Identifying the unmet needs of breast cancer patients post-primary treatment: the Cancer Survivor Profile (CSPro).

Abstract

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.