Cancer Appetite and Symptom Questionnaire (CASQ) for Brazilian Patients: Cross-Cultural Adaptation and Validation Study.
BACKGROUND
Appetite and symptoms, conditions generally reported by the patients with cancer, are somewhat challenging for professionals to measure directly in clinical routine (latent conditions). Therefore, specific instruments are required for this purpose. This study aimed to perform a cultural adaptation of the Cancer Appetite and Symptom Questionnaire (CASQ), into Portuguese and evaluate its psychometric properties on a sample of Brazilian cancer patients.


METHODS
This is a validation study with Brazilian cancer patients. The face, content, and construct (factorial and convergent) validities of the Cancer Appetite and Symptom Questionnaire, the study tool, were estimated. Further, a confirmatory factor analysis (CFA) was conducted. The ratio of chi-square and degrees of freedom (χ2/df), comparative fit index (CFI), goodness of fit index (GFI) and root mean square error of approximation (RMSEA) were used for fit model assessment. In addition, the reliability of the instrument was estimated using the composite reliability (CR) and Cronbach's alpha coefficient (α), and the invariance of the model in independent samples was estimated by a multigroup analysis (Δχ2).


RESULTS
Participants included 1,140 cancer patients with a mean age of 53.95 (SD = 13.25) years; 61.3% were women. After the CFA of the original CASQ structure, 2 items with inadequate factor weights were removed. Four correlations between errors were included to provide adequate fit to the sample (χ2/df = 8.532, CFI = .94, GFI = .95, and RMSEA = .08). The model exhibited a low convergent validity (AVE = .32). The reliability was adequate (CR = .82 α = .82). The refined model showed strong invariance in two independent samples (Δχ2: λ: p = .855; i: p = .824; Res: p = .390). A weak stability was obtained between patients undergoing chemotherapy and radiotherapy (Δχ2: λ: p = .155; i: p < .001; Res: p < .001), and between patients undergoing chemotherapy combined with radiotherapy and palliative care (Δχ2: λ: p = .058; i: p < .001; Res: p < .001).


CONCLUSIONS
The Portuguese version of the CASQ had good face and construct validity and reliability. However, the CASQ still presented invariance in independent samples of Brazilian patients with cancer. However, the tool has low convergent validity and weak invariance in samples with different treatments.
Departamento de Alimentos e Nutrição, Faculdade de Ciências Farmacêuticas de Araraquara - UNESP - Univ Estadual Paulista, Rod. Araraqura-Jaú, km 01, Araraquara, São Paulo, Brazil.
Maria Claudia Bernardes
http://orcid.org/0000-0001-7681-1422
MC
Spexoto
Barretos Cancer Hospital - Fundação Pio XII - Barretos, São Paulo, Brazil.
Sergio Vicente
SV
Serrano
Public Health, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.
Vanessa
V
Halliday
Departamento de Ciências Psicológicas e Unidade de Investigação em Psicologia e Saúde, ISPA-IU, Rua Jardim do Tabaco, n°34, 1149-041, Lisboa, Portugal.
João
J
Maroco
Departamento de Alimentos e Nutrição, Faculdade de Ciências Farmacêuticas de Araraquara - UNESP - Univ Estadual Paulista, Rod. Araraquara-Jaú, km 01, Araraquara, São Paulo, Brazil.
Juliana Alvares Duarte Bonini
JA
Campos
D000328:Adult; D000368:Aged; D001066:Appetite; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology / Q000523:psychology; D011594:Psychometrics; D011795:Surveys and Questionnaires