Translation and validation of the activities of daily living scale with Iranian elderly cancer patients treated in an oncology unit

Abstract

Background: This study evaluated the validity and reliability of applying the Katz's Activities of Daily Living (ADL) scale in an Iranian sample of elderly oncologic patients following initial cancer treatment.

Materials and methods: The scale was translated with the forward-backward procedure to give an Iranian version. The ADL scale was then applied in a random sample of 400 oncologic patients aged 60 and older following initial cancer treatment. Assessment of the scale stability was twice, with a 14-days (two weeks) interval, to 30 (of the 400) eligible elderly cancer patients in March 2012. To measure treatment effects, the index was run with 150 patients in a three month recall, following oncology processing. Exploratory and confirmatory factor analysis was performed for assessment of construct validity of the Katz's ADL. Reliability was measured with internal consistency (Cronbach's alpha co-efficient), and test/retest (Spearman's r value) of the instrument. Criterion validity was evaluated by comparing the Katz with Physical Function (PF) subscale of SF 36. Known-group validity was approved by comparing of Katz' ADL between quartile groups of PF subscale of SF 36.

Results: In our study the ADL demonstrated a high degree of internal homogeneity (Cronbach's alpha 0.923). There was a high correlation between scores of two time measurement of Katz's ADL (p value of two- related- samples test was 0.3). Construct validity showed a correlation coefficient of 0.572 between the ADL and PF scores. In factor analysis, 2 factors were extracted. Evidence for the reliability of the questionnaire was good and known group validity was approved by significant differences of ADL score between quartiles of the PF subscale of SF36.

Conclusions: The results suggest that the Iranian version of ADL applied for oncologic older adult patients following initial cancer treatment is a reliable and a valid clinical instrument and comparable to those reported in other studies.