ORIGINAL RESEARCH article
Front. Psychol.
Sec. Quantitative Psychology and Measurement
Cross-Cultural Adaptation and Psychometric Validation of the Breast Cancer Stigma Assessment Scale Among Chinese Patients
Provisionally accepted
- 1First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
- 2Jinzhou Medical University, Jinzhou, China
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Background: Breast cancer stigma significantly impacts patients' psychological well-being, yet culturally validated assessment tools remain limited in Chinese contexts. This study aimed to translate and culturally adapt the Breast Cancer Stigma Assessment Scale (BCSAS) and evaluate its psychometric properties among Chinese breast cancer patients. Methods: Following Brislin's translation model, the BCSAS was rigorously adapted through forward-backward translation and cultural adaptation. Six multidisciplinary experts (nursing psychology, n=4; breast surgery, n=2) evaluated content, semantic, and conceptual equivalence. A total of 550 questionnaires were distributed to women with breast cancer from three tertiary hospitals in western Liaoning, China, yielding 500 valid responses (response rate = 90.91%). Psychometric evaluation included content validity assessment, confirmatory factor analysis (CFA), reliability testing, and convergent validity assessment. Exploratory network analysis complemented CFA findings. Results: The Chinese version (C-BCSAS) demonstrated excellent content validity (S-CVI = 0.98), strong internal consistency (Cronbach's α = 0.890; dimension-specific α = 0.712–0.876), and good test-retest reliability (ICC = 0.825, 95% CI = 0.691–0.903). CFA revealed fit indices of χ²/df = 4.446, CFI = 0.829, TLI = 0.800, RMSEA = 0.083. While slightly below commonly cited thresholds, all factor loadings substantially exceeded 0.50 (range: 0.540–0.846, p < 0.001), supporting item-level validity. The original seven-factor, 28-item structure was retained to preserve theoretical integrity and enable cross-cultural comparisons. Conclusions: The C-BCSAS is a reliable and culturally valid instrument for assessing breast cancer stigma in Chinese contexts, suitable for both clinical assessment and international comparative research.
Keywords: breast cancer, stigma, Cross-cultural adaptation, Psychometric validation, confirmatory factor analysis
Received: 02 Jul 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Lin, Li, Li and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiuli Wang, 13464642551@163.com
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