Optimizing Community and Hospital Services Using the Cancer Support Source Program

The Cancer Support Community developed the Cancer Support Source (CSS) to assess the needs of cancer patients with distress. Each item on this self-administered questionnaire represents an area of concern which the patient rates and indicates their need for action with a "staff person," but no details about the category of staff is given.

To examine the factor structure of the CSS and to increase its utility to triage patients for referral to services based on a needs assessment.

Data from 690 patients who completed the CSS over a 1-year period were analyzed. In study 1, an exploratory principal component analysis was conducted. In study 2, the fit of this proposed model was evaluated with confirmatory factor analysis (CFA).

Three factors were retained in the final CFA: emotional distress, physical health concerns, and resource needs. This model demonstrated adequate fit, Root Mean Square Error of Approximation (RMSEA)= 0.056, Comparitive Fit Index (CFI) = .907, Standardized Root Mean Square Residual (SRMR) = 0.050.

Three factors are proposed as CSS subscales to guide referral and coordinate services: Emotional Distress/Patient and Family Counselor, Physical Health Concerns/Medical Care Provider, and Resource Needs/Case Management-Clinical Social Worker. The clinical utility of these referral subscales should be established with additional research.