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Validation of the 60‑Item Brief COPE for Assessing Coping Mechanisms Among Informal Caregivers of Patients with Cancer in Uganda Cover

Validation of the 60‑Item Brief COPE for Assessing Coping Mechanisms Among Informal Caregivers of Patients with Cancer in Uganda

Open Access
|Jan 2026

Figures & Tables

Table 1

Step‑by‑step procedure for validating the 60‑item brief COPE.

STEPDESCRIPTION
  • 1. Translation

The Brief COPE was translated into relevant local languages by a certified language expert to ensure cultural relevance and linguistic clarity.
  • 2. Back‑translation

The translated version was back‑translated into English by an independent expert to verify accuracy and conceptual equivalence.
  • 3. Pilot testing

A pilot test was conducted with a small group of 10 informal caregivers to identify unclear wording and ensure cultural appropriateness. Adjustments were made as needed.
  • 4. Recruitment

200 informal caregivers were recruited from two cancer treatment centers and grouped according to the site. Eligibility criteria were confirmed before enrollment.
  • 5. Consent and ID coding

Written informed consent was obtained. Each participant received a unique identification code to protect confidentiality and track responses for test–retest reliability.
  • 6. Administration

Participants completed the self‑administered questionnaire in private rooms within the centers. Trained research assistants provided standardized instructions.
  • 7. Assistance

Research assistants remained available to clarify items or assist participants with reading difficulties, ensuring they did not influence answers.
  • 8. Test–retest subsample

A subgroup of 30 participants was randomly selected to complete the same questionnaire again after two weeks to assess test–retest reliability.
  • 9. Data collection

Completed forms were collected immediately, checked for completeness, and securely stored for data entry and statistical analysis.
Table 2

Sociodemographic characteristics of respondents.

VARIABLEMALEFEMALEOVERALLTEST STATp‑VALUE
Age of caregiver (mean, SD)37.3 (12.2)33.5 (11.4)34.7 (11.8)3.1810.002
Age of patient (mean, SD)38.0 (24.1)32.0 (22.7)35.4 (23.6)2.5060.013
Occupation (%, N)19.1140.014
Farmer59 (34.3)113 (65.7)173 (39.9)
Business32 (28.6)80 (71.4)113 (26.0)
Others49 (0.0)98 (100)1 (0.23)
Distance to nearest HC (%, N)7.2980.199
 Less than 20 km12164 (37.2)228,108 (62.7)349,172 (40.1)
 More than 20 km18 (24)57 (76)75 (17.6)
 Non‑response1 (14.2)6 (85.7)7 (1.62)
Education level (%, N)20.7300.004
 Primary level47 (29.94)118 (70.0)157 (36.94)
 Secondary school level50 (29.31)97 (70.69)147 (27.29)
 Completion of certificate course22 (37.92)36 (62.07)58 (13.65)
University education11 (40.74)20 (59.26)31(6.35)
 Non‑response1030 (16.7)40 (1.39)
Disability (%, N)1.7020.427
 No136 (32.5)282 (67.5)420 (97.7)
 Yes4.0 (40)6.0 (60)10 (2.3)
 Non‑response0 (.0)3.0 (100)3 (0.69)
Level income (000) (median, range)309710.7 (402374.1)276182.6 (555397.6)150,000 (300–5,000,000.5880.557
Religion (%, N)16.4170.006
 Anglican62 (41.6)87 (58.4)152 (36.1)
 Roman Catholic49 (33.3)98 (66.7)147 (34.9)
 Moslem5 (11.4)39 (88.6)44 (10.5)
 Born again19 (26)54 (74)73 (17.3)
 Seventh day Adventist1 (20)4 (80)5 (1.2)
 Non‑response4 (30.7)9 (69.3)13 (3.01)
Type of CA (%, N)
Breast cancer11 (31.4)24 (68.6)35 (8.1)
Colorectal cancer6 (40)9 (60)16 (3.7)
Prostate cancer13 (48.1)14 (51.8)27 (6.2)
Cervical cancer18 (27.7)47 (72.3)65 (15.0)
Leukemia28 (35.4)51 (64.5)80 (18.5)
Head and neck Cancer14 (31.8)30 (68.2)45 (10.4)
Childhood cancer2 (12.5)14 (87.5)16 (3.7)
Not known48 (31.6)102 (68.4)150 (34.4)
Stage of CA (%, N)10.4950.033
 Early stage37 (45.1)45 (54.9)82 (19.3)
 Late stage35 (34.3)67 (65.7)104 (24.4)
 Terminal stage11 (31.4)24 (68.6)36 (8.5)
 Not known57 (26.1)155 (73.9)213 (47.9)
aogh-92-1-4948-g1.png
Figure 1

Coping mechanism applied by caregivers.

