CancerSupportSource®-15+: development and evaluation of a short form of a distress screening program for cancer patients and survivors

Abstract Purpose CancerSupportSource® (CSS) is a distress screening program implemented at community-based organizations and hospitals nationwide. The 25-item CSS assesses distress across five domains, with capacity to screen for clinically significant depression and anxiety. This study examined psychometric properties of a shortened form to enhance screening opportunities when staff or patient burden considerations are significant. Methods Development and validation were completed in multiple phases. Item reduction decisions were made with 1436 cancer patients by assessing external/internal item quality and judging theoretical and practical implications of items. Pearson correlations and confirmatory factor analysis were conducted on a separate sample of 957 patients to corroborate psychometric properties and dimensionality of the shortened scale. Nonparametric receiver operating characteristic (ROC) curve analyses determined scoring thresholds for depression and anxiety risk scales. Results Scale refinement resulted in a 15-item short form plus one screening item assessing tobacco and substance use (CSS-15+). At least two items from each CSS domain were retained to preserve multidimensionality. In confirmatory analysis, the model explained 59% of the variance and demonstrated good fit. Correlation between CSS-15+ and 25-item CSS was 0.99, p < 0.001. Sensitivity of 2-item depression and 2-item anxiety risk scales in the confirmatory sample were 0.82 and 0.83, respectively. Conclusions CSS-15+ is a brief, reliable, and valid multidimensional measure of distress. The measure retained excellent internal consistency (α = 0.94) and a stable factor structure. CSS-15+ is a practical and efficient screening tool for distress and risk for depression and anxiety among cancer patients and survivors, particularly in community-based settings.

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HSR19-100: CancerSupportSource®-15: Development and Evaluation of a Short Form of a Distress Screening Program for Cancer Survivors

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2018.7160 ◽

2019 ◽

Vol 17 (3.5) ◽

pp. HSR19-100

Author(s):

Shauna McManus ◽

Alexandra K. Zaleta ◽

Melissa F. Miller ◽

Joanne S. Buzaglo ◽

Julie S. Olson ◽

...

Keyword(s):

Factor Analysis ◽

Confirmatory Factor Analysis ◽

Cancer Survivors ◽

Psychometric Properties ◽

Internal Consistency ◽

Short Form ◽

Distress Screening ◽

Cancer Support ◽

Confirmatory Factor ◽

Item Quality

Background: CancerSupportSource (CSS) is a 25-item distress screening tool implemented at community-based cancer support organizations and hospitals nationwide. CSS assesses distress over 5 domains: (1) emotional concerns (including depression and anxiety risk screening subscales), (2) symptom burden, (3) body and healthy lifestyle, (4) healthcare team communication, and (5) relationships. This study developed a short form of CSS and examined its psychometric properties. Methods: 2,379 cancer survivors enrolled in the Cancer Support Community’s Cancer Experience Registry. Participants provided demographic and clinical background and completed CSS-25 and PROMIS-29, a measure of health-related quality of life. Item reduction was conducted with a subsample of 1,435 survivors and included external item quality (correlations between items and PROMIS-29 scales), internal item quality (inter-item and inter-factor correlations, factor loadings and structure, and item communalities from an exploratory factor analysis of CSS-25), and professional judgement (ranking/prioritization of items by CSS-25 developers, accounting for theoretical and practical implications). Pearson correlations and confirmatory factor analysis were conducted on a separate subsample of 944 survivors to corroborate psychometric properties and dimensionality of the shortened scale. Results: Scale refinement resulted in a 15-item short form of CSS (CSS-15). At least 1 item from each of the 5 CSS-25 domains was retained to preserve multidimensionality, including anxiety and depression risk screening subscale items. Additionally, 1 item about tobacco/substance use was kept due to clinical significance for risk assessment. In confirmatory factor analysis, the model explained 59% of the variance and demonstrated good fit (RMSEA=0.068, 90% CI=0.061–0.075; SRMR=0.033; CFI=0.959; χ2(68)=334.75, P<.001). Correlation between CSS-15 and CSS-25 was 0.986, P<.001. Total distress was associated with PROMIS subscales (rs=−.65–.75, ps<.001); internal consistency reliability was excellent (α=.92). Conclusions: CSS-15 is a brief, reliable, and valid multidimensional measure of distress. The reduced measure retained excellent internal consistency and a stable factor structure, while correlating well with CSS-25 and PROMIS-29. CSS-15 can serve as a practical tool to efficiently screen for distress among cancer patients and survivors.

