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Development and evaluation of an instrument to assess social difficulties in routine oncology practice

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Abstract

Purpose: To develop and preliminarily evaluate a Social Difficulties Inventory (SDI) for use in oncology practice. Methods: Item generation from patients (n=96), staff (n=49) and the literature. Questions constructed and pre-tested (n=42) resulting in a 22-item questionnaire. Psychometric evaluation (n=271) assessed frequency of endorsement, factor structure, summated scales and construct validity followed by randomisation to criterion validity or test-retest arms. Results: Items met preset frequency of endorsement criteria. Factor analysis revealed a four-factor structure, three clearly definable, (1) Physical ability, (2) Providing for the family and (3) Contact with others, explaining 45.8% variance. Summated scales developed from these demonstrated good reliability (Cronbach’s alpha > 0.7) and were used to test and confirmed construct validity. Several comparators from the Life Events and Difficulties Schedule (LEDS) and CAncer Rehabilitation Evaluation System Short Form (CARES-SF) tested criterion validity and majority agreements were moderate to good. Test–retest reliability was good with most kappa values > 0.6. One item was eliminated resulting in a 21-item questionnaire. Conclusion: The SDI is relevant and easy to understand. Initial psychometric evaluation was encouraging. Ongoing work to evaluate the clinical meaning and utility of the instrument and to examine the relationships between SDI scores and clinical outcomes will provide guidance about its usefulness as an assessment tool in routine oncology practice.

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Abbreviations

SDI:

Social Difficulties Inventory

QL:

Quality of Life

EORTC QLQ-C30:

European Organization for Research and Treatment of Cancer QLQ-C30

FACT-G:

Functional Assessment of Cancer Therapy general measure

BIDS:

Bath Information and Data Services

CARES:

CAncer Rehabilitation Evaluation System

CARES-SF:

CAncer Rehabilitation Evaluation System Short Form

FLIC:

Functional Living Index-Cancer

LASA:

Linear.Analogue.Self.Assessment

SPQ:

Social Problem Questionnaire

LEDS:

Life Events and Difficulties Schedule

HADS:

Hospital Anxiety and Depression Scale

MHI-5:

Mental Health Inventory 5

SPSS:

Statistical Package for Social Sciences

References

  • NL Wells ME. Turney (2001) Common issues facing adults with cancer MM Lauria EJ Clark JF Hermann NM Stearns (Eds) Social Work in Oncology. American Cancer Society Atlanta 27–43

    Google Scholar 

  • A Cull M Stewart DG Altman (1995) ArticleTitleAssessment of and intervention for psychosocial problems in routine oncology practice. Br J Canc 72 229–235

    Google Scholar 

  • CM Nezu AM Nezu SH Friedman PS Houts LA DelliCarpini C Bildner et al. (1999) ArticleTitleCancer and psychological distress: two investigations regarding the role of social problem-solving. J Psychosoc Oncol 16 27–40

    Google Scholar 

  • JC Holland (1997) ArticleTitlePreliminary guidelines for the treatment of distress. Oncology 11 IssueID11A 109–114

    Google Scholar 

  • NK Aaronson S Ahmedzi B Bergamn M Bullinger A Cull NJ Duez et al. (1993) ArticleTitleThe European Organization for Research and Treatment of Cancer QLQ-C30: A quality of life instrument for use in international clinical trials in oncology. J Natl Canc Inst 85 IssueID5 365–376

    Google Scholar 

  • DF Cella DS Tulsky G Gray B Sarafian E Linn A Bonomi et al. (1993) ArticleTitleThe Functional Assessment of Cancer Therapy scale: Development and validation of the general measure. J Clin Oncol 11 570–579 Occurrence Handle1:STN:280:ByyC1cjmvFc%3D Occurrence Handle8445433

    CAS  PubMed  Google Scholar 

  • A Cull A Gould A House A Smith V Strong G Velikova et al. (2001) ArticleTitleValidating automated screening for psychological distress by means of computer touchscreens for use in routine oncology practice. Br J Canc 85 1842–1849

    Google Scholar 

  • S Newell A Girgis RW Sanson-Fisher J Stewart (1997) ArticleTitleAre touchscreen computer surveys acceptable to medical oncology patients? J Psychosoc Oncol 15 IssueID2 37–46

    Google Scholar 

  • PA Taenzer M Speca MJ Atkinson BD Bultz S Page P Harasym et al. (1997) ArticleTitleComputerized quality-of-life screening in an oncology clinic. Canc Pract 5 IssueID3 168–175

    Google Scholar 

  • G Velikova EP Wright AB Smith A Cull A Gould D Forman et al. (1999) ArticleTitleAutomated collection of quality-of-life data: a comparison of paper and computer touch-screen questionnaires. J Clin Oncol 17 IssueID3 998–1007

    Google Scholar 

  • EP Wright PJ Selby M Crawford C Johnston A Gillibrand TJ Perren et al. (2003) ArticleTitleFeasibility and compliance of automated measurement of quality of life in oncology practice. J Clin Oncol 21 IssueID2 374–382

    Google Scholar 

  • G Velikova JM Brown AB Smith PJ Selby (2002) ArticleTitleComputer based quality of life questionnaires may contribute to doctor patient interactions. Br J Canc 86 IssueID1 51–59

    Google Scholar 

  • Thomas C, Morris S, Soothill K, McIllmurray K, Francis B, Harman J. What are the Psychosocial Needs of Cancer Patients and Their Carers? Lancaster University, Institute for Health Research Lancaster University. 2001: 1–259.

