Todd Briana L, Feuerstein Michael, Gehrke Amanda, Hydeman Jennifer, Beaupin Lynda
Departments of Medical and Clinical Psychology and Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
J Cancer Surviv. 2015 Jun;9(2):137-60; quiz 151-60. doi: 10.1007/s11764-015-0428-0. Epub 2015 Mar 29.
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.
Breast cancer survivors can use the CSPro to prioritize problem areas following cancer treatment.
本研究旨在开发一种针对乳腺癌初次治疗后患者所经历问题领域的简短测量工具。
通过对定量和定性文献进行系统综述，为量表项目的选择提供依据，具体方式包括：（1）从国家项目库（患者报告结局测量信息系统[PROMIS]）中选取有效且可靠的项目；（2）采用先前乳腺癌幸存者研究中的现有量表；或（3）由研究人员自行开发的项目。
参与者（n = 400）平均年龄51岁，受教育程度高，为白种人，被诊断为I - III期乳腺癌，初次治疗后中位数为1.96年。对随机样本（n = 200）进行主成分分析，并在第二个随机样本（n = 200）上进行验证，结果表明所考虑的每个量表都为症状负担（CFI = 0.95）、健康行为（CFI = 1.00）、功能限制（CFI = 0.99）、寻求医疗保健技能（CFI = 0.98）和癌症相关经济压力（CFI = 1.00）等广泛领域提供了显著的测量模型。克朗巴哈系数中位数为0.91。该测量工具具有收敛效度、区分效度、结构效度和临床效度。较低水平的疲劳（β = 0.251，p < 0.000）和疼痛（β = 0.221，p < 0.000）以及较高的健康能力（β = 0.278，p < 0.000）和身体活动水平（β = 0.165，p < 0.000）与自我评定的总体健康状况相关（F = 60.43，p < 0.000）。最终的测量工具由73个项目组成，大约需要15分钟完成。
癌症幸存者概况（CSPro）提供了一个基于对乳腺癌幸存者未满足需求的流行病学和定性研究支持的问题领域概况。
乳腺癌幸存者可以使用CSPro来确定癌症治疗后问题领域的优先顺序。
