A cross-sectional study on the Arabic Version of the Adjustment Disorder–New Module20 for Cancer Patients: Tool Validation, Prevalence, and Risk Factors

Abstract

Background Adjustment disorder (AjD) is a common mental health condition whose symptoms include the development of a group of emotional and behavioral disturbances caused by inadequate adaptation to stressors. Adjustment Disorder – New Module 20 (ADNM-20) is a tool used to assess the new diagnostic concept of AjD according to the International Classification of Diseases 11 (ICD-11). This study aimed to evaluate the validity of the Arabic version of the ADNM-20 and investigate the risk factors for and prevalence of AjD among cancer patients. Methods A total of 146 adult cancer patients were recruited from cancer societies in Saudi Arabia (SA) and King Saud Medical City, a tertiary care center in Riyadh, Saudi Arabia. Test–retest stability, internal consistency, and item-total correlations were used to assess the reliability and validity of the ADNM-20. A cutoff score of 47.5 with the ADNM-20 scale was used to determine the prevalence of AjD, and the characteristics of the group at high risk of AjD were highlighted. Results The Arabic version of the ADNM-20 has shown high reliability, with Cronbach’s α = 0.92. The test-retest correlation coefficient was 0.76, and the correlation between the subscales of ADNM-20 and the total scale was high. We found that 43.84% of adult cancer patients were at risk of AjD, and there were no significant differences between the scores of the hospital and community cancer patients. The risk factors in this study were being female, unemployment, exposure to multiple stressors or financial difficulties, and receiving chemotherapy. Conclusions Our results suggest that ADNM-20 is reliable, valid, and applicable for clinical use and research into AjD in cancer patients. Additional research is needed to validate a structured assessment of AjD symptoms in Arabic culture.