Validation of the Sinhala version of the Comprehensive Needs Assessment Tool for Informal Cancer Caregivers (S-CNAT-ICs) in Sri Lanka

Abstract

Cancer is a major condition that affects many people, directly and indirectly. This study examined the psychometric properties of the Sinhala version of the Comprehensive Needs Assessment Tool (S-CNAT). A 41-item CNAT was administered to 226 ICs providing palliative care for patients with advanced cancer at the Apeksha Hospital in Sri Lanka. It has seven unmet needs domains. A cross-cultural adaptation of the CNAT was done using WHO guidelines. ICs completed the S-CNAT, the Centre for Epidemiological Studies-Depression (CES-D), the World Health Organization-Quality of Life-Brief (WHOQOL-BREF), and demographic details. Reliability was assessed using test-retest and internal consistency. The convergent and divergent validity of the S-CNAT was tested using the CES-D scale and WHOQOL-BREF. The construct validity was assessed by performing exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The mean (±SD) age of the ICs was 41.78(±14.54) years. Most ICs were female (60%) and married (72%). The test-retest reliability was 0.965, and the Cronbach’s alpha was 0.903. Both EFA and CFA revealed a structure comprised of seven factors (35 items); re-named as healthcare staff/nurses’ support and information, physical/practical needs, medical officers’ support, psychological needs, social and family support, spiritual/religious support, and hospital facilities/service. The S-CNAT was found to have a negative correlation with the WHOQOL-BREF, while it was positively correlated with the CES-D. The S-CNAT is a valid and reliable tool for assessing informal cancer caregivers' unmet needs (S-CNAT-ICs). The findings of this study will help health authorities understand and assess the unmet needs of ICs. The healthcare support needs were the most prominent unmet needs among ICs.