Cross-cultural adaptation and preliminary psychometric evaluation of the Chinese version of the Self-Blame Attribution for Cancer Scale in patients with gynecologic cancer.

PURPOSE: Self-blame is a common psychological response after cancer diagnosis. It can impair patients' emotional adjustment and thereby increase their need for supportive care and psychological interventions. This study aimed to translate the Self-Blame Attribution for Cancer Scale (SBAC) into Chinese and to conduct a preliminary psychometric evaluation of the Chinese version (SBAC-C) in patients with gynecologic cancer.

METHODS

This methodological study was conducted in three phases: translation using the Brislin model, cross-cultural adaptation through two rounds of expert consultation and pilot testing, and psychometric evaluation in a convenience sample of 132 patients with gynecologic cancer. Item analysis, content validity, preliminary dimensional analysis using exploratory factor analysis with principal axis factoring, internal consistency, split-half reliability, and test-retest reliability were assessed.

RESULTS

The final SBAC-C contained 11 items across two dimensions: behavioral self-blame and characterological self-blame. Item-level content validity indices ranged from 0.89 to 1.00, and the scale-level content validity index was 0.82. Exploratory factor analysis using principal axis factoring suggested a preliminary two-factor pattern, explaining 74.818% of the extracted variance, with factor loadings ranging from 0.460 to 0.932. Cronbach's alpha for the total scale was 0.905. Split-half reliability was 0.945, and test-retest reliability over a 3-week interval was 0.833.

CONCLUSIONS

The SBAC-C demonstrated acceptable reliability and initial evidence of validity in patients with gynecologic cancer. The SBAC-C may serve as a preliminary tool for research use. Large-scale, multicenter validation including confirmatory factor analysis is warranted to firmly establish the factor structure.