Psychometric properties of the acceptance and action questionnaire (AAQ II) Malay version in cancer patients
Open accessAbstract
OBJECTIVES: Acceptance and action questionnaire (AAQ II) is a scale used to assess psychological inflexibility. The aim of this study is to translate AAQ II into Malay language and evaluate the psychometric properties of AAQ II Malay version. METHODS: The AAQ II which has been translated into Malay language via back translation procedure was distributed to 101 cancer patients and 100 non-cancer patients. The evaluation of psychometric properties in this study included content validity index, internal consistency, parallel reliability, exploratory factor analysis, concurrent validity, sensitivity and specificity of AAQ II Malay version. RESULTS: AAQ II Malay version has established good content validity index, acceptable internal consistency with Cronbach's alpha value of 0.91, excellent parallel reliability and adequate concurrent validity. Exploratory factor analysis (EFA) results demonstrated AAQ II Malay version is a unidimensional factor instrument. The result of sensitivity and specificity of AAQ II Malay version indicated cancer patients who scored more than 17.5 were having significant psychological inflexibility. CONCLUSION: AAQ II Malay version is a reliable and valid instrument to measure psychological inflexibility among cancer patient in Malaysia.
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The Malay version of the AAQ-II has demonstrated strong psychometric properties, making it a reliable and acceptable tool for assessing psychological inflexibility among Malay-speaking populations.
“The Malay version of the AAQ-II has demonstrated strong psychometric properties, making it a reliable and acceptable tool for assessing psychological inflexibility among Malay-speaking populations.”
From Effectiveness of Acceptance and Commitment Therapy (ACT) on disease acceptance for breast cancer patients: Study protocol of a randomized controlled trial (2024) · cites this paper as [39]
The Abstract Results report good validity and reliability, and the Abstract Conclusion calls the Malay AAQ-II a reliable and valid measure of psychological inflexibility among cancer patients in Malaysia. The broader claim that it is suitable for Malay-speaking populations generally goes beyond that conclusion; the paper’s Conclusion describes its psychometric properties as “acceptable and promising,” rather than establishing validity across those populations. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe AAQ-II Malay version is suitable for use in clinical and research settings to measure psychological inflexibility accurately.
“These findings support the AAQ-II Malay version’s use in clinical and research settings to measure psychological inflexibility accurately [39].”
From Effectiveness of Acceptance and Commitment Therapy (ACT) on disease acceptance for breast cancer patients: Study protocol of a randomized controlled trial (2024) · cites this paper as [39]
The Abstract Conclusion says the AAQ-II Malay version is a reliable and valid measure of psychological inflexibility among cancer patients in Malaysia; the Results also report supporting psychometric findings. The cited paper does not establish its accuracy for clinical and research use beyond that population, which the citing sentence leaves unspecified. (LLM, conf=0.82)
Experimental — accuracy not yet measuredAAQ-II has showed good reliability and validity across a range of linguistic and clinical populations, including Norwegian samples and among patients with breast cancer.
“The AAQ-II has showed good reliability and validity across a range of linguistic and clinical populations, including Norwegian samples and among patients with breast cancer [69,70]”
From Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): Protocol for a randomized controlled trial (2022) · cites this paper as [69]
The Questionnaires section reports acceptable reliability for Chinese, Turkish and Greek versions, and the Abstract Results report reliability and validity for the Malay version in cancer patients. The paper does not establish those properties in Norwegian samples or specifically in patients with breast cancer; its cancer sample is not identified as breast-cancer patients. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe Malay version of the Acceptance and Action Questionnaire-II has excellent internal consistency with a Cronbach's alpha of 0.91 and is a unidimensional scale measuring psychological inflexibility or experiential avoidance.
“Validation of the Malay version of the AAQ-II indicated that the tool has excellent internal consistency with a Cronbach’s alpha of 0.91, and it has been found to be a unidimensional scale that measures psychological inflexibility or EA.46”
The AAQ-II Malay version exhibited good content validity.
“It exhibited good content validity, reflecting the relevance and representativeness of its items.”
From Effectiveness of Acceptance and Commitment Therapy (ACT) on disease acceptance for breast cancer patients: Study protocol of a randomized controlled trial (2024) · cites this paper as [39]
Exploratory factor analysis confirmed that the AAQ-II Malay version is a unidimensional instrument.
“Exploratory factor analysis confirmed that the AAQ-II Malay version is a unidimensional instrument.”
From Effectiveness of Acceptance and Commitment Therapy (ACT) on disease acceptance for breast cancer patients: Study protocol of a randomized controlled trial (2024) · cites this paper as [39]
The AAQ-II Malay version had high internal consistency (Cronbach's alpha 0.91) and excellent parallel reliability.
“The internal consistency was high, with a Cronbach’s alpha value of 0.91, and the tool also showed excellent parallel reliability.”
From Effectiveness of Acceptance and Commitment Therapy (ACT) on disease acceptance for breast cancer patients: Study protocol of a randomized controlled trial (2024) · cites this paper as [39]
The AAQ-II Malay version effectively distinguishes cancer patients with significant psychological inflexibility (scores above 17.5) from those without.
“Additionally, the sensitivity and specificity analyses indicated that the AAQ-II Malay version effectively distinguishes cancer patients with significant psychological inflexibility (scores above 17.5) from those without.”
From Effectiveness of Acceptance and Commitment Therapy (ACT) on disease acceptance for breast cancer patients: Study protocol of a randomized controlled trial (2024) · cites this paper as [39]
The AAQ-II Malay version has adequate concurrent validity, established through significant correlations with other measures of similar constructs.
“Adequate concurrent validity was established through significant correlations with other measures of similar constructs.”
From Effectiveness of Acceptance and Commitment Therapy (ACT) on disease acceptance for breast cancer patients: Study protocol of a randomized controlled trial (2024) · cites this paper as [39]
The Malay version of the AAQ-II has excellent internal consistency (Cronbach's alpha 0.91) and is a unidimensional scale measuring psychological inflexibility/EA.
“Validation of the Malay version of the AAQ-II has indicated that the tool has excellent internal consistency with a Cronbach’s alpha of 0.91, and it has been found to be a unidimensional scale that measures psychological inflexibility/EA [64].”
The Cronbach's α = 0.91 in a separate Malay validation of the AAQ-II.
“The Cronbach’s α = 0.91 in a separate Malay validation [37].”
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Acceptance and Action Questionnaire-II (AAQ-II)
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Acceptance and Action Questionnaire-II (AAQ-II)
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- Authors
- Shari, N. I., Zainal, N. Z., Guan, N. C., Ahmad Sabki, Z., & Yahaya, N. A.
- Affiliations
- Universiti Sains Malaysia (MY)
- University of Malaya (MY)
- Corresponding author
- Shari, Nurul Izzah
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2019-02-26
- Volume
- 14
- Issue
- 2
- Pages
- e0212788
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6391017
- OpenAlex
- W2915731636
- Cited by
- 39
- References
- 36
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 7 · 2023: 2 · 2022: 10 · 2021: 9 · 2020: 2
- FWCI
- 6.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- The University of Malaya Research Repository (University of Malaya) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- Acceptance and Action Questionnaire-II, psychological inflexibility, Malay translation, cross-cultural adaptation, cancer patients, psychometric properties, scale validation, acceptance and commitment therapy
- MeSH terms
- Adult, Female, Humans, Malaysia, Male, Middle Aged, Neoplasms, Psychometrics, Quality of Life, Surveys and Questionnaires
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