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Psychometric properties of the Chinese version of Five Facet Mindfulness Questionnaire—short form in cancer patients: a Bayesian structural equation modeling approach

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01692-1 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Ted C. T. Fong ◽

Adrian H. Y. Wan ◽

Venus P. Y. Wong ◽

Rainbow T. H. Ho

Keyword(s):

Psychometric Properties ◽

Cancer Patients ◽

Structural Equation ◽

Short Form ◽

Equation Modeling ◽

Five Facet Mindfulness Questionnaire ◽

Health Measures ◽

Acting With Awareness ◽

Colorectal Cancer Patients ◽

Bayesian Structural Equation Modeling

Abstract Background Mindfulness has emerged as an important correlate of well-being in various clinical populations. The present study evaluated the psychometric properties of the 20-item short form of the Five Facet Mindfulness Questionnaire (FFMQ-SF) in the Chinese context. Methods The study sample was 127 Chinese colorectal cancer patients who completed the FFMQ-SF and validated physical and mental health measures. Factorial validity of the FFMQ-SF was assessed using Bayesian structural equation modeling (BSEM) via informative priors on cross-loadings and residual covariances. Linear regression analysis examined its convergent validity with the health measures on imputed datasets. Results The five-factor BSEM model with approximate zero cross-loadings and one residual covariance provided an adequate model fit (PPP = 0.07, RMSEA = 0.06, CFI = 0.95). Satisfactory reliability (ω = 0.77–0.85) was found in four of the five facets (except nonjudging). Acting with awareness predicted lower levels of perceived stress, negative affect, anxiety, depression, and illness symptoms (β = − 0.37 to − 0.42) and better quality of life (β = 0.29–0.32). Observing, nonjudging, and nonreacting did not show any significant associations (p > .05) with health measures. Acting with awareness was not significantly correlated (r < 0.15) with the other four facets. Conclusion The present findings provide partial support for the psychometric properties of the FFMQ-SF in colorectal cancer patients. The nonjudging facet showed questionable validity and reliability in the present sample. Further studies with larger sample sizes are needed to elucidate the viability of FFMQ-SF as a measure of mindfulness facets in cancer patients.

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Multiple Group Confirmatory Factor Analysis of the DASS-21 Depression and Anxiety Scales: How Do They Perform in a Cancer Sample?

Psychological Reports ◽

10.1177/0033294117727747 ◽

2017 ◽

Vol 121 (3) ◽

pp. 548-565 ◽

Cited By ~ 13

Author(s):

Rina S. Fox ◽

Teresa A. Lillis ◽

James Gerhart ◽

Michael Hoerger ◽

Paul Duberstein

Keyword(s):

Factor Analysis ◽

Standard Deviation ◽

Confirmatory Factor Analysis ◽

Psychometric Properties ◽

Cancer Patients ◽

Internal Consistency Reliability ◽

Total Sample ◽

Depression And Anxiety ◽

Multiple Group ◽

Confirmatory Factor

The DASS-21 is a public domain instrument that is commonly used to evaluate depression and anxiety in psychiatric and community populations; however, the factor structure of the measure has not previously been examined in oncologic settings. Given that the psychometric properties of measures of distress may be compromised in the context of symptoms related to cancer and its treatment, the present study evaluated the psychometric properties of the DASS-21 Depression and Anxiety scales in cancer patients ( n = 376) as compared to noncancer control participants ( n = 207). Cancer patients ranged in age from 21 to 84 years (mean = 58.3, standard deviation = 10.4) and noncancer control participants ranged in age from 18 to 81 years (mean = 45.0, standard deviation = 11.7). Multiple group confirmatory factor analysis supported the structural invariance of the DASS-21 Depression and Anxiety scales across groups; the factor variance/covariance invariance model was the best fit to the data. Cronbach’s coefficient alpha values demonstrated acceptable internal consistency reliability across the total sample as well as within subgroups of cancer patients and noncancer control participants. Expected relationships of DASS-21 Depression and Anxiety scale scores to measures of suicidal ideation, quality of life, self-rated health, and depressed mood supported construct validity. These results support the psychometric properties of the DASS-21 Depression and Anxiety scales when measuring psychological distress in cancer patients.

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CancerSupportSource®: validation of a revised multi-dimensional distress screening program for cancer patients and survivors

Supportive Care in Cancer ◽

10.1007/s00520-019-04753-w ◽

2019 ◽

Vol 28 (1) ◽

pp. 55-64 ◽

Cited By ~ 3

Author(s):

Joanne S. Buzaglo ◽

Alexandra K. Zaleta ◽

Shauna McManus ◽

Mitch Golant ◽

Melissa F. Miller

Keyword(s):

Cancer Patients ◽

Screening Program ◽

Distress Screening

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Psychological Distress Screening in Cancer Patients: Psychometric Properties of Tools Available in Italy

Tumori Journal ◽

10.1177/030089161209800416 ◽

2012 ◽

Vol 98 (4) ◽

pp. 501-509 ◽

Cited By ~ 5

Author(s):

Barbara Muzzatti ◽

Maria Antonietta Annunziata

Keyword(s):

Psychological Distress ◽

Psychometric Properties ◽

Cancer Patients ◽

Distress Screening

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Distress screening in oncology-evaluation of the Questionnaire on Distress in Cancer Patients-short form (QSC-R10) in a German sample

Psycho-Oncology ◽

10.1002/pon.1821 ◽

2011 ◽

Vol 20 (3) ◽

pp. 287-293 ◽

Cited By ~ 30

Author(s):

Katrin Book ◽

Birgitt Marten-Mittag ◽

Gerhard Henrich ◽

Andreas Dinkel ◽

Patrick Scheddel ◽

...

