Hassan Bassam Abdul Rasool, Mohammed Ali Haider, Alsammarraie Ahmed Zuhair Abdulhameed, Alabboodi Musaab Kadhim
Department of Pharmacy, Al Rafidain University College, Baghdad, Iraq.
School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
J Cancer Educ. 2025 Jul 24. doi: 10.1007/s13187-025-02687-y.
Radiotherapy resistance (RTR) is a significant barrier in oncology, affecting treatment outcomes and clinical decision-making. Despite its importance, no standardized tool exists to measure oncologists' knowledge of RTR. This study aimed to develop and validate a comprehensive questionnaire to assess oncologists' knowledge of RTR. A 29-item questionnaire was developed following a multi-phase process. An initial pool of 45 items was refined through content and face validity assessments by a panel of 5 experts, leading to item revisions and deletions. Data were collected from 400 oncologists in Iraq. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted to establish construct validity, while Cronbach's alpha, Composite Reliability (CR), and Item Response Theory (IRT) analysis were used to assess internal consistency and item performance. EFA confirmed the eight-domain structure of the questionnaire, with factor loadings exceeding 0.70 for all items. CFA demonstrated good model fit, with indices of CFI = 0.92, TLI = 0.91, and RMSEA = 0.06. Internal consistency was high, with a Cronbach's alpha of 0.93 and a CR of 0.94 for the overall questionnaire. IRT analysis revealed that all items had acceptable difficulty, discrimination, and guessing parameters, indicating that the items effectively differentiate oncologists with varying levels of knowledge. The final 29-item questionnaire covered key RTR domains, including Conventional and Combined Therapies, Radioresistance, and Sensitivity and Resistance. The validated 29-item knowledge questionnaire demonstrated strong psychometric properties, making it a reliable tool for assessing oncologists' knowledge of RTR. This tool can support oncology education, training, and research. Future studies should focus on cross-cultural validation, test-retest reliability, and examining how RTR knowledge influences clinical decision-making. This tool is especially relevant for improving oncology training and clinical decision-making in Iraq, where systemic barriers such as limited equipment, training gaps, and uneven access to radiosensitizers challenge cancer care.
放疗抵抗（RTR）是肿瘤学中的一个重大障碍，影响治疗结果和临床决策。尽管其很重要，但目前尚无标准化工具来衡量肿瘤学家对RTR的了解程度。本研究旨在开发并验证一份全面的问卷，以评估肿瘤学家对RTR的了解。经过多阶段过程，编制了一份包含29个条目的问卷。最初有45个条目，经5位专家组成的小组进行内容和表面效度评估后进行了完善，导致条目修订和删除。从伊拉克的400名肿瘤学家收集了数据。进行探索性因子分析（EFA）和验证性因子分析（CFA）以建立结构效度，同时使用克朗巴哈系数、组合信度（CR）和项目反应理论（IRT）分析来评估内部一致性和条目表现。EFA证实了问卷的八领域结构，所有条目的因子载荷均超过0.70。CFA显示模型拟合良好，CFI = 0.92、TLI = 0.91和RMSEA = 0.06。总体问卷的内部一致性较高，克朗巴哈系数为0.93，CR为0.94。IRT分析表明所有条目具有可接受的难度、区分度和猜测参数，表明这些条目有效地区分了知识水平不同的肿瘤学家。最终的29个条目问卷涵盖了关键的RTR领域，包括传统和联合疗法、放射抗性以及敏感性和抗性。经过验证的29个条目的知识问卷显示出强大的心理测量特性，使其成为评估肿瘤学家对RTR了解程度的可靠工具。该工具可支持肿瘤学教育、培训和研究。未来的研究应侧重于跨文化验证、重测信度，以及研究RTR知识如何影响临床决策。该工具对于改善伊拉克的肿瘤学培训和临床决策尤为重要，在伊拉克，诸如设备有限、培训差距以及放射增敏剂获取不均等系统性障碍对癌症护理构成挑战。