  • EP Wright MA Kiely P Lynch A Cull PJ Selby (2002) ArticleTitleSocial problems in oncology. Br J Canc 87 1099–1104

    Google Scholar 

  • EP Wright PJ Selby A Gould A Cull (2001) ArticleTitleDetecting Social Problems in Cancer Patients. Psycho Oncol 10 IssueID3 242–250

    Google Scholar 

  • Sprangers M, Cull A, Groenvold M. EORTC Quality of Life Study Group Guidelines for Developing Questionnaire Modules. 2nd ed. Brussels, EORTC, 1998.

  • S Sudman NM Bradburn (1982) Asking Questions. Jossey-Bass Ind., Publishers San Francisco, London

    Google Scholar 

  • CAC Schag RL Heinrich (1990) ArticleTitleDevelopment of a comprehensive quality of life measurement tool: CARES. Oncology 4 IssueID5 29–50

    Google Scholar 

  • H Schipper J Clinch A McMurray M Levitt (1984) ArticleTitleMeasuring the quality of life of cancer patients: The Functional Living Index-Cancer: development and validation. J Clin Oncol 2 IssueID5 107–118

    Google Scholar 

  • PJ Selby JAW Chapman J Etazadi-Amoli D Dalley NF Boyd (1984) ArticleTitleThe development of a method for assessing the quality of life of cancer patients. Br J Canc 50 13–22

    Google Scholar 

  • J Harrison P Maguire T Ibbotson R MacLeod P Hopwood (1994) ArticleTitleConcerns, confiding and psychiatric disorder in newly diagnosed cancer patients: A descriptive study. Psycho Oncol 3 173–179

    Google Scholar 

  • RH Corney AW Clare (1985) ArticleTitleThe construction, development and testing of a self-report questionnaire to identify social problems. Psychol Med 15 637–649

    Google Scholar 

  • B Bonevski RW Sanson-Fisher A Girgis L Burton P Cook A Boyes (2000) ArticleTitleEvaluation of an instrument to assess the needs of patients with cancer. Cancer 88 IssueID1 217–225

    Google Scholar 

  • CAC Schag RL Hienrich (1991) ArticleTitleCancer Rehabilititation Evaluation System–short form (CARES-SF). Cancer 68 IssueID6 1406–1413

    Google Scholar 

  • GW Brown TO Harris (1989) Life Events and Illness. Unwin Hyman London

    Google Scholar 

  • GW Brown T Harris (Eds) (1978) Life-events and Depression. Tavistock London 100–116

    Google Scholar 

  • GW Brown (1993) ArticleTitleLife events and affective disorder: Replication and limitations. Psychosom Med 55 248–259

    Google Scholar 

  • GW Brown TO Harris MJ Eales (1996) ArticleTitleSocial factors and comorbidity of depressive and anxiety disorders. Br J Psychiatr 168(suppl. 30) 50–57

    Google Scholar 

  • Yorkshire Health. A Census Based View of the Population and its Health. Harrogate, Yorkshire Health. Yorkshire Health public health report, 1994: 1–67.

  • AS Zigmond RP Snaith (1983) ArticleTitleThe Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67 361–370 Occurrence Handle1:STN:280:BiyB2sbhtVw%3D Occurrence Handle6880820

    CAS  PubMed  Google Scholar 

  • DM Berwick JM Murphy PA Goldman JE Ware AJ Barsky MC Weinstein (1991) ArticleTitlePerformance of a five-item mental health screening test. Med Care 29 IssueID2 169–176

    Google Scholar 

  • JF Hair RE Anderson RL Tatham WC Black (Eds) (1998) Multivariate Data Analysis Prentice-Hall, Inc., Upper Saddle River 87–138

    Google Scholar 

  • J Harrison P Maguire (1995) ArticleTitleInfluence of age on psychological adjustment to cancer. Psycho Oncol 4 33–38

    Google Scholar 

  • DG. Altman (Eds) (1991) Practical Statistics for Medical Research Chapman & Hall London 396–439

    Google Scholar 

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Authors and Affiliations

  1. Cancer Research UK, Clinical Centre in Leeds, St James’s University Hospital, Beckett Street, Leeds, LS9 7TF, UK

    E. P. Wright, M. Kiely, C. Johnston, A. B. Smith & P. J. Selby

  2. Cancer Research UK Medical Oncology Unit, Western General Hospital, Crewe Road, Edinburgh, UK

    A. Cull

Authors
  1. E. P. Wright
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  2. M. Kiely
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  3. C. Johnston
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  4. A. B. Smith
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  5. A. Cull
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  6. P. J. Selby
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Corresponding author

Correspondence to E. P. Wright.

Additional information

Presented in part at the British Cancer Research Meeting (poster presentation) 2001 and at the World Congress of Psycho-Oncology (poster presentation) 2003.

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Wright, E.P., Kiely, M., Johnston, C. et al. Development and evaluation of an instrument to assess social difficulties in routine oncology practice . Qual Life Res 14, 373–386 (2005). https://doi.org/10.1007/s11136-004-5332-4

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  • DOI: https://doi.org/10.1007/s11136-004-5332-4

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