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01-07-2015 | Uitgave 7/2015

Quality of Life Research 7/2015

Cross-cultural adaptation and psychometric assessment of the Chinese version of the comprehensive needs assessment tool for cancer caregivers (CNAT-C)

Quality of Life Research > Uitgave 7/2015
Yin-Ping Zhang, Xin-Shuang Zhao, Bei Zhang, Lu-Lu Zhang, Chun-Ping Ni, Nan Hao, Chang-Bei Shi, Caroline Porr



The comprehensive needs assessment tool for cancer caregivers (CNAT-C) is a systematic and comprehensive needs assessment tool for the family caregivers. The purpose of this project was twofold: (1) to adapt the CNAT-C to Mainland China’s cultural context and (2) to evaluate the psychometric properties of the newly adapted Chinese CNAT-C.


Cross-cultural adaptation of the original CNAT-C was performed according to published guidelines. A pilot study was conducted in Mainland China with 30 Chinese family cancer caregivers. A subsequent validation study was conducted with 205 Chinese cancer caregivers from Mainland China. Construct validity was determined through exploratory and confirmatory factor analyses. Reliability was determined using internal consistency and test–retest reliability.


The split-half coefficient for the overall Chinese CNAT-C scale was 0.77. Principal component analysis resulted in an eight-factor structure explaining 68.11 % of the total variance. The comparative fit index (CFI) was 0.91 from the modified model confirmatory factor analysis. The Chi-square divided by degrees of freedom was 1.98, and the root mean squared error of approximation (RMSEA) was 0.079. In relation to the known-group validation, significant differences were found in the Chinese CNAT-C scale according to various caregiver characteristics. Internal consistency was high for the Chinese CNAT-C reaching a Cronbach α value of 0.94. Test–retest reliability was 0.85.


The newly adapted Chinese CNAT-C scale possesses adequate validity, test–retest reliability, and internal consistency and therefore may be used to ascertain holistic health and support needs of cancer patients’ family caregivers in Mainland China.

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