Development and Validation of the Questionnaire of Factors Related to the Adaptability to Return to Work Among Cancer Patients.

Aim: Enhancing the adaptability to return to work among cancer patients can help them fully mobilize coping resources and adapt to the environment during the reintegration process. However, influenced by multiple factors, the adaptability to return to work among cancer patients in China remains inadequate and requires improvement. To address this, we aim to develop and validate the Questionnaire of Factors related to the Adaptability to Return to Work Among Cancer Patients (abbreviated as QF-ARTWCP). Grounded in the theoretical model "Cancer Patients' Return-to-Work Adaptation Experience and Coping Resources," social ecosystems theory, and social support theory, this instrument will provide a foundation for subsequent investigations and the development of targeted intervention programs.

Methods: The development of the QF-ARTWCP was conducted in three phases: (1) Item generation: A literature review identified relevant influencing factors and existing evaluation tools. This was followed by three rounds of experts consultations (15 experts) and a pilot survey (30 patients), resulting in a 59-item initial questionnaire; (2) Preliminary survey: Item analysis, exploratory factor analysis (EFA), and reliability testing were performed with 238 participants. Content validity was assessed by 8 experts; and (3) Formal verification investigation: Confirmatory Factor Analysis (CFA) using fit indices (e.g., χ²/df, RMSEA, SRMR) evaluated model-data fit. Convergent validity was quantified via average variance extracted (AVE), and composite reliability (CR), with 277 participants.

Results: The final QF-ARTWCP consists of 34 items across nine factors: Healthy Cognition; Work Cognition; Emotional Coping; Work Coping; Unit Support; Support from Friends and Relatives, Financial Burden; Social Atmosphere; and Policy Support. The CFA demonstrated acceptable model fit (χ²/df = 2.245, P < 0.001; RMSEA = 0.067, SRMR = 0.052; CFI = 0.914, and TLI = 0.902. Additionally, the AVE (0.615-0.792) and CR (0.834-0.938) values indicated strong aggregate validity.

Discussion: The QF-ARTWCP is a validated, user-friendly tool tailored for cancer patients. This questionnaire enables the evaluation and monitoring of the adaptability to return to work in occupational settings, supporting targeted interventions.