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

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Acknowledgments

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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Authors and Affiliations

  1. Department of Medical Social Sciences, Feinberg School of Medicine at Northwestern University, 710 North Lake Shore drive, #729, Chicago, IL, 60611, USA

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

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  1. Jin-Shei Lai
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  2. Sofia F. Garcia
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  3. John M. Salsman
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  4. Sarah Rosenbloom
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  5. David Cella
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Correspondence to Jin-Shei Lai.

Appendices

Appendix 1

Table 4.

Table 4 Positive illness impact: item descriptions, sub-domains (local factors) and factor loadings
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Appendix 2

Table 5.

Table 5 Negative illness impact: item descriptions, sub-domains (local factors), and factor loadings
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Lai, JS., Garcia, S.F., Salsman, J.M. et al. The psychosocial impact of cancer: evidence in support of independent general positive and negative components. Qual Life Res 21, 195–207 (2012). https://doi.org/10.1007/s11136-011-9935-2

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