Abstract
PurposeTo 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.MethodsCSS 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.ResultsFive 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.ConclusionsResults 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.
Highlights
It is estimated that there will be more than 1,700,000 new cases of cancer in the U.S in 2018 [1]
Given the immediate and long-range implications of distress among persons with cancer, the Institute of Medicine [7] and the National Comprehensive Cancer Network [8] have recognized that screening, referral, and follow-up for psychosocial concerns are critical to ensuring quality cancer care for the whole patient
The sample comprised a wide range of cancer patients and survivors representing various cancer diagnoses
Summary
It is estimated that there will be more than 1,700,000 new cases of cancer in the U.S in 2018 [1]. Many survivors will receive state-of-the-science biomedical treatment, but will not receive care that adequately assesses or addresses their psychosocial concerns [2]. This is problematic in part because distress and unmet psychosocial needs can have adverse implications for health outcomes, health service use, treatment adherence, and health care costs [3, 4]. A number of validated measures exist to assess distress [11,12,13] and identify areas of unmet need [14, 15] Among those tools that assess patient preference for help, few ask the patient to delineate the type of help they wish to receive or have the ability to integrate across electronic systems via a web-based platform. Even fewer were developed and validated for use in community-based care settings, despite the fact that a majority of cancer patients are treated in community cancer centers, hospitals, and private practices [16]
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