Assessment of coping with cancer-related burdens: psychometric properties of the Cognitive-Emotional Coping with Cancer scale and the German Mini-mental Adjustment to Cancer scale

Cwik, Jan Christopher; Vaganian, Lusine; Bussmann, Sonja; Labouvie, Hildegard; Houwaart, Stefanie; Gerlach, Alexander L.; Kusch, Michael

doi:10.1097/or9.0000000000000046

Cited by 10 publications

(10 citation statements)

References 68 publications

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“…The psycho-oncological examinations in the isPO care program are carried out with the help of three psychometric instruments, Hospital Anxiety and Depression Scale (HADS [ 64 ]), Psychosocial Risk Questionnaire (German: Psychosozialer Risikofragebogen; PSR [ 65 ]) Cognitive-Emotional Coping with Cancer questionnaire (CECC) (German: Fragebogen zur Kognitiv-Emotionalen Auseinandersetzung mit Krebs; KEA-K) [ 146 ]. …”

Section: Care Pathways Of the Ispo Care Programmentioning

confidence: 99%

“…Cognitive-Emotional Coping with Cancer questionnaire (CECC) (German: Fragebogen zur Kognitiv-Emotionalen Auseinandersetzung mit Krebs; KEA-K) [ 146 ].…”

Section: Care Pathways Of the Ispo Care Programunclassified

“…Cognitive-Emotional Coping with Cancer questionnaire (CECC) (German: Fragebogen zur Kognitiv-Emotionalen Auseinandersetzung mit Krebs; KEA-K) [ 146 ]. The CECC is a self-rating questionnaire developed at beginning of the isPO project to measure aspects of emotional regulation with cancer within the last seven days, based on the common-sense model of illness and health [ 161 ] and the emotion-regulation model [ 77 ].…”

Section: Care Pathways Of the Ispo Care Programmentioning

confidence: 99%

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Integrated, cross-sectoral psycho-oncology (isPO): a new form of care for newly diagnosed cancer patients in Germany

Kusch

Labouvie

Schiewer

et al. 2022

BMC Health Serv Res

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Background The annual incidence of new cancer cases has been increasing worldwide for many years, and is likely to continue to rise. In Germany, the number of new cancer cases is expected to increase by 20% until 2030. Half of all cancer patients experience significant emotional and psychosocial distress along the continuum of their disease, treatment, and aftercare, and also as long-term survivors. Consequently, in many countries, psycho-oncological programs have been developed to address this added burden at both the individual and population level. These programs promote the active engagement of patients in their cancer therapy, aftercare and survivorship planning and aim to improve the patients' quality of life. In Germany, the “new form of care isPO” (“nFC-isPO”; integrated, cross-sectoral psycho-oncology/integrierte, sektorenübergreifende Psycho-Onkologie) is currently being developed, implemented and evaluated. This approach strives to accomplish the goals devised in the National Cancer Plan by providing psycho-oncological care to all cancer patients according to their individual healthcare needs. The term “new form of care" is defined by the Innovation Fund (IF) of Germany's Federal Joint Committee as “a structured and legally binding cooperation between different professional groups and/or institutions in medical and non-medical care”. The nFC-isPO is part of the isPO project funded by the IF. It is implemented in four local cancer centres and is currently undergoing a continuous quality improvement process. As part of the isPO project the nFC-isPO is being evaluated by an independent institution: the Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Germany. The four-year isPO project was selected by the IF to be eligible for funding because it meets the requirements of the federal government's National Cancer Plan (NCP), in particular, the “further development of the oncological care structures and quality assurance" in the psycho-oncological domain. An independent evaluation is required by the IF to verify if the new form of care leads to an improvement in cross-sectoral care and to explore its potential for permanent integration into the German health care system. Methods The nFC-isPO consists of six components: a concept of care (C1), care pathways (C2), a psycho-oncological care network (C3), a care process organization plan (C4), an IT-supported documentation and assistance system (C5) and a quality management system (C6). The two components concept of care (C1) and care pathways (C2) represent the isPO clinical care program, according to which the individual cancer patients are offered psycho-oncological services within a period of 12 months after program enrolment following the diagnosis of cancer. The remaining components (C3-C6) represent the formal-administrative aspects of the nFC-isPO that are intended to meet the legally binding requirements of patient care in the German health care system. With the aim of systematic development of the nFC-isPO while at the same time enabling the external evaluators to examine its quality, effectiveness and efficiency under conditions of routine care, the project partners took into consideration approaches from translational psycho-oncology, practice-based health care research and program theory. In order to develop a structured, population-based isPO care program, reference was made to a specific program theory, to the stepped-care approach, and also to evidence-based guideline recommendations. Results The basic version, nFC-isPO, was created over the first year after the start of the isPO project in October 2017, and has since been subject to a continuous quality improvement process. In 2019, the nFC-isPO was implemented at four local psycho-oncological care networks in the federal state North Rhine-Westphalia, in Germany. The legal basis of the implementation is a contract for "special care" with the German statutory health insurance funds according to state law (§ 140a SCB V; Social Code Book V for the statutory health insurance funds). Besides the accompanying external evaluation by the IMVR, the nFC-isPO is subjected to quarterly internal and cross-network quality assurance and improvement measures (internal evaluation) in order to ensure continuous quality improvement process. These quality management measures are developed and tested in the isPO project and are to be retained in order to ensure the sustainability of the quality of nFC-isPO for later dissemination into the German health care system. Discussion Demands on quality, effectiveness and cost-effectiveness of in the German health care system are increasing, whereas financial resources are declining, especially for psychosocial services. At the same time, knowledge about evidence-based screening, assessment and intervention in cancer patients and about the provision of psychosocial oncological services is growing continuously. Due to the legal framework of the statutory health insurance in Germany, it has taken years to put sound psycho-oncological findings from research into practice. Ensuring the adequate and sustainable financing of a needs-oriented, psycho-oncological care approach for all newly diagnosed cancer patients, as required by the NCP, may still require many additional years. The aim of the isPO project is to develop a new form of psycho-oncological care for the individual and the population suffering from cancer, and to provide those responsible for German health policy with a sound basis for decision-making on the timely dissemination of psycho-oncological services in the German health care system. Trial registration The study was pre-registered at the German Clinical Trials Register (https://www.drks.de/DRKS00015326) under the following trial registration number: DRKS00015326; Date of registration: October 30, 2018.

