Measuring the psychological consequences of breast cancer screening: a confirmatory factor analysis of the Psychological Consequences Questionnaire

Abstract

To use confirmatory factor analysis (CFA) to test the proposed factor structure of the Psychological Consequences Questionnaire (PCQ), a measure of the psychological impact of breast cancer screening. A further aim was to examine the robustness of the proposed factor structure across key demographic and clinical variables. Following visits to breast cancer screening clinics, women who received a false-positive diagnosis and a matched sample of women who had received all-clear diagnoses were sent a questionnaire package containing the PCQ and a demographics measure. A total of 220 women returned completed questionnaires. CFA was used to test the factor structure and multiple indicator-multiple cause (MIMIC) models were used to test the robustness of the factor structure across the test result group, age, and family history of breast cancer diagnosis. The CFA results suggested support for both a three- and a one-factor model; a one-factor model was preferred, however, due to the very high covariance between the three latent factors in the three-factor model. A CFA MIMIC model suggested that the test result impacted on the latent factor: women who initially received a false-positive diagnosis showed significantly higher levels of psychological dysfunction after screening. The PCQ appears to be a promising tool for assessing psychological dysfunction after breast cancer screening; however, a one-factor model received more support than the initially proposed three-factor model. There was little evidence of differential item functioning across key demographic and clinical variables for the PCQ.