Development and psychometric properties of the Stressors in Breast Cancer Scale

Abstract

BackgroundA diagnosis of breast cancer generates psychological stress, due not only to treatment and its side effects but also to the impact on different areas of the patient’s daily life. Although there are instruments for measuring psychological stress in the cancer context, there is currently no tool for assessing stressors specific to breast cancer.AimsThe aim of this study was to develop the Stressors in Breast Cancer Scale (SBCS).MethodA panel of experts evaluated the clarity and relevance of scale items, providing validity evidence based on test content. Psychometric properties of the scale were then analyzed.ResultsValidity evidence based