Development and Preliminary Psychometric Evaluation of the ACRIS-CS: A Theory-Based Measure of Prospective Acceptability of Cognitive Rehabilitation in Cancer Survivors

Background/Objectives: Cancer-related cognitive impairment (CRCI) affects 44-75% of cancer survivors, significantly impacting quality of life. While cognitive rehabilitation is recommended as a first-line intervention, implementation remains challenging, with high attrition rates. Acceptability is critical for implementation success yet remains understudied. This study developed and validated the Acceptability of Cognitive Rehabilitation Interventions Survey - Cancer Survivors (ACRIS-CS) and examined prospective acceptability among Portuguese cancer survivors. Methods: A web-based cross-sectional study was conducted with 154 non-central nervous system (non-CNS) cancer survivors (94.8% female; 72.7% breast cancer; mean age 47.28 years, SD = 8.96). Acceptability was assessed using the newly developed 11-item ACRIS-CS, grounded in the Theoretical Framework of Acceptability. Psychometric properties were evaluated through exploratory factor analysis (EFA) and internal consistency. Multiple regression analyses explored factors associated with acceptability. Results: EFA identified three factors explaining 68.70% of the variance: (1) affective attitude and perceived effectiveness, (2) perceived benefits and self-efficacy, and (3) perceived burden. Internal consistency was acceptable (α = 0.85). Survivors reported high prospective acceptability (mean = 67.36/100), with 21.4% scoring above 75. Affective attitude/effectiveness showed the highest ratings (mean = 75.43), whereas perceived burden was moderate (mean = 49.35). Being in active treatment and having prior knowledge of CRCI predicted higher acceptability (R² adjusted = 0.113). Conclusions: The ACRIS-CS is a valid and reliable measure of prospective acceptability for cognitive rehabilitation among cancer survivors. High acceptability indicates strong receptivity, while concerns about burden highlight the need for flexible delivery formats. By identifying survivors who may be less receptive before treatment begins, the ACRIS-CS can support the integration of cognitive rehabilitation into survivorship care and inform tailored strategies—such as targeted psychoeducation—to enhance adherence and improve clinical outcomes.