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Volume 19, Issue 3 (Iranian Journal of Breast Diseases 2026)
ijbd 2026, 19(3): 20-36 |
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Ethics code: IR.DUMS.REC.1402.046
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Habibi Behrooz N, Zareiyan A, Bigdeli Shamloo M B, Ramezanpour E. Development and Structural Validation of the Husbands Adaptation of Iranian women with mastectomy scale (HAMS). , ijbd. 2026; 19 (3) :20-36
URL: http://ijbd.ir/article-1-1247-en.html
URL: http://ijbd.ir/article-1-1247-en.html
1- Student Research Committee, School of Nursing, Dezful University of Medical Sciences, Dezful, Iran
2- Public Health Department, Health in Disaster & Emergencies, Research Center for Cancer Screening and Epidemiology, AJA University of Medical Sciences, Tehran, Iran
3- Department of Operating Room, School of Paramedicine, Dezful University of Medical Sciences, Dezful, Iran ,big1364@yahoo.com
4- School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
2- Public Health Department, Health in Disaster & Emergencies, Research Center for Cancer Screening and Epidemiology, AJA University of Medical Sciences, Tehran, Iran
3- Department of Operating Room, School of Paramedicine, Dezful University of Medical Sciences, Dezful, Iran ,
4- School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
Abstract: (571 Views)
Introduction: Mastectomy, as the most common surgical treatment for breast cancer, severely affects the husband's psychosocial adaptation. Despite the key role of the husband in the treatment process, a valid instrument to assess multiple dimensions of husbands' adaptation has not been developed in Iran. This study evaluated the construct validity and reliability of the Husbands' Adaptation to Mastectomy Scale (HAMS)
Methods: This descriptive-analytical study was conducted in 2024 on 468 husbands of women with breast cancer who had undergone mastectomy. The research instrument was the 51-item Husbands' Adaptation to Mastectomy Scale (HAMS) in six dimensions. Construct validity was assessed using confirmatory factor analysis (CFA) in AMOS version 24. Convergent validity was assessed using average variance extracted (AVE) and composite reliability (CR). In contrast, discriminant validity was evaluated through the Fornell-Larcker criterion, the heterotrait-monotrait (HTMT) ratio, and the maximum shared variance (MSV) index.
Results: A six-factor model of 51 items was tested on an independent sample. The fit indices of the model were χ²=2264.49, df=752, χ²/df=3.01, RMSEA=0.068, TLI=0.903, IFI=0.912, and CFI=0.911. In the first-order confirmatory factor analysis, all items with factor loadings less than .5 were eliminated, thus eliminating 10 items. In the second-order factor analysis, all items had factor loadings above .5. The CR values in all dimensions were higher than AVE, and MSV were lower than AVE, confirming the desired convergence and differentiation. The HTMT ratio in all dimensions was less than 0.85.
Conclusion: The 41-item HAMS demonstrates acceptable psychometric properties and can serve as a practical instrument for screening and needs assessment of spouses in oncology settings, particularly for identifying those at risk of maladjustment following their partner's mastectomy. It can be used to assess the adaptation of husbands of women undergoing mastectomy in research and support programs; however, it is recommended to examine temporal stability, criterion validity, and measurement invariance in independent samples.
Methods: This descriptive-analytical study was conducted in 2024 on 468 husbands of women with breast cancer who had undergone mastectomy. The research instrument was the 51-item Husbands' Adaptation to Mastectomy Scale (HAMS) in six dimensions. Construct validity was assessed using confirmatory factor analysis (CFA) in AMOS version 24. Convergent validity was assessed using average variance extracted (AVE) and composite reliability (CR). In contrast, discriminant validity was evaluated through the Fornell-Larcker criterion, the heterotrait-monotrait (HTMT) ratio, and the maximum shared variance (MSV) index.
Results: A six-factor model of 51 items was tested on an independent sample. The fit indices of the model were χ²=2264.49, df=752, χ²/df=3.01, RMSEA=0.068, TLI=0.903, IFI=0.912, and CFI=0.911. In the first-order confirmatory factor analysis, all items with factor loadings less than .5 were eliminated, thus eliminating 10 items. In the second-order factor analysis, all items had factor loadings above .5. The CR values in all dimensions were higher than AVE, and MSV were lower than AVE, confirming the desired convergence and differentiation. The HTMT ratio in all dimensions was less than 0.85.
Conclusion: The 41-item HAMS demonstrates acceptable psychometric properties and can serve as a practical instrument for screening and needs assessment of spouses in oncology settings, particularly for identifying those at risk of maladjustment following their partner's mastectomy. It can be used to assess the adaptation of husbands of women undergoing mastectomy in research and support programs; however, it is recommended to examine temporal stability, criterion validity, and measurement invariance in independent samples.
Keywords: Breast cancer, Mastectomy, Husbands, Adaptation, Confirmatory Factor Analysis, Construct Validity
Type of Study: Research |
Subject:
Nutrition, psychology, sport
Received: 2026/05/16 | Accepted: 2026/08/8 | Published: 2026/10/22
Received: 2026/05/16 | Accepted: 2026/08/8 | Published: 2026/10/22
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