Assessing patient–caregiver communication in cancer—a psychometric validation of the Cancer Communication Assessment Tool (CCAT-PF) in a German sample
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The recently introduced Cancer Communication Assessment Tool (CCAT-PF) measures congruence in patient–caregiver communication and was initially validated in lung cancer patients. Contributing to a greater proportion of the variance in the conflict scores, primary caregivers were hypothesized to experience greater stress. For a detailed understanding of conflicting communication patterns of cancer-affected families, our study aimed for psychometric validation of the CCAT-PF in a sample covering heterogeneous tumor entities.
Subsequent to a cross-sectional survey of 189 pairs of cancer patients (31 % gastrointestinal, 34 % lung, and 35 % urological) and their caregivers’ exploratory factor analysis with principal component condensation and varimax rotation was conducted (response rate, 74.2 %). Reliability and construct validity were assessed calculating Cronbach’s α and Pearson correlation coefficients for CCAT-P and CCAT-F scales and related constructs, respectively.
Cancer-related communication according to the CCAT-PF can be subdivided into four factors including the scales Disclosure, Limitation of treatment, Family involvement in treatment decisions, and Continuing treatment. Reliability ranged from α = .51–.68. The Disclosure scale, describing poor cancer-related communication of the patient, was correlated with patient’s distress (QSC-R10: r = .30, p < .0001), unmet needs in several areas (SCNS-SF-34: r = .25–.32, p < .001), and negatively with social/family well-being (FACT: r = −0.31, p < .0001). Higher scores on the scale were significantly associated with considerable decrements in emotional well-being especially for caregivers perceiving patients’ disclosure as problematic.
The Disclosure scale originating from the CCAT-PF emerged as a short, valid, and reliable stand-alone instrument for identifying conflicting communication in patient–caregiver–dyads at risk.
KeywordsCancer Communication Caregiver Questionnaire Validation Distress
Conflict of interest
In accordance with the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals proposed by the International Committee of Medical Journal Editors (ICMJE), the authors’ declare that there is no conflict of interest. The study was conducted without involvement of a sponsor.
The authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and the accuracy of the data analysis.
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