title: Assessing cancer patients' quality of life and supportive care needs: Translation-revalidation of the CARES in Flemish and exhaustive evaluation of concurrent validity.
abstract: BACKGROUND
  The prevalence of cancer increases every year, leading to a growing population of patients and survivors in need for care. To achieve good quality care, a patient-centered approach is essential. Correct and timely detection of needs throughout the different stages of the care trajectory is crucial and can be supported by the use of screening and assessment in a stepped-care approach. The Cancer Rehabilitation Evaluation System (CARES) is a valuable and comprehensive quality of life and needs assessment instrument. For use in Flemish research and clinical practice, the CARES tool was translated for the Dutch-speaking part of Belgium (Flanders) from its original English format. This protocol paper describes the translation and revalidation of this Flemish CARES version.
  
  
  METHODS
  After forward-backward translation of the CARES into Flemish we aim to recruit 150 adult cancer patients with a primary cancer diagnosis (stage I, II or III) for validation. In this study with a combination of qualitative and a quantitative approach, qualitative data will be collected through focus groups and supplemented by two phases of quantitative data collection: i) an initial patient survey containing questions on socio-demographic and medical data, the CARES and seven concurrent instruments; and ii) a second survey administered after 1 week containing the CARES and supplementary questions to explore their impressions on the content and the feasibility of the CARES.
  
  
  CONCLUSIONS
  With this extensive data collection process, psychometric validity of the Flemish CARES can be tested thoroughly using classical test theory. Internal consistency of summary scales, test-retest reliability, content validity, construct validity, concurrent validity and feasibility of the instrument will be examined. If the Flemish CARES version is found reliable, valid and feasible, it will be used in future research and clinical practice. Comprehensive assessment with the CARES in a stepped-care approach can facilitate timely identification of cancer patients' psychosocial concerns and care needs so it can contribute to efficient provision of patient-centered quality care.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT02282696 (July 16, 2014).
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. bojoura.schouten@uhasselt.be.|Department of Experimental and Applied Psychology, Faculty of Psychological and Educational Sciences, Free University of Brussels, Pleinlaan 2, 1050, Elsene, Belgium. bojoura.schouten@uhasselt.be.
authors.forename: Bojoura
authors.initials: B
authors.lastname: Schouten
authors.affiliation: Department of Experimental and Applied Psychology, Faculty of Psychological and Educational Sciences, Free University of Brussels, Pleinlaan 2, 1050, Elsene, Belgium.
authors.forename: Elke
authors.initials: E
authors.lastname: Van Hoof
authors.affiliation: Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, PB 7001, 3000, Leuven, Belgium.|Belgian Center for Evidence-Based Medicine (CEBAM), Kapucijnenvoer 33- blok J, 3000, Leuven, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Vankrunkelsven
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.
authors.forename: Ward
authors.initials: W
authors.lastname: Schrooten
authors.affiliation: Jessaziekenhuis, Stadsomvaart 11, 3500, Hasselt, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Bulens
authors.affiliation: Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Kapucijnenvoer 33, PB 7001, 3000, Leuven, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Buntinx
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.|Jessaziekenhuis, Stadsomvaart 11, 3500, Hasselt, Belgium.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Mebis
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.|ICURO, Guimardstraat 1, 1040, Brussel, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Vandijck
authors.affiliation: KCE - Belgian Health Care Knowledge Centre, Kruidtuinlaan 55, 1000, Brussel, Belgium.
authors.forename: Irina
authors.initials: I
authors.lastname: Cleemput
authors.affiliation: Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium.|AZ Delta, Rode-Kruisstraat 20, 8800, Roeselare, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Hellings
mesh_terms: D000328:Adult; D001530:Belgium; D005260:Female; D017144:Focus Groups; D006801:Humans; D007802:Language; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology*; D011594:Psychometrics; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Cancer; Distress; Needs assessment; Psychosocial; Quality of life; Supportive care; Validation