Table 3

Internal consistency testing results of the COPE instrument.

TOOLS USEDSUBSCALES OF THE TOOLSNAMES OF THE SUBSCALESCRONBACH’S α
COPESubscale 1
Subscale 2
Subscale 3
Problem‑solving
Denial
Active coping
0.91
0.92
0.91
Table 4

Factor analysis results of the COPE instrument.

VARIABLESFACTOR 1FACTOR 2FACTOR 3UNIQUENESS
cope1new–0.4554–0.3300–0.07470.6782
cope2new–0.0749–0.34680.17190.8446
cope3new–0.2491–0.66940.03350.4887
cope4new0.45270.21790.08960.7395
cope5new0.44880.2990–0.00820.7091
cope6new–0.1968–0.50000.19660.6726
cope7new0.5742–0.0522–0.02260.6671
cope8new–0.1180–0.56480.02870.6663
cope9new0.33020.49350.04400.6455
cope10new0.53730.21860.20950.6196
cope11new0.56430.32530.10950.5638
cope12new0.63920.17660.08090.5537
cope13new–0.5022–0.23570.02700.6915
cope14new0.17370.6241–0.16900.5518
cope15new–0.2524–0.58260.06550.5926
cope16new0.56190.0061–0.06950.6794
cope17new0.56030.26530.13760.5967
cope18new0.39360.38560.13550.6781
cope19new–0.2499–0.5222–0.17100.6356
cope20new0.54320.22940.17660.6212
cope21new–0.0523–0.6014–0.13250.6180
cope22new0.25110.43290.15320.7260
cope23new–0.01290.6048–0.16240.6076
cope24new0.33610.4173–0.09980.7030
cope25new0.42050.37970.05570.6759
cope26new0.46270.13000.01510.7688
cope27new–0.0520–0.5594–0.12940.6677
cope28new0.50380.28350.12580.6500
cope29new0.45190.31830.05510.6914
cope30new0.48770.24650.13940.6820
cope31new–0.1215–0.6139–0.00370.6084
cope32new0.29830.3055–0.15710.7930
cope33new0.59300.0902–0.17900.6081
cope34new–0.1201–0.52130.40890.5466
cope35new0.45920.2887–0.07730.6998
cope36new0.50220.2417–0.28560.6078
cope37new0.06850.2909–0.32380.8058
cope38new0.51850.1527–0.04680.7056
cope39new0.58330.1601–0.00590.6341
cope40new–0.3463–0.32080.14870.7551
cope41new0.51700.3031–0.07420.6353
cope42new0.3948–0.0202–0.05080.8412
cope43new–0.3585–0.41760.23920.6399
cope44new–0.1453–0.56230.05180.6600
cope45new0.60730.3071–0.06240.5330
cope46new0.51680.1727–0.20200.6624
cope47new–0.4410–0.28950.22720.6701
cope48new0.52450.2627–0.12850.6393
cope49new–0.1640–0.33770.24490.7991
cope50new0.62060.0757–0.16060.5833
cope51new0.67680.0146–0.09890.5320
cope52new0.59950.0393–0.18870.6035
aogh-92-1-4948-g2.png
Figure 2

Strategic application of the Brief COPE in hospitals for cancer caregivers.

DOI: https://doi.org/10.5334/aogh.4948 | Journal eISSN: 2214-9996
Language: English
Submitted on: Aug 28, 2025
|
Accepted on: Nov 27, 2025
|
Published on: Jan 30, 2026
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2026 Rachel Kansiime, Jackson Oryem, Nixon Niyonzima, Milton Mutto, Godfrey Zari Rukundo, Simon Kizito, Joyeeta Talukdar, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.