseini and Amir Hossein Emami and Kamran Roudini and Mehrzad Mirzania and Farhad Shahi and Mohsen Esfandbod and Mojtaba Habibi Asgarabad},
journal = {Journal of evaluation in clinical practice},
year = {2026},
month = oct,
doi = {10.1111/jep.70705},
url = {https://europepmc.org/article/MED/42950126},
note = {CC BY},
}
RIS
TY - JOUR
TI - Development and Psychometric Assessment of a Measurement Instrument for Functioning and Function-Affecting Factors in Women With Breast Cancer: A Rasch Analysis Approach.
AU - Farkhondeh Jamshidihosseinabadi
AU - Maryam Farzad
AU - Enayatollah Bakhshi
AU - Seyed Ali Hosseini
AU - Amir Hossein Emami
AU - Kamran Roudini
AU - Mehrzad Mirzania
AU - Farhad Shahi
AU - Mohsen Esfandbod
AU - Mojtaba Habibi Asgarabad
PY - 2026
DA - 2026/10/01
JO - Journal of evaluation in clinical practice
DO - 10.1111/jep.70705
UR - https://europepmc.org/article/MED/42950126
AB - Purpose To develop and psychometrically evaluate an instrument for assessing functioning and function-affecting factors in women with breast cancer, based on the International Classification of Functioning, Disability and Health (ICF) Core Set for Breast Cancer.Methods This methodological study combined a systematic literature review, qualitative interviews with women with breast cancer, and expert consultation to develop the questionnaire. Face validity was assessed in 10 women with breast cancer, content validity by 10 experts, and structural validity and reliability in 305 women with breast cancer. Rasch analysis was performed using dichotomized item responses, and confirmatory factor analysis (CFA) was conducted in R using the WLSMV estimator for ordered categorical variables. Internal consistency was evaluated using McDonald's Omega.Results Following content validation, the preliminary questionnaire contained 70 items (40 functioning and 30 function-affecting factors). Rasch analysis identified misfitting items and resulted in a final 55-item instrument comprising 32 functioning items and 23 function-affecting items. CFA supported the proposed multidimensional structure after theoretically justified model refinement. The functioning section demonstrated satisfactory model fit (CFI = 0.976, TLI = 0.974, RMSEA = 0.040, 90% CI = 0.034-0.046), while the function-affecting factors section also demonstrated acceptable fit (CFI = 0.979, TLI = 0.977, RMSEA = 0.054, 90% CI = 0.046-0.062). Although several items showed relatively low standardized factor loadings, they were retained because of acceptable Rasch fit, satisfactory content validity, and conceptual importance. McDonald's Omega indicated acceptable internal consistency across the retained subscales.Conclusion The findings provide preliminary evidence supporting the reliability and structural validity of this ICF-based instrument for assessing functioning and function-affecting factors in women with breast cancer. Further validation in independent populations is recommended before broader clinical implementation.
SN - 1356-1294
SN - 1365-2753
ER -