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Openness to discuss cancer in the nuclear family: scale, development, and validation
I Mesters1, H van den Borne, L McCormick
1Faculty of Health Sciences, Department of Health Education, University of Limburg, The Netherlands.
Objective:
To describe the development and validation of a scale for assessing openness to discuss cancer in the family.
Method:
Two studies were conducted. Study 1 was a cross-sectional study designed to test the factor structure of the scale. Four hundred ninety-eight patients with either breast cancer or Hodgkin's disease were interviewed. In Study 2, a longitudinal study, 133 patients with cancer in the head and neck were tested at four points in time: just before treatment, 6 weeks, 13 weeks and 52 weeks after treatment. Study 2 aimed to confirm the factor structure established in Study 1, to test for construct validity in a new population, to test the psychometric properties of the Openness Scale, and to test the scale's sensitivity to change.
Results:
In Study 1, a one-factor solution was revealed, resulting in a scale of eight items. In Study 2, the factor structure found in Study 1 was confirmed. In line with theoretical expectations, subjects who perceived their communication about cancer as more open showed more positive rehabilitation outcomes especially at 13 weeks after treatment (less uncertainty, fewer negative feelings, more control, higher self-esteem, fewer psychological and physical complaints). Furthermore, more open communication related with more support by family members and more discussion with the partner. The scale was found to be stable over time.
Conclusions:
The scale's construction and subsequent analysis show that open discussion of problems (related to cancer) in the family can be measured reliably with an eight-item instrument. Additional validation of the scale is indicated.