Cancer Support Community, Research and Training Institute, 520 Walnut Street, Suite 1170, Philadelphia, PA, 19106, USA.
Concerto HealthAI, 501 Boylston Street 10th Floor, Boston, MA, 02116, USA.
Support Care Cancer. 2020 Jan;28(1):55-64. doi: 10.1007/s00520-019-04753-w. Epub 2019 Apr 12.
To facilitate access to and provision of psychosocial care to cancer patients in the community, the Cancer Support Community (CSC) developed CancerSupportSource® (CSS), an evidence-based psychosocial distress screening program. The current study examined the psychometric properties and multi-dimensionality of a revised 25-item version of CSS, and evaluated the scale's ability to identify individuals at risk for clinically significant levels of depression and anxiety.
CSS development and validation were completed in multiple phases. Exploratory factor analysis was completed with 1436 individuals diagnosed with cancer to examine scale dimensionality, and nonparametric receiver operating characteristic (ROC) curve analyses were used to determine scoring thresholds for depression and anxiety risk scales. Internal consistency reliability and convergent and discriminant validity were also examined. Confirmatory factor analysis and intraclass correlation coefficients were subsequently calculated with a separate sample of 1167 individuals to verify the scale factor structure and examine test-retest reliability.
Five factors were identified and confirmed: (1) emotional well-being, (2) symptom burden and impact, (3) body image and healthy lifestyle, (4) health care team communication, and (5) relationships and intimacy. Psychometric evaluation of the total scale and factors revealed strong internal consistency reliability, test-retest reliability, and convergent and divergent validity. Sensitivity of CSS 2-item depression and 2-item anxiety risk scales were .91 and .92, respectively.
Results indicate that CancerSupportSource is a reliable, valid, multi-dimensional distress screening program with the capacity to screen for those at risk for clinically significant levels of depression and anxiety.
为了方便社区癌症患者获得和提供社会心理关怀，癌症支持社区（CSC）开发了 CancerSupportSource®（CSS），这是一个基于证据的心理困扰筛查项目。本研究考察了 CSS 修订后的 25 项版本的心理测量学特性和多维性，并评估了该量表识别有临床显著抑郁和焦虑风险个体的能力。
CSS 的开发和验证分多个阶段完成。对 1436 名确诊癌症的个体进行了探索性因素分析，以检验量表的维度，而非参数接收者操作特征（ROC）曲线分析用于确定抑郁和焦虑风险量表的评分阈值。还检验了内部一致性信度、收敛和判别效度。随后，使用 1167 名个体的独立样本计算了验证性因素分析和组内相关系数，以验证量表的因子结构并检验测试-重测信度。
确定并确认了五个因素：（1）情绪健康，（2）症状负担和影响，（3）身体形象和健康生活方式，（4）医疗团队沟通，（5）关系和亲密关系。对总量表和因子的心理测量评估显示出较强的内部一致性信度、测试-重测信度以及收敛和发散效度。CSS 2 项抑郁和 2 项焦虑风险量表的敏感性分别为 0.91 和 0.92。
结果表明，CancerSupportSource 是一种可靠、有效的多维困扰筛查程序，能够筛查出有临床显著抑郁和焦虑风险的个体。
