A Study of Factor Structure of Persian Version of Acceptance and Action Questionnaire in People with Cancer

Document Type : Original Article

Authors

1 Associate Professor of Biostatistics, Department of Biostatistics, Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

2 Master of Science, Department of Biostatistics, Student Research Committee, University of Welfare and Rehabilitation Sciences

Abstract
Introduction & Objective: Cancer is the result of abnormal growth of the cells with the potential to invade or spread to other parts of the body which affects psychological patients’ aspects. Some of mental health disorders in cancer patients are due to lack of psychological flexibility. An assessment tool that can be used on these patients will be helpful to prepare patients not only for surgery but also after surgery. This study aimed to determine the factor structure of the Persian version of acceptance and action questionnaire (AAQ-II) in the cancer patients. Materials & Methods: This study was a cross-sectional study in which 95 cancer patients that admitted to Firoozgar Hospital in Tehran participated in the study. The Persian version of acceptance and action questionnaire (AAQ-II), Heartland Forgiveness Scale (HFS) and Beck Depression Inventory-II (BDI-II) were used to this study. Exploratory and confirmatory factor analysis methods, convergent-divergent validity were used to examine the validity of the study. The internal consistency coefficient was used to reliability. Data analysis was performed in IBM SPSS 22 and Amos 22 software. Results: Exploratory factor analysis by principle component analysis and Varimax rotation indicated that the two factors are extractable from the Persian version of the scale (named as feelings and worries and negative memories) and the fitting indices confirmed the results of the confirmatory factor analysis of the dual factors. Correlation coefficients between the scores with other valid tools, Heartland Forgiveness Scale (HFS) and Beck Depression Inventory-II (BDI-II), showed that the convergence and divergence validity of the scale is acceptable and the Cronbach's alpha coefficient (0.824) confirmed internal consistency. Conclusions: The Persian version of AAQ-II in cancer patients was resulted two-factor structure, and it seems that it is more appropriate than single-factor structure and suggested. This questionnaire can be used for cancer patients before surgery.

Keywords


1. Mousavi M, Hatami M, Nouryghasemabadi R. The Evaluation of effect of acceptance and commitment therapy on fatigue and anxiety in patients with breast cancer. Research in Medicine. 2017; 41(3): 189-98.
2. Thapa P, Rawal N, Bista Y. A study of depression and anxiety in cancer patients. Nepal Medical College journal: NMCJ. 2010; 12(3): 171-5.
3. Seyyed Tabaei S RP, Sehat R. The Prevalence of Behavioral Symptoms of Psychological Disorders in Cancer Patients. Thought and Behavior in Clinical Psychology. 2015.
4. Twohig MP. Acceptance and commitment therapy: Introduction. Elsevier; 2012.
5. Imani M, Pourshahbazi M. Prediction of borderline personality disorder based on psychological flexibility components: acceptance and action, values and cognitive defusion. Journal of Research in Psychological Health (RPH). 2017; 10 (4):1-9.
6. Gholamhoseini B, Koolaee AK, Taghvaee D. The effectiveness of acceptance and commitment group therapy on depression and body image in women with obesity. Community Health (Salāmat-i ijtimāī). 2015; 2(2): 72-9.
7. Imani M, Karimi J, Behbahani M, Omidi A. Role of mindfulness, psychological flexibility and integrative self-knowledge on psychological well-being among the university students. Feyz. 2017; 21 (2):170-177.
8. Gaudiano BA. A review of acceptance and commitment therapy (ACT) and recommendations for continued scientific advancement. Scientific Review Mental Health Practice 2011; 8: 5-22.
9. Westin V, Hayes SC, Andersson G. Is it the sound or your relationship to it? The role of acceptance in predicting tinnitus impact. Behav res Therapy 2008; 46(12): 1259-65
10. Dinis A, Carvalho S, Gouveia JP, Estanqueiro C. Shame memories and depression symptoms: the role of cognitive fusion and experiential avoidance. International Journal of Psychology and Psychological Therapy. 2015; 15(1): 63-86.
11. Salande JD, Hawkins I, Raymond C. Psychological flexibility, attachment style, and personality organization: Correlations between constructs of differing approaches. Journal of Psychotherapy Integration. 2017; 27(3): 365.
12. Asghari Ebrahimabad M MM. An investigation into the role of psychological flexibility and hardiness in explaining Soldiers’ psychological well-being. Research in Clinical Psychology and Counseling. 2018: 37-51.
13. Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire - II: A revised measure of psychological inflexibility and experiential avoidance. Behavior therapy. 2011; 42(4): 676-88.
14. Fledderus M, Oude Voshaar MA, ten Klooster PM, Bohlmeijer ET. Further evaluation of the psychometric properties of the Acceptance and Action Questionnaire – II. Psychological assessment. 2012; 24(4): 925.
15. Pennato T, Berrocal C, Bernini O, Rivas T. Italian version of the Acceptance and Action Questionnaire II (AAQ - II): Dimensionality, reliability, convergent and criterion validity. Journal of Psychopathology and Behavioral Assessment. 2013; 35(4): 552-63.
16. Abbasi I FL, Mawludi R, Zarabi H. Psychometric correctness of the Persian Version of the Acceptance and Practice Questionnaire - Second Edition. Journal of Psychological Models and Methods. 2013: 65-80.
17. García-Batista ZE, Guerra-Peña K, Cano-Vindel A, Herrera-Martínez SX, Medrano LA4. Validity and reliability of the Beck Depression Inventory (BDI-II) in general and hospital population of Dominican Republic. PLoS One. 2018; 13(6):e0199750. doi: 10.1371/journal.pone.0199750. eCollection 2018.
18. Hamidi, R., Fekrizadeh, Z., Azadbakht, M., Garmaroudi, G., Taheri Tanjani, P., Fathizadeh, S., Ghisvandi, E. Validity and reliability Beck Depression Inventory - II among the Iranian elderly Population. Journal of Sabzevar University of Medical Sciences, 2015; 22(1): 189-198.
19. Ebrahimi M, Azkhosh M, Shoaai F, Froughan M, Dolatshahi B. Psychometric properties of Persian version of Heartland Forgiveness Scale in elderly. IJRN. 2017; 3 (4): 9-20.
20. Bugay A1, Demir A, Delevi R. Assessment of reliability and validity of the Turkish version of Heartland Forgiveness Scale. Psychol Rep. 2012; 111(2): 575-84.
21. Thompson LY, Snyder CR, Hoffman L, Michael ST, Rasmussen HN, Billings LS, et al. Dispositional forgiveness of self, others, and situations. Journal of personality. 2005; 73(2): 313-60.
22. Shahar B, Herr NR. Depressive symptoms predict inflexibly high levels of experiential avoidance in response to daily negative affect: A daily diary study. Behaviour Research and Therapy. 2011; 49(10):
676-81.