• Norhaliza Abd Hamid Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia
  • Nur Amirah Hamdan Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia
  • Nizuwan Azman Division of Research and Networking, Advanced Medical and Dental Institute, Universiti Sains Malaysia
  • Mohammad Farris Iman Leong Bin Abdullah Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia
Keywords: Awareness, Reliability and validity, validation study, cancer, Malaysia


Satisfaction with treatment among cancer patients is vital for planning of healthcare strategies and to ensure compliance to cancer therapy. Hence, this study translated the original English version of the Cancer Therapy Satisfaction Questionnaire (CTSQ) into Malay and investigated the reliability and validity of the Malay version for use to assess satisfaction with treatment among Malaysian cancer patients. Initially, concurrent translation and back translation of the English version of the CTSQ was performed. Then, the Malay version of the CTSQ (CTSQ-M) was administered to 200 cancer patients with different sites and stages of cancer for assessment of its reliability and validity. The CTSQ-M and its domains exhibited acceptable internal consistency (Cronbach’s α ranged from 0.724 to 0.882). Convergent and discriminant validity were achieved by the CTSQ-M. Construct validity was achieved by the CTSQ-M as exploratory factor analysis extracted 3 factors, while confirmatory factor analysis confirmed that the CTSQ-M consisted of 16 items in 3 domains. We concluded that the CTSQ-M had acceptable psychometric properties.


Crow R, Gage H, Hampson S, et al. The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature. Health Technol Assess 2002; 6(32):1-244.

Bergenmar M, Nylen U, Lidbrink E, et al. Improvements in patient satisfaction at an outpatient clinic for patients with breast cancer. Acta Oncol 2006; 45(5):550-8.

Abetz L, Coombs JH, Keininger DL, et al. Development of the cancer therapy satisfaction questionnaire: item generation and content validity testing. Value Health 2005; 8(Suppl 1):S41-S53.

von Gruenigen VE, Hutchins JR, Reidy AM, et al. Gynecologic oncology patients’ satisfaction and symptom severity during palliative chemotherapy. Health Qual Life Outcomes 2006; 4:84.

Mathiesen TP, Willaing I, Frell M, et al. How do patients with colorectal cancer perceive treatment and care compared with the treating health care professionals? Med Care 2007; 45(5):394-400.

Sherlaw-Johnson C, Datta P, McCarthy M. Hospital differences in patient satisfaction with care for breast, colorectal, lung and prostate cancers. Eur J Cancer 2008; 44(11):1559-65.

Bharmal M, Payne K, Atkinson MJ, et al. Validation of an abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9) among patients on antihypertensive medications. Health Qual Life Outcomes 2009; 7:36.

Campbell JL, Kiebert GM, Partridge MR. Development of the Satisfaction with Inhaled Asthma Treatment Questionnaire. Eur Respir J 2003; 22:127-34.

Brédart A, Anota A, Young T, et al. Phase III study of the European Organisation for Research and Treatment of Cancer satisfaction with cancer care core questionnaire (EORTC PATSAT-C33) and specific complementary outpatient module (EORTC OUT-PATSAT7). Eur J Cancer Care (Engl) 2018; 27(1).

Trask PC, Tellefsen C, Espindle D, et al. Psychometric validation of the cancer therapy satisfaction questionnaire. Value Health 2008; 11(4):669-79.

Park SJ, An SM, Kim SH. Development of a Korean version of the Cancer Therapy Satisfaction Questionnaire (CTSQ): cross-cultural adaptation, reliability, and validity. Qual Life Res 2013; 22(2):431-6.

Cheung K, de Mol M, Visser S, et al. Reliability and validity of the Cancer Therapy Satisfaction Questionnaire in lung cancer. Qual Life Res 2016; 25(1):71-80.

Ramli M, Mohd Ariff F, Khalid Y, et al. Validation of the Bahasa Malaysia version of the Coping Inventory for Stressful Situation. Malaysian Journal of Psychiatry Online 2008; 17(2):1-8.

Bryant FB, Yarnold PR. Principal-components analysis and exploratory and confirmatory factor analysis. In Grimm LG, Yarnold PR, eds. Reading and understanding multivariate statistics. Washington, DC: American Psychological Association 1995:99-136.

Terwee CB, Bot SDM, de Boer MR, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007; 60(1):34–42.

Zamanzadeh V, Ghahramanian A, Rassouli M, et al. Design and implementation content validity study: development of an instrument for measuring patient-centered communication. J Caring Sci 2015; 4(5):165–78.

Shi J, Mo X, Sun Z. Content validity index in scale development. Zhong Na Da Xue Xue Bao Yi Xue Ban 2012; 37(2):152–5.

Mehnert A, Berg P, Henrich G, et al. Fear of cancer progression and cancer-related intrusive cognitions in breast cancer survivors. Psychooncology 2009; 18(12):1273–80.

Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling 1999; 6(1):1-55.

Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess 1994; 6(4):284-90.

World Health Organization. Process of translation and adaptation of instruments. 2019 [Online] [Accessed 25 August 2020]. Available from

Lua PL, Wong SY. The reliability of the Malay versions of hospital anxiety depression scale (HADS) and McGill quality of life questionnaire (MQOL) among a group of patients with cancer in Malaysia. Malaysian Journal of Psychiatry 2012; 21(1):1-13.

Prudon P. Confirmatory factor analysis as a tool in research using questionnaires: a critique. Comprehensive Psychology 2015; 4:10

How to Cite
Abd Hamid, N., Hamdan, N. A., Azman, N., & Leong Bin Abdullah, M. F. I. (2021). VALIDATION OF THE MALAY VERSION OF THE CANCER THERAPY SATISFACTION QUESTIONNAIRE AMONG MALAYSIAN CANCER PATIENTS. Malaysian Journal of Public Health Medicine, 21(1), 274-285.