Measures of Thriving in Breast Cancer: A COSMIN Systematic Review of Psychometric Properties

Thriving, a construct reflecting personal growth, resilience, and emotional vitality after adversity, is gaining attention in oncology and health-related quality-of-life research. However, consensus is lacking on which patient-reported outcome measures (PROMs) best assess thriving in individuals with breast cancer.

A systematic search across nine databases identified studies reporting the development or psychometric evaluation of PROMs for thriving in adults.

Two reviewers independently assessed methodologic quality using the COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) Risk of Bias checklist. Measurement properties were evaluated against COSMIN criteria and graded using the COSMIN-modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.

Five PROMs were identified: Thriving Scale, Psychological Thriving Scale, Comprehensive Inventory of Thriving, Brief Inventory of Thriving, and Brief Thriving Scale. No instrument was originally developed or validated in individuals with cancer. The Brief Inventory of Thriving scale shows the greatest potential for use in breast cancer care but requires further validation.

The lack of validated measures limits nurses' ability to assess thriving in cancer care. The Brief Inventory of Thriving scale appears promising but requires cancer-specific validation. Engaging survivors in tool development may enhance content relevance.