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Section: Care Pathways Of the Ispo Care Programmentioning

confidence: 99%

“…Cognitive-Emotional Coping with Cancer questionnaire (CECC) (German: Fragebogen zur Kognitiv-Emotionalen Auseinandersetzung mit Krebs; KEA-K) [ 146 ].…”

Section: Care Pathways Of the Ispo Care Programunclassified

Section: Care Pathways Of the Ispo Care Programmentioning

confidence: 99%

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Integrated, cross-sectoral psycho-oncology (isPO): a new form of care for newly diagnosed cancer patients in Germany

Kusch

Labouvie

Schiewer

et al. 2022

BMC Health Serv Res

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“…This question was designed as a multiple-choice task with several answer options as well as an open, descriptive category "other", so that several cancer diagnoses could be named at the same time. Social media platforms, a forum for cancer patients, and mailing lists from self-help groups were used to advertise the study as part of another validation study [31]. All participants gave their informed consent online, after being informed about study content and aims, procedures, and planned publications.…”

Section: Participants and Proceduresmentioning

confidence: 99%

Psychometric evaluation of the Positive Mental Health (PMH) scale using item response theory

et al. 2022

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Background The investigation of patient-reported outcomes and psycho-oncological interventions mainly focuses on psychological distress or psychopathology. However, the recognition of the equal importance of positive mental health (PMH) has increased lately. The PMH-scale is a brief questionnaire allowing to assess well-being in individuals in the general population and in patients. Previous studies evaluated the psychometric properties of the PMH-scale using classical test theory (CTT). This study is the first to investigate the PMH-scale in patients with cancer using item analysis according to the Rasch model. Methods In total, N = 357 cancer patients participated in the study. A Rasch analysis of the PMH-scale was conducted including testing of unidimensionality, local independence, homogeneity and differential item functioning (DIF) with regard to age, gender, type of cancer, the presence of metastases, psycho-oncological support, and duration of disease. Additionally, the ordering of the item thresholds as well as the targeting of the scale were investigated. Results After excluding one misfitting item and accounting for local dependence by forming superitems, a satisfactory overall fit to the Rasch model was established (χ2 = 30.34, p = 0.21). The new PMH-8 scale proved to be unidimensional, and homogeneity of the scale could be inferred. All items showed ordered thresholds, there was no further item misfit. DIF was found for age, but as the impact of DIF was not substantial, no adjustment related to the age-DIF had to be made. The Person Separation Index (PSI = 0.89) was excellent, indicating excellent discriminatory power between different levels of positive mental health. Overall, the targeting of the PMH-8 was good for the majority of the present sample. However, at both ends of the scale item thresholds are missing as indicated by a slight floor effect (1.4%) and a considerable ceiling effect (9.8%). Conclusions Overall, the results of the analysis according to the Rasch model support the use of the revised PMH-scale in a psycho-oncological context.

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“…Participants were invited to participate in the study using SoSciSurvey [19] as an online survey consisting of various questionnaires. The link was posted on social media platforms and online cancer support groups as part of a validation study [20]. All participants gave their informed consent online.…”

Section: Participants and Proceduresmentioning

confidence: 99%

An item analysis according to the Rasch model of the German 12-item WHO Disability Assessment Schedule (WHODAS 2.0)

et al. 2021

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Purpose The World Health Organization Disability Assessent Schedule 2.0 (WHODAS 2.0) assesses disability in individuals irrespective of their health condition. Previous studies validated the usefulness of the WHODAS 2.0 using classical test theory. This study is the first investigating the psychometric properties of the 12-items WHODAS 2.0 in patients with cancer using item analysis according to the Rasch model. Methods In total, 350 cancer patients participated in the study. Rasch analysis of the 12-items version of the WHODAS 2.0 was conducted and included testing unidimensionality, local independence, and testing for differential item functioning (DIF) with regard to age, gender, type of cancer, presence of metastases, psycho-oncological support, and duration of disease. Results After accounting for local dependence, which was mainly found across items of the same WHODAS domain, satisfactory overall fit to the Rasch model was established (χ2 = 36.14, p = 0.07) with good reliability (PSI = 0.82) and unidimensionality of the scale. DIF was found for gender (testlet ‘Life activities’) and age (testlet ‘Getting around/Self-care’), but the size of DIF was not substantial. Conclusion Overall, the analysis results according to the Rasch model support the use of the WHODAS 2.0 12-item version as a measure of disability in cancer patients.

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Assessment of coping with cancer-related burdens: psychometric properties of the Cognitive-Emotional Coping with Cancer scale and the German Mini-mental Adjustment to Cancer scale

Cited by 10 publications

References 68 publications

Integrated, cross-sectoral psycho-oncology (isPO): a new form of care for newly diagnosed cancer patients in Germany

Integrated, cross-sectoral psycho-oncology (isPO): a new form of care for newly diagnosed cancer patients in Germany

Psychometric evaluation of the Positive Mental Health (PMH) scale using item response theory

An item analysis according to the Rasch model of the German 12-item WHO Disability Assessment Schedule (WHODAS 2.0)

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