Keyword(s):

Cancer Patients ◽

Short Form ◽

Distress Screening ◽

German Sample

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Psychometric Properties of the Fear of Progression Questionnaire for Children (FoP-Q-SF/C)

Klinische Pädiatrie ◽

10.1055/a-1128-0471 ◽

2020 ◽

Vol 232 (03) ◽

pp. 136-142

Author(s):

Johanne Katrin Luz ◽

Julia Martini ◽

Katharina Clever ◽

Peter Herschbach ◽

Holger Christiansen ◽

...

Keyword(s):

Quality Of Life ◽

Psychometric Properties ◽

Cancer Patients ◽

Pediatric Cancer ◽

Psychological Health ◽

Short Form ◽

Self Report ◽

Fear Of Progression ◽

Pediatric Cancer Patients

Abstract Background Recent research shows that parents of children suffer from fear of progression (FoP), the fear of further disease progression. It is most possible that children also develop FoP, which could impair treatment and psychological health. The aim of this study is to adapt the adult’s version of the Fear of Progression Questionnaire – Short Form (FoP-Q-SF) for children and to examine the psychometric properties in pediatric cancer patients. Patients 32 pediatric cancer patients between 10 and 18 years with different diagnoses and in different treatment states participated in this study. Method In the cross-sectional study participants completed the adapted Fear of Progression Questionnaire – Short Form for Children (FoP-Q-SF/C) and self-report measures assessing quality of life, depression, fear and coping satisfaction. Results The questionnaire (FoP-Q-SF/C) showed adequate psychometric properties (Cronbachs α=0.86) and good results for construct validity. Significant medium to large correlations of children’s FoP was observed with quality of life (r=− 0.37), depression (r=0.52), fear (r=0.33 – 0.76), and satisfaction with coping (r=− 0.44). One-fifth of the sample was classified as having high FoP with values over 37. Conclusions The FoP-Q-SF/C is a short, economic questionnaire that is applicable in children with cancer. Clinicians can use the questionnaire to explore specific fear and the need for psychosocial support. Further research for specific treatment approaches for FoP in pediatric cancer patients are warranted.

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Feasibility of brief psychological distress screening by a community-based telephone helpline for cancer patients and carers

BMC Cancer ◽

10.1186/1471-2407-10-14 ◽

2010 ◽

Vol 10 (1) ◽

Cited By ~ 36

Author(s):

Anna L Hawkes ◽

Karen L Hughes ◽

Sandy D Hutchison ◽

Suzanne K Chambers

Keyword(s):

Psychological Distress ◽

Cancer Patients ◽

Distress Screening ◽

Community Based ◽

Telephone Helpline

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The Engaged Patient

Psycho-Oncology ◽

10.1093/med/9780190097653.003.0050 ◽

2021 ◽

pp. 393-399

Author(s):

Mitch Golant ◽

Alexandra K. Zaleta ◽

Susan Ash-Lee ◽

Joanne S. Buzaglo ◽

Kevin Stein ◽

...

Keyword(s):

Cancer Patients ◽

New Technologies ◽

Screening Program ◽

Psychosocial Oncology ◽

Distress Screening ◽

Patient Centered ◽

Digital Platforms ◽

Innovative Strategies ◽

Psychosocial Experiences ◽

Integrated Medical Care

Patient engagement is ever more essential to developing innovative strategies that shape how comprehensive, integrated medical care is delivered to cancer patients and their families. With over 300 licensed professionals across the network, Cancer Support Community (CSC) is the largest nonprofit employer of psychosocial oncology mental health professionals in the United States. Through decades of working with cancer patients, families, and caregivers, CSC has developed a portfolio of evidence-informed programs that engage patients around their most pressing concerns—unwanted aloneness, loss of control, and lack of hope. CSC’s facilities, which provide support groups, education, exercise and nutrition classes, children’s programs, and social activities, are available at no cost for families. These services are replicated on CSC’s helpline and digital platforms. This chapter highlights a comprehensive integrated model of developing and delivering evidence-informed psychosocial programs and services in the community. The chapter also reviews CSC patient-centered research projects including (1) the Cancer Experience Registry®, an online observational study of cancer patients, survivors, and informal caregivers to identify and quantify their psychosocial experiences; (2) CancerSupportSource®, a reliable, valid, multidimensional distress screening program for patients and caregivers; and (3) Open To Options®, a shared decision-making program that helps patients prepare a highly personalized list of questions, concerns, and goals to share with their doctor. The extent to which the psychosocial oncology community can integrate care across healthcare systems, by leveraging new technologies, behavioral and implementation science principles, and community-based services, will determine its success in meeting the needs of cancer patients.

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