Alvisi Maria F, Repetto Claudia, Rancati Tiziana, Badenchini Fabio, Magnani Tiziana, Marenghi Cristina, Villa Silvia, Nicolai Nicola, Salvioni Roberto, Avuzzi Barbara, Valdagni Riccardo, Bellardita Lara
1 Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
2 Department of Urology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
Tumori. 2018 Jun;104(3):172-178. doi: 10.5301/tj.5000646. Epub 2018 May 9.
The Memorial Anxiety Scale for Prostate Cancer (MAX-PC) is a self-report questionnaire that was developed in English to assess prostate cancer (PCa)-related anxiety. The aim of this study was to perform a cultural adaptation for the tool to be used in a population of Italian men on active surveillance (AS).
A total of 222 patients with localized PCa who were recruited for the Prostate Cancer Research International: Active Surveillance (PRIAS) protocol completed the MAX-PC. Psychometric analysis was performed to assess reliability indexes. A Spearman rank correlation was used to test the association between MAX-PC scales and other questionnaires and was used for longitudinal analysis.
Cronbach coefficients and item to total correlation demonstrated good internal consistency. Some items related to the repetition of the PSA test showed a large floor effect and thus were poorly effective in measuring anxiety for PSA testing in patients on AS. Confirmatory factor analysis partly failed to reproduce the structure of the original version. A modified version of MAX-PC, excluding the items with a large floor effect, was thus considered for AS patients. Factor analysis on this version demonstrated considerable consistency with the presence of 3 subscales: anxiety related to PCa, anxiety related to PSA testing, and anxiety related to the fear of tumor progression. Longitudinal analysis showed an acceptable validity over time. The MAX-PC was correlated with the anxious preoccupation subscale of the Mini-Mental Adjustment to Cancer scale.
A slightly modified version of the MAX-PC was developed for use in Italian men on AS. This instrument appears to be a valid and reliable tool that measures anxiety in men with PCa who are enrolled in AS programs.
前列腺癌纪念焦虑量表（MAX-PC）是一份自填式问卷，最初以英文编制，用于评估前列腺癌（PCa）相关焦虑。本研究旨在对该工具进行文化适应性调整，以便用于接受主动监测（AS）的意大利男性人群。
共有222例局限性PCa患者入选国际前列腺癌主动监测（PRIAS）方案，并完成了MAX-PC问卷。进行心理测量分析以评估信度指标。采用Spearman等级相关分析来检验MAX-PC各分量表与其他问卷之间的相关性，并用于纵向分析。
Cronbach系数和项目与总分相关性显示出良好的内部一致性。一些与重复进行前列腺特异抗原（PSA）检测相关的项目显示出较大的地板效应，因此在测量接受AS的患者对PSA检测的焦虑方面效果不佳。验证性因素分析部分未能重现原始版本的结构。因此，考虑为接受AS的患者制定一个排除具有较大地板效应项目的MAX-PC修订版。对该版本进行因素分析显示，其存在3个分量表具有相当的一致性：与PCa相关的焦虑、与PSA检测相关的焦虑以及与肿瘤进展恐惧相关的焦虑。纵向分析显示随着时间推移具有可接受的效度。MAX-PC与癌症心理适应简易量表的焦虑专注分量表相关。
开发了一个稍作修改的MAX-PC版本，用于接受AS的意大利男性。该工具似乎是一种有效且可靠的工具，可用于测量参与AS项目的PCa男性的焦虑。
