Quality of Life Research

, Volume 21, Issue 2, pp 195–207 | Cite as

The psychosocial impact of cancer: evidence in support of independent general positive and negative components

  • Jin-Shei Lai
  • Sofia F. Garcia
  • John M. Salsman
  • Sarah Rosenbloom
  • David Cella



Considerable research has demonstrated the negative psychosocial impact of cancer. Recent work has highlighted positive psychosocial outcomes. Research is now needed to evaluate the relationship between negative and positive impacts. This paper reports the development and validation of a measurement model capturing positive and negative psychosocial illness impacts.


The sample included 754 cancer patients on- or post-treatment. Item development was informed by literature review, expert input patient interviews and the results of a pilot study of 205 cancer patients, resulting in 43 positive and 46 negative items. Factor analyses were used to evaluate the dimensionality of the item pools. Analysis of variance (ANOVA) was used to examine relationships between psychosocial illness impact and other variables.


Unidimensionality was demonstrated within but not across negative and positive impact items. ANOVA results showed differential relationships between negative and positive impacts, respectively, and patient sociodemographic and clinical variables.


Positive and negative psychosocial illness impacts are best conceptualized and measured as two independent factors. Computerized adaptive tests and short-form measures developed from this comprehensive psychosocial illness impact item bank may benefit future research and clinical applications.


Psychosocial sequelae Cancer Cancer survivors Bi-factor analysis 



This project was supported by the National Cancer Institute (CA60068, PI: David Cella). Special acknowledgements to Kelly Dineen, Ph.D. and Kimberly Davis, Ph.D. for their contributions to the item pool development used for the pilot study, and Jacquelyn George and Rachel Hanrahan for coordinating the study.


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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Jin-Shei Lai
    • 1
  • Sofia F. Garcia
    • 1
  • John M. Salsman
    • 1
  • Sarah Rosenbloom
    • 1
  • David Cella
    • 1
  1. 1.Department of Medical Social SciencesFeinberg School of Medicine at Northwestern UniversityChicagoUSA

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