{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:07:48Z","timestamp":1788934068121,"version":"build-2803163510"},"reference-count":66,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to develop and psychometrically validate a patient-centered Knowledge\u2013Attitude\u2013Practice (KAP) questionnaire for cancer pain management in Chinese geriatric cancer patients. Existing pain assessment tools were largely developed for younger or mixed-age populations and seldom capture culture-specific psychosocial factors or the patient\u2019s own perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The Knowledge\u2013Attitude\u2013Practice Questionnaire for Geriatric Cancer Pain Management (KAP-CPGQ) was developed across five sequential phases: item generation (literature review and semi-structured key-informant interviews with 6 clinical experts), content validity (a two-round modified Delphi consultation with an independent panel of 12 experts), face validity (cognitive interviewing with 10 geriatric cancer patients), construct validity, and reliability analysis. Construct validity was examined in 440 geriatric cancer patients, randomly partitioned into two independent subsamples (\n                      <jats:italic>n<\/jats:italic>\n                      = 220 each) for exploratory (EFA) and confirmatory factor analysis (CFA). Test\u2013retest reliability was assessed in 30 participants after a 2-week interval.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The final instrument retained 28 items across three domains: knowledge (10 items), attitudes (9 items), and practices (9 items), each rated on a 5-point Likert scale. Content validity was supported by an overall content validity ratio (CVR) of 0.90 and a scale-level content validity index (S-CVI\/Ave) of 0.91, and all 28 items exceeded the Item Impact Score threshold of 1.5 (range 3.5\u20134.2). EFA identified a three-factor structure (KMO = 0.94; Bartlett\u2019s test\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) explaining 61.0% of the total variance, with all item loadings &amp;gt;0.50. CFA confirmed good model fit (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \/df = 1.158; CFI = 0.986; NNFI = 0.984; IFI = 0.986; NFI = 0.903; AGFI = 0.869; RMR = 0.026; RMSEA = 0.027), with standardized factor loadings ranging from 0.66 to 0.83. Reliability was high: overall Cronbach\u2019s \u03b1 = 0.94 (subscales 0.92\u20130.93), split-half reliability = 0.90 (subscales 0.87\u20130.89), and 2-week test\u2013retest reliability ranged from 0.89 to 0.91 across the three domains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The KAP-CPGQ is a reliable, valid, and culturally adapted instrument measuring knowledge, attitudes, and practices in geriatric cancer pain management. It offers clinicians and researchers a tool to identify patient-level barriers to pain control and to guide targeted educational and behavioral interventions for geriatric cancer patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1808383","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:00:48Z","timestamp":1788933648000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and psychometric validation of a patient-centered Knowledge, Attitude, and Practice (KAP) Questionnaire for Geriatric Cancer Pain Management"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiaoyan","family":"Li","sequence":"first","affiliation":[{"name":"School of Medicine, Lishui University, Lishui","place":["Zhejiang, China"]},{"name":"Department of Community Health, Universiti Sains Malaysia, Pusat Kanser Tun Abdullah Ahmad Badawi (PKTAAB)","place":["Kepala Batas, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yubin","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Nursing, Harbin Medical University, Daqing","place":["Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihua","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Health Medicine, Nantong Institute of Technology, Nantong","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor Mastura","family":"Mohd Mujar","sequence":"additional","affiliation":[{"name":"Department of Community Health, Universiti Sains Malaysia, Pusat Kanser Tun Abdullah Ahmad Badawi (PKTAAB)","place":["Kepala Batas, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohayu","family":"Hami","sequence":"additional","affiliation":[{"name":"Department of Community Health, Universiti Sains Malaysia, Pusat Kanser Tun Abdullah Ahmad Badawi (PKTAAB)","place":["Kepala Batas, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nizuwan","family":"Azman","sequence":"additional","affiliation":[{"name":"Division of Research and Networking, Pusat Kanser Tun Abdullah Ahmad Badawi, Universiti Sains Malaysia","place":["Kepala Batas, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1177\/0253717620946111","article-title":"Designing and conducting knowledge, attitude, and practice surveys in psychiatry: Practical guidance.","volume":"42","author":"Andrade","year":"2020","journal-title":"Indian J. 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