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Supportive Care in Cancer

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Open Access 01-05-2010 | Original Article

Intrapersonal and interpersonal dimensions of cancer perception: a confirmatory factor analysis of the cancer experience and efficacy scale (CEES)

Author: Wai Kai Hou

Published in: Supportive Care in Cancer | Issue 5/2010

Abstract

Purpose

Sociocultural factors influence psychological adjustment to cancer in Asian patients in two major ways: prioritization of relationships over individual orientations and belief in the efficacy of interpersonal cooperation. We derived and validated among Chinese colorectal cancer (CRC) patients an instrument assessing cancer perceptions to enable the study of the sociocultural processes.

Patients and methods

Qualitative interviews (n = 16) derived 15 items addressing interpersonal experience in Chinese CRC patients’ adjustment. These 15 items and 18 corresponding self-referent items were administered to 166 Chinese CRC survivors and subjected to exploratory factor analysis (EFA) to establish the initial scale structure and reliability. The final 29 items, together with other psychometric measures, were administered to a second cohort of 215 CRC patients and subjected to confirmatory factor analysis (CFA).

Results

EFA (63.35% of the total variance) extracted six factors: personal strain, socioeconomic strain, emotional strain, personal efficacy, collective efficacy, and proxy efficacy. CFA confirmed the psychometric structure [χ ²(df) = 702.91(368); Comparative Fit Index = 0.95; Nonnormed Fit Index = 0.94; Incremental Fit Index = 0.95; standardized root mean square residual = 0.08] of the six factors by using a model with two latent factors: experience and efficacy. All subscales were reliable (α = 0.76–0.92). Appropriate correlations with adjustment outcomes (symptom distress, psychological morbidity, and subjective well-being), optimistic personalities, and social relational quality indicated its convergent and divergent validity. Known group comparisons (i.e., age, active treatment, and colostomy) showed its clinical utility.

Conclusion

The cancer experience and efficacy scale is a valid multidimensional instrument for assessing intrapersonal and interpersonal dimensions of cancer experience in Asian patients, potentiating existing patient-reported outcome measures.

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Title: Intrapersonal and interpersonal dimensions of cancer perception: a confirmatory factor analysis of the cancer experience and efficacy scale (CEES)
Author: Wai Kai Hou
Publication date: 01-05-2010
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 5/2010
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-009-0687-2

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Abstract

Purpose

Patients and methods

Results

Conclusion

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