Self-efficacy is a coping resource with a positive impact on well-being, quality of life, anxiety, and depression in cancer patients, even after treatment. This study focused on the validation of the Cancer Behavior Inventory-Brief Version (CBI-B) in Portuguese patients with breast cancer. The study included 115 patients with breast cancer receiving outpatient chemotherapy in four hospitals located in Portugal. Participants (N = 115) completed the translated version of the CBI-B in Portuguese and measures of quality of life (QLQ- C30), psychological distress (HADS), and illness perceptions (IPQ-B). Confirmatory factor analysis supported the four-factor original structure of the CBI-B. The Portuguese version of the CBI-B showed good psychometric properties as shown by measures of internal consistency (Cronbach’s alpha = .88), test–retest reliability (intraclass correlation coefficient = .59), convergent validity with the QLQ-C30 (r = .43, p < .001), and divergent validity with the HADS (r = -.60, p < .001) and the IPQ-B (r = -.51, p < .001). The Portuguese version of the CBI-B is a valid and reliable instrument to evaluate the self-efficacy for coping in Portuguese breast cancer patients. Future studies should validate the CBI-B in patients with other types of cancer.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., & Kaasa, S. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. JNCI: Journal of the National Cancer Institute, 85(5), 365–376.
Adams, R. N., Mosher, C. E., Cohee, A. A., Stump, T. E., Monahan, P. O., Sledge, G. W., Cella, D., & Champion, V. L. (2016). Avoidant coping and self-efficacy mediate relationships between perceived social constraints and symptoms among long-term breast cancer survivors. Psycho-Oncology, 26(7), 982–990. https://doi.org/10.1002/pon.4119.
Bandura, A. (1997). Self-efficacy: The exercise of control. . W H Freeman/Times Books/ Henry Holt & Co.
Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191. https://doi.org/10.1097/00007632-200012150-00014
Bigatti, S. M., Steiner, J. L., & Miller, K. D. (2012). Cognitive appraisals, coping and depressive symptoms in breast cancer patients. Stress & Health, 28, 355–361. https://doi.org/10.1002/smi.2444.
BorjAlilu, S., Kaviani, A., Helmi, S., Karbakhsh, M., & Mazaheri, M. A. (2017). Exploring the role of self-efficacy for coping with breast cancer: A systematic review. Archives of Breast Cancer, 4, 42–47. https://doi.org/10.19187/abc.20174242-57.
Brandão, T., Tavares, R., Schulz, M. S., & Matos, P. M. (2015). Measuring emotion regulation and emotional expression in breast cancer patients: A systematic review. Clinical Psychology Review, 43, 114–127. https://doi.org/10.1016/j.cpr.2015.10.002.
Broadbent, E., Petrie, K. J., Main, J., & Weinman, J. (2006). The brief illness perception questionnaire. Journal of Psychosomatic Research, 60, 631–637. https://doi.org/10.1016/j.jpsychores.2005.
Brown, T. A. (2015). Model Revision and Comparison. In Confirmatory factor analysis for applied research (2nd ed., pp. 139–185). New York, NY: Guilford Publications.
Busemeyer, J. R., & Diederich, A. (2014). Estimation and testing of computational psychological models. Neuroeconomics. https://doi.org/10.1016/b978-0-12-416008-8.00004.
Casellas-Grau, A., Vives, J., Font, A., & Ochoa, C. (2016). Positive psychological functioning in breast cancer: An integrative review. The Breast, 27, 136–168. https://doi.org/10.1016/j.breast.2016.04.001.
Chirico, A., Serpentini, S., Merluzzi, T., Mallia, L., Del Bianco, P., Martino, R., & Giordano, A. (2017). Self-efficacy for coping moderates the effects of distress on quality of life in palliative cancer care. Anticancer Research, 37, 1609–1615. https://doi.org/10.21873/anticanres.11491.
Chou, F.-Y. (2019). Cancer illness perception and self-management of Chinese patients. Asiatic-Pacific Journal Oncology Nursing, 6, 57–63. https://doi.org/10.4103/apjon.apjon_56_18.
Cohen, M. (2002). Coping and emotional distress in primary and recurrent breast cancer patients. Journal of Clinical Psychology in Medical Settings, 9, 245–251. https://doi.org/10.1023/a:1016007529278.
Cooper, A. F., Hankins, M., Rixon, L., Eaton, E., & Grunfeld, E. A. (2012). Distinct work-related, clinical and psychological factors predict return to work following treatment in four different cancer types. Psycho-Oncology, 22(3), 659–667. https://doi.org/10.1002/pon.3049.
Dehghan, H., Keshtkaran, A., Ahmadloo, N., Bagheri, Z., & Hatam, N. (2018). Patient involvement in care and breast cancer patients’ quality of life—a Structural Equation Modeling (SEM) Approach. Asian Pacific Journal of Cancer Prevention, 19, 2511–2517. https://doi.org/10.22034/APJCP.2018.19.9.2511.
Fabrigar, L. R., Wegener, D. T., MacCallum, R. C., & Strahan, E. J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4, 272–299. https://doi.org/10.1037/1082-989X.4.3.272.
Ferlay, J., Colombet, M., Soerjomataram, I., Mathers, C., Parkin, D. M., Piñeros, M., Znaor, A., & Bray, F. (2019). Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. International Journal of Cancer, 144(8), 1941-1953. https://doi.org/10.1002/ijc.31937
Ferlay, J., Steliarova-Foucher, E., Lortet-Tieulent, J., Rosso, S., Coebergh, J. W. W., Comber, H., & Bray, F. (2013). Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer, 49(6), 1374–1403. https://doi.org/10.1016/j.ejca.2012.12.027.
Field, A. (2018). Discovering statistics using IBM SPSS statistics. (5th ed.). Sage.
Figueiras, M., Marcelino, D. S., Claudino, A., Cortes, M. A., Maroco, J., & Weinman, J. (2010). Patients’ illness schemata of hypertension: The role of beliefs for the choice of treatment. Psychology and Health, 25, 507–517. https://doi.org/10.1080/08870440802578961.
Glanz, K., & Schwartz, M. D. (2008). Stress, coping, and health behavior. In K. Glanz, B. K. Rimer, & K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice. (pp. 211–236). Jossey-Bass.
Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate Data Analysis. (7th ed.). Pearson.
Heitzmann, C. A., Merluzzi, T. V., Jean-Pierre, P., Roscoe, J. A., Kirsh, K. L., & Passik, S. D. (2011). Assessing self-efficacy for coping with cancer: Development and psychometric analysis of the brief version of the Cancer Behavior Inventory (CBI-B). Psycho-Oncology, 20, 302–312. https://doi.org/10.1002/pon.1735.
Hinz, A., Einenkel, J., Briest, S., Stolzenburg, J.-U., Papsdorf, K., & Singer, S. (2012). Is it useful to calculate sum scores of the quality of life questionnaire EORTC QLQ-C30? European Journal of Cancer Care, 21(5), 677–683. https://doi.org/10.1111/j.1365-2354.2012.01367.x.
Iyigun, E., Tastan, S., Gezginci, E., Korkmaz, S., Demiral, S., & Beyzadeoglu, M. (2017). Cross-cultural adaptation and psychometric evaluation of the Turkish version of the cancer behavior inventory-brief version. Journal of Pain and Symptom Management, 54, 929–935. https://doi.org/10.1016/j.jpainsymman.2017.08.006.
Koo, T. K., & Li, M. Y. (2016). A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine, 15, 155–163. https://doi.org/10.1016/j.jcm.2016.02.012.
Kroemeke, A., & Sobczyk-Kruszelnicka, M. (2019). Salutary effect of daily coping self-efficacy: Impact on day-by-day coping to mood effects within dyads following hematopoietic stem cell transplantation. Anxiety, Stress, & Coping, 32, 728–741. https://doi.org/10.1080/10615806.2019.1660321.
Lazarus, R. S., & Folkman, S. (1987). Transactional theory and research on emotions and coping. European Journal of Personality, 1, 141–169. https://doi.org/10.1002/per.2410010304.
Lee, M. K., Park, S., Lee, E. S., Ro, J., Kang, H. S., Shin, K. H., Lee, K. S., Chung, K. W., Kim, S. W., Yun, Y. H. (2011). Social support and depressive mood 1 year after diagnosis of breast cancer compared with the general female population: A prospective cohort study. Supportive Care in Cancer, 19(9), 1379–1392. https://doi.org/10.1007/s00520-010-0960-4
Merluzzi, T. V., & Martinez Sanchez, M. A. (1997). Assessment of self-efficacy and coping with cancer: Development and validation of the cancer behavior inventory. Health Psychology, 16(2), 163.
Merluzzi, T. V., Nairn, R. C., Hegde, K., Martinez Sanchez, M. A., & Dunn, L. (2001). Self-efficacy for coping with cancer: Revision of the Cancer Behavior Inventory (version 2.0). Psycho-Oncology, 10, 206–217.
Merluzzi, T. V., Philip, E. J., Heitzmann Ruhf, C. A., Liu, H., Yang, M., & Conley, C. C. (2018). Self-efficacy for coping with cancer: Revision of the Cancer Behavior Inventory (Version 3.0). Psychological Assessment, 30, 486–499. https://doi.org/10.1037/pas0000483.
Nejad, Z. K., Aghdam, M. A., Hassankhani, H., Jafarabadi, A. M., & Sanaat, Z. (2015). Cancer-related self-efficacy in Iranian women with breast cancer. Women’s Health Bulletin, 2, e23248. https://doi.org/10.17795/whb-23248.
Neo, J., Fettes, L., Gao, W., Higginson, I. J., & Maddocks, M. (2017). Disability in activities of daily living among adults with cancer: A systematic review and meta-analysis. Cancer Treatment Reviews, 61, 94–106. https://doi.org/10.1016/j.ctrv.2017.10.006.
Nunnally, J., & Bernstein, I. (1994). Psychometric theory. McGraw-Hill.
Ohaeri, B. M., Ofi, A. B., & Campbell, O. B. (2012). Relationship of knowledge of psychosocial issues about cancer with psychic distress and adjustment among breast cancer clinic attendees in a Nigerian teaching hospital. Psycho-Oncology, 21(4), 419–426. https://doi.org/10.1002/pon.1914.
Oken, M. M., Creech, R. H., Tormey, D. C., Horton, J., Davis, T. E., McFadden, E. T., & Carbone, P. P. (1982). Toxicity and response criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology, 5(6), 649–656. https://doi.org/10.1097/00000421-198212000-00014 .
Pais-Ribeiro, J. L., Pinto, C., & Santos, C. (2008). Validation study of the Portuguese version of the QLC-C30-V3. Psicologia, Saúde & Doenças, 9(1), 89–102.
Pais-Ribeiro, J., Silva, I., Ferreira, T., Martins, A., Meneses, R., & Baltar, M. (2007). Validation study of a Portuguese version of the hospital anxiety and depression scale. Psychology Health & Medicine, 12, 225–237. https://doi.org/10.1080/13548500500524088.
Pallant, J. (2016). SPSS survival manual. A step by step guide to data analysis using SPSS program. (6th ed.). McGraw-Hill Education.
Pereira, M. G., Vilaça, M., Pereira, M., Bacalhau, R., Monteiro, S., Fernandes, B., Faria, S., & Ferreira, G. (2020). Validation of the caregiver oncology quality of life questionnaire in Portuguese caregivers of myeloma patients. Palliative & Supportive Care, 18(2), 178-185. https://doi.org/10.1017/S1478951519000476.
Rottmann, N., Dalton, S. O., Christensen, J., Frederiksen, K., & Johansen, C. (2010). Self-efficacy, adjustment style and well-being in breast cancer patients: A longitudinal study. Quality of Life Research, 19, 827–836. https://doi.org/10.1007/sl1136-010-9653-1.
Serpentini, S., Del Bianco, P., Chirico, A., Merluzzi, T. V., Martino, R., Lucidi, F., De Salvo, G. L., Trentin, L., & Capovilla, E. (2019). Self-efficacy for coping: Utility of the Cancer behavior inventory (Italian) for use in palliative care. BMC Palliative Care. https://doi.org/10.1186/s12904-019-0420-y.
Shafaee, F. S., Mirghafourvand, M., Harischi, S., Esfahani, A., & Amirzehni, J. (2018). Self-confidence and quality of life in women undergoing treatment for breast cancer. Asian Pacific Journal of Cancer Prevention, 19, 733–740. https://doi.org/10.22034/APJCP.2018.19.3.733.
Shelby, R. A., Crespin, T. R., Wells-Di Gregorio, S. M., Lamdan, R. M., Siegel, J. E., & Taylor, K. L. (2008). Optimism, social support, and adjustment in African American women with breast cancer. Journal of Behavioral Medicine, 31(5), 433–444. https://doi.org/10.1007/s10865-008-9167-2.
Shim, E.-J., Lee, J. W., & Min, Y. H. (2018). Does depression decrease the moderating effect of self-efficacy in the relationship between illness perception and fear of progression in breast cancer? Psycho-Oncology, 27, 539–547. https://doi.org/10.1002/pon.4532.
Wilkes, L. M., O’Baugh, J., Luke, S., & George, A. (2003). Positive attitude in cancer: Patients’ perspectives. Oncology Nursing Forum, 30, 412–416. https://doi.org/10.1188/03.onf.412-416.
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.
This study was conducted at the Psychology Research Centre (PSI/01662), School of Psychology, University of Minho, supported by the Foundation for Science and Technology (FCT) through the Portuguese State Budget (Ref.: UIDB/PSI/01662/2020) and a PhD fellowship awarded to first author (SFRH/BD/137321/2018 PHD Fellowship) supported by the FCT and European Social Fund (Human Capital Operational Programme—HCOP).
Conflict of interest
The authors declare that they have no conflict of interest.
Human Participants and/or Animals Rights and Informed Consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Hospital Ethics Committees and the Helsinki Declaration of 1964. Participants who agreed to participate in this study voluntarily signed an informed consent.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Pereira, M., Izdebski, P. & Pereira, M.G. Validation of the Brief Version of the Cancer Behavior Inventory in Breast Cancer Portuguese Patients. J Clin Psychol Med Settings 28, 491–502 (2021). https://doi.org/10.1007/s10880-021-09773-5
- Breast cancer
- Cancer behavior inventory-brief version
- Self-efficacy for coping