Reliability and Validity of the Translated Chinese Version of Comprehensive Assessment of Acceptance and Commitment Therapy Processes (Compact-C) in Breast Cancer Survivors

Purpose: This study aimed to translate and validate a Chinese version of the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT-C), a 23 -item questionnaire for measuring an individual's level of psychological flexibility among Chinese breast cancer survivors for utilisation of Acceptance and commitment therapy (ACT) -based interventions in breast cancer patients. Methods: Six translators translated the original English version into Chinese according to Brislin's Translation Model. Psychometric properties tests were conducted on the CompACT-C, including internal consistency, test-retest reliability (two-week interval), face validity, content validity, convergent validity with experiential avoidance, and construct validity (confirmatory factor analysis). Results: 308 Chinese breast cancer survivors with mastectomies were conveniently recruited. The translated scale showed satisfactory test-retest reliability (two-week interval, r = 0.53-0.72, p < 0.001), face validity, and content validity (CVI-Scale/CVS-Item = 1.00). According to the confirmatory factor analysis results, the final Chinese version remained the 23 items and three dimensions, with the modification of item six from the dimension of openness to experience to behavioural awareness for better model fitness [structural equation model analysis, chi 2 = 559.486, df = 226, NC (chi 2/df) = 2.476, RMSEA = 0.069, CFI = 0.834, TLI = 0.815, SRMR = 0.079] and satisfactory internal consistency (Cronbach's alpha = 0.71), convergent validity with AAQ-2 (r = -0.57, p < 0.001) in these breast cancer patients. Conclusions: The Chinese version of the CompACT showed good reliability and validity among Chinese breast cancer patients. Future research is suggested to confirm its psychometric properties with diverse breast and other cancer groups.