Psycho-Oncology Psycho-Oncology 18: 1097–1105 (2009) Published online 17 December 2008 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/pon.1500 Measuring social relational quality in colorectal cancer: the Social Relational Quality Scale (SRQS) Wai Kai Hou 1,2 , Wendy Wing Tak Lam 2,3Ã , Chi Ching Law 4 , Yiu Tung Fu 4 and Richard Fielding 2,3 1 Department of Psychology, The University of Hong Kong, Hong Kong, China 2 Centre for Psycho-Oncology Research and Teaching, The University of Hong Kong, Hong Kong, China 3 School of Public Health, The University of Hong Kong, Hong Kong, China 4 Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China Abstract Objectives: Social relationships are central in Asian communities. Despite colorectal cancer (CRC) incidence increasing in Asian populations the roles of social activity in facilitating adjustment and optimizing coping resources in Asian peoples remains largely unknown. We derived and validated among Chinese CRC patients, an instrument assessing social relational quality to enable study of these social processes. Methods: Qualitative interviews (n 5 16) generated 22-items subsequently administered to 166 Chinese CRC survivors. Principal components analyses identified underlying constructs. The draft instrument, plus measures of optimism, affect, physical symptoms, and perceived social support were administered to a second cohort of 234 newly diagnosed Chinese CRC patients. Results: Three factors were extracted (54.44% of the total variance): Family Intimacy (7 items, 33.08%), Family Commitment (5 items, 14.17%), and Friendships (5 items, 7.19%). All subscales were internally consistent (a 5 0.75–0.82), exhibiting concurrent validity in negative correlations with anxiety and depression and positive correlations with physical and psychological well-being. Convergent validity was indicated by significant positive correlations with optimism, and divergent validity by insignificant inverse correlations with physical symptoms and moderate correlations with perceived social support. Hierarchical regressions revealed positive correlations of the three subscales with psychological well-being, controlling for perceived social support (b 5 0.13–0.28). Good criterion validity was indicated. Conclusion: The Social Relational Quality Scale is a psychometrically sound self-report measure of social relational quality among Chinese CRC patients and needs further validation among other Asian groups. Copyright r 2008 John Wiley & Sons, Ltd. Keywords: social relational quality; Family Intimacy and Commitment; friendships; adaptation resources; Chinese; colorectal cancer Introduction As with other ‘affluence’ cancers, colorectal cancer (CRC) incidence is increasing across urban Asia [1–3]. Sociocultural factors probably influence psychosocial adjustment to cancer in Asian CRC patients differently from those acculturated to or living by westernized value systems for several reasons. First, Asian cultures traditionally prior- itize relationships over individual orientations. Exhibiting greater fatalism, multi-causality of events, and interdependence among close social partners, Asians place less emphasis on Western cultural imperatives of personal agency and accomplishment [4–6]. Cross-cultural evidence sug- gests that Asian communities emphasize collecti- vistic rather than individualistic aspects during stressful events, such as relational harmony and significant others’ well-being [7]. While interperso- nal cooperation is associated with less psychoso- matic and depressive symptoms in demanding situations among Hong Kong Chinese, perceived personal mastery is associated with psychological well-being among Americans [8]. Second, most Asian CRC patients are older adults [1,2]. Older people emphasize strengthening existing relationships rather than building new ones, generating smaller but more emotionally rewarding social networks [9–11]. Social relationship quality (SRQ) may have greater adaptive influence in older compared with younger CRC patients. Second, generic relational quality modulates perceived social support during demand adaptation [12]. Asian communities’ collectivist cultural background is found more on generalized impres- sions of intimate relationships than on actual * Correspondence to: Centre for Psycho-Oncology Research and Teaching, School of Public Health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong. E-mail: wwtlam@hkucc.hku.hk Received: 15 May 2008 Revised: 13 October 2008 Accepted: 13 October 2008 Copyright r 2008 John Wiley & Sons, Ltd.