Objective To identify self-report self-care scales for patients with cancer and critically evaluate their measurement properties. Design Systematic literature review based on COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology.
Data sources A comprehensive search was conducted from database inception to March 2025 through PubMed, CINAHL, Embase, Scopus, Web of Science and APA PsycINFO. Potentially eligible articles were also identified by consulting the reference lists of the included studies.
Eligibility criteria Studies were eligible if they reported on the development or validation of self-report instruments measuring self-care in adult patients with cancer and provided data on at least one measurement property as defined by the COSMIN framework. Data extraction and synthesis This review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement.
Risk of bias and methodological quality were assessed according to COSMIN criteria. A modified Grading of Recommendations Assessment, Development and Evaluation approach was applied to determine the level of evidence for each psychometric property and to formulate recommendations for instrument use.
Results 30 studies involving 26 instruments were included.
This systematic review sought self-report instruments that measure self-care in adults with cancer and to appraise their measurement properties using the COSMIN framework.
The review aimed to identify available scales, evaluate methodological quality, and grade instruments for clinical or research use.
A COSMIN-guided systematic review was performed, with reporting aligned to PRISMA.
Searches spanned inception to March 2025 across PubMed, CINAHL, Embase, Scopus, Web of Science and APA PsycINFO, and reference lists of included reports were inspected for additional studies.
The review protocol was registered in PROSPERO (CRD42024519219).
Included studies reported development or validation of self-report self-care measures for adults with cancer and presented data on at least one COSMIN-defined measurement property.
Risk of bias and methodological quality across studies were rated using COSMIN criteria.
A modified GRADE approach was applied to synthesize evidence per psychometric property and to generate recommendations for instrument use.
Thirty studies examining 26 distinct instruments met inclusion criteria.
The instruments targeted self-care constructs in oncological populations; details on specific cancer types represented across all studies were not exhaustively reported in the source summary.
Three instruments achieved the highest recommendation (Grade A), reflecting adequate content validity and internal consistency: the self-management instrument for patients with breast cancer undergoing adjuvant therapy; the Self-Care of Oral Anticancer Agents Index; and the Leuven questionnaire for Patient Self-care during Chemotherapy.
Two instruments received a negative recommendation (Grade C): the Self-Care Agency Scale was downgraded due to high-quality evidence of insufficient structural validity, and the Breast Cancer-Related Lymphoedema Self-Care Scale was downgraded for inadequate internal consistency.
The majority of instruments were assigned Grade B, indicating they may be suitable for use but require additional psychometric validation.
The authors report substantial gaps in the psychometric literature for oncology self-care measures.
Many instruments lack comprehensive evaluation across COSMIN properties, and the evidence base is frequently incomplete or inconsistent.
The need for more rigorous assessments and broader instrument development to cover diverse oncology populations is emphasized.
The source summary did not provide granular details on study-level sample characteristics, specific psychometric statistics, cross-cultural validations, or responsiveness data.