Patient competence in the context of cancer: its dimensions and their relationships with coping, coping self-efficacy, fear of progression, and depression

Jürgen M Giesler,Joachim Weis

doi:10.1007/s00520-020-05699-0

Jürgen M Giesler, Joachim Weis

Open Access

https://doi.org/10.1007/s00520-020-05699-0

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Abstract

PurposeInfluenced in part by research on coping, patient empowerment and self-efficacy, and by patient self-help initiatives, the construct of patient competencies (PC) has been elaborated and later integrated into Germany’s National Cancer Plan. As a self-report measure of PC, the Patient Competence Questionnaire 57 (PCQ-57) has only rarely been evaluated psychometrically. Therefore, we aimed to re-examine its dimensionality and its relationships with related constructs and potential psychosocial cancer outcomes.MethodsWe surveyed 424 breast, colorectal, and prostate cancer patients from clinics for oncological rehabilitation and private oncology practices who completed the PCQ-57 and self-report measures of coping, coping self-efficacy, fear of progression, and depression. Patients’ PCQ-57 responses were submitted to principal axis factor analyses. Using the original scoring keys, we computed internal consistencies (Cronbach’s α) and Pearson correlations between all measures.ResultsFactor analyses suggested 5 of the 8 original PCQ-57 dimensions to replicate satisfactorily, their internal consistencies ranging from 0.74 to 0.88. The competency of managing distress correlated significantly, highly, and negatively with fear of progression and depression (|r’s| ≥ 0.43) and positively with coping self-efficacy (r = 0.58).ConclusionThe results support the reliability and validity of 5 of the 8 original PCQ-57 scales while suggesting refinement of the others. The replicated scales may help identify patients in need of support for dealing with the multiple tasks of adjusting to cancer. Further research should clarify the conceptual and empirical relationships between PC, health literacy, and patient activation as well as potential effects of PC on psychosocial cancer outcomes.

Highlights

IntroductionSince patient competencies (PC) may be expected to help cancer patients manage distressing emotions, it would be interesting to learn how PC relates to, e.g., fear of progression or depression as frequent comorbid conditions of cancer that continue to attract the interest of researchers [3, 4, 34, 35]
During the course of its development as a scientific discipline [1], central goals of psycho-oncology have come to include supporting cancer patients as well as their family and friendsElectronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.Support Care Cancer (2021) 29:2133–2143 the concept of self-efficacy defined as confidence in being able to perform specific behaviors, while distinguishing it from coping which traditionally focuses on factual behaviors aimed at managing specific task and emotion-focused challenges of one’s cancer
To evaluate the factor structure of the Patient Competence Questionnaire 57 (PCQ-57) and the internal consistency of its scales, factor analyses and item analyses based on the socalled classical test theory were computed which assumes an observed test score to be a composite of an individuals’ unobservable “true score” and a random error component

Summary

Introduction

Since PC may be expected to help cancer patients manage distressing emotions, it would be interesting to learn how PC relates to, e.g., fear of progression or depression as frequent comorbid conditions of cancer that continue to attract the interest of researchers [3, 4, 34, 35]. Such relationships would underline that PC could fruitfully be linked to concepts of self-regulation of action and emotion [12, 30, 36]

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