The purpose of this study is to develop a brief measure of problem areas experienced by patients following primary treatment for breast cancer.
Systematic reviews of the quantitative and qualitative literature were used to inform selection of scale items using (1) valid and reliable items from a national item bank (patient reported outcomes measurement information system [PROMIS]), (2) existing scales from prior breast cancer survivorship research, or (3) items developed by the investigators.
Participants (n = 400) were on average 51 years old, highly educated, Caucasian, diagnosed with stage I–III breast cancer, and a median of 1.96 years post-primary treatment. Principal component analysis on a random sample (n = 200) and confirmation on a second random sample (n = 200) indicated that each of the scales under consideration provided a significant measurement model for the symptom burden (CFI = 0.95), health behavior (CFI = 1.00), functional limitation (CFI = 0.99), health care seeking skill (CFI = 0.98), and cancer-related financial strain (CFI = 1.00) broad domains. The median Cronbach’s alpha was 0.91. The measure demonstrated convergent, divergent, construct, and clinical validity. Lower levels of fatigue (β = 0.251. p < 0.000) and pain (β = 0.221, p < 0.000) and greater health competence (β = 0.278, p < 0.000) and physical activity (β = 0.165, p < 0.000) were associated with self-rated global health (F = 60.43, p < 0.000). The final measure consists of 73 items and requires approximately 15 min to complete.
The Cancer Survivor Profile (CSPro) provides a profile of problem areas supported by epidemiological and qualitative research on unmet needs of breast cancer survivors.
Implications for Cancer Survivors
Breast cancer survivors can use the CSPro to prioritize problem areas following cancer treatment.
Breast cancer Survivorship Assessment Survivor care plan
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Conflict of interest
The authors declare that they have no conflict of interest.
De Moor J, Mariotto A, Parry C, Alfano C, Padgett L, Kent E, et al. Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care. Cancer Epidemiol Biomarkers Prev. 2013;22(4):561–70.PubMedCentralCrossRefPubMedGoogle Scholar
Shi Q, Smith T, Michonski J, Stein K, Kaw C, Cleeland C. Symptom burden in cancer survivors 1 year after diagnosis—a report from the American cancer society's studies of cancer survivors. Cancer. 2011;117:2779–90.PubMedCentralCrossRefPubMedGoogle Scholar
Elliott J, Fallows A, Staetsky L, Smith P, Foster C, Maher E, et al. The health and well-being of cancer survivors in the UK: findings from a population-based survey. Br J Cancer. 2011;105(105):S11–20.PubMedCentralCrossRefPubMedGoogle Scholar
Hewitt M, Bamundo A, Day R, Harvey C. Perspectives on post-treatment cancer care: qualitative research with survivors, nurses, and physicians. J Clin Oncol. 2007;25(16):2270–3.CrossRefPubMedGoogle Scholar
Rechis R, Beckjord E, Arvey S, Reynolds K, Mcgoldrick D. The essential elements of survivorship care: a livestrong brief. austin, TX: lance Armstrong foundation (Livestrong). 2011.Google Scholar
Andersen Bl, Derubeis Rj, Berman Bs, Gruman J, Champion Vl, Massie Mj Et Al. Screening, Assessment, and care of anxiety and depressive symptoms in adults with cancer: an american society of Clinical oncology guideline adaptation. J Clin Oncol. 2014:Jco. 2013.52. 4611.Google Scholar
Aower J, Bak K, Berger A, Breitbart W, Escalante C, Ganz P, et al. Screening, assessment, and management of fatigue in adult survivors of cancer: an American society of clinical oncology clinical practice guideline adaptation. J Clin Oncol. 2014;32(17):1840–50.CrossRefGoogle Scholar
Hershman Dl, Lacchetti C, Dworkin Rh, Smith Eml, Bleeker J, Cavaletti G Et Al. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American society of clinical oncology clinical practice guideline. J Clin Oncol. 2014:Jco. 2013.54. 0914.Google Scholar
Boyajian R, Grose A, Grenon N, Roper K, Sommer K, Walsh M, et al. Desired elements and timing of cancer survivorship care: one approach may not fit all. J Oncol Prac. 2014;10(5):E293–E8.CrossRefGoogle Scholar
Kukar M, Watroba N, Miller A, Kumar S, Edge S. Fostering coordinated survivorship care in breast cancer: who is lost to follow-up? J Cancer Survivor. 2014;8(2):199–204.CrossRefGoogle Scholar
Blanch-Hartigan D, Forsythe L, Alfano C, Smith T, Nekhlyudov L, Ganz Pa Et A. Provision and discussion of survivorship care plans among cancer survivors: results of a nationally representative survey of oncologists and primary care physicians. J Clin Oncol. 2014;32(15):1578–85.PubMedCentralCrossRefPubMedGoogle Scholar
Paskett E, Harrop J, Wells K. Patient navigation: an update on the state of the science. Ca: Cancer J Clin. 2011;61(4):237–49.Google Scholar
Kenyon M, Mayer D, Owens A. Late and long‐term effects of breast cancer treatment and surveillance management for the general practitioner. J Obstet Gynecol Neonatal Nurs. 2014;43(3):382–98.CrossRefPubMedGoogle Scholar
Hambleton R, Russell W. Comparison of classical test theory and item response theory and their application to test development. Educ Meas: Issues Practice. 1993;38–47.Google Scholar
Streiner D, Norman G.. Health measurement scales—a practical guide to their development and use (second edition). New York: University Press; 1995.Google Scholar
Campbell D, Fiske D. Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull. 1959;56(2):81–105.Google Scholar
Randloff S. The CES-D: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.Google Scholar
Vodermaier A, Linden W, Siu C. Screening for emotional distress in cancer patients: a systematic review of assessment instruments. J Nat Cancer Inst. 2009;101(21):1464–88.PubMedCentralCrossRefPubMedGoogle Scholar
Centers for disease control and prevention. behavioral risk factor surveillance questionnaire atlanta, georgia: U.S. department of health and health services, centers for disease control and prevention 2011 january 27, 2011.Google Scholar
Pierannunzi C, Hu S, Balluz L. A systematic review of publications assessing reliability and validity of the behavioral risk factor surveillance system (BRFSS), 2004–2011. BMC Med Res Methodol. 2013;13(1):49.PubMedCentralCrossRefPubMedGoogle Scholar
Buysse D, Reynolds C, Monk T, Berman S, Kupfer D. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatr Res. 1989;28(2):193–213.Google Scholar
Humpel N, Iverson D. Sleep quality, fatigue and physical activity following a cancer diagnosis. Eur J Cancer Care. 2010;19(6):761–8.CrossRefGoogle Scholar
Smith M, Winkel G, Egert J, Diaz-Wionczek M, Duhamel K. Patient-physician communication in the context of persistent pain: validation of a modified version of the patients’ perceived involvement in care scale. J Pain Symptom Manag. 2006;32(1):71–81.CrossRefGoogle Scholar
Fischer D, Fick C. Measuring social desirability: short forms of the Marlowe-Crowne social desirability scale. Educ Psychol Meas. 1993;53:417–24.CrossRefGoogle Scholar
Celis-Morales C, Perez-Bravo F, Ibanez L, Salas C, Bailey M, Gill J. Objective vs. self-reported physical activity and sedentary time: effects of measurement method on relationships with risk biomarkers. PLoS ONE. 2012;7(5):E36345.PubMedCentralCrossRefPubMedGoogle Scholar
Wu H-S, Harden Jk. Symptom burden and quality of life in survivorship. 2014.Google Scholar
Halpern Mt, Viswanathan M, Evans T, Birken S, Basch E, Mayer Dk. models of cancer survivorship care: overview and summary of current evidence. J Oncol Prac. 2014:Jop. 2014.001403.Google Scholar
Mc Cabe M, Bhatia S, Oeffinger K, Reaman G, Tyne C, Wollins Ds Et A. American society of clinical oncology statement: achieving high-quality cancer survivorship care. J Clin Oncol. 2013;31(5):631–40.Google Scholar