Gender invariance of the perceived illness experience scale in childhood cancer survivors and its association with cancer impact and quality of life

Abstract Background Illness perception refers to how individuals cognitively and emotionally interpret their illness and influences adaptation by shaping emotions, treatment adherence, recovery, and quality of life. Measuring it helps reveal patients’ needs and guide health strategies. The Revised-Perceived Illness Experience (R-PIE) is a six-dimensional model assessing: school/peer rejection, preoccupation with illness, physical appearance, parental behavior, manipulation, and interference with activities. The present study examines the psychometric properties and measurement of gender invariance of the Persian version of R-PIE in Iranian adolescents with a history of childhood cancer. Methods A sample of 142 adolescents with a history of childhood cancer (50.8% female; 12–20 years, mean age = 16.24) completed self-reports, including the Persian R-PIE, IOC-CS, and QOL-CS scales. We examined the Persian R-PIE’s factor structure, reliability, concurrent and convergent validity, and measurement invariance across genders. Results Confirmatory Factor Analysis (CFA) supported the six-factor first-order oblique model (χ 2 /df = 1.78, CFI = 0.96, TLI = 0.96, RMSEA = 0.075, 90% CI = 0.063–0.086) of the R-PIE, consistent with the original sample. The findings showed acceptable internal consistency. Quality of life was negatively correlated with R-PIE dimensions, while the impact of childhood cancer showed mixed associations. Subscales demonstrated adequate discriminant validity as indicated by Average Variance Extracted (AVE), except for school/peer rejection. Measurement invariance confirmed comparable properties across genders. Conclusion The six-factor model is a valid tool for assessing illness perception in Iranian adolescents; however, its generalizability is limited by the urban sample, self-report data, and the cross-sectional design. Findings support gender-specific interventions and highlight the importance of addressing illness perceptions to enhance adolescent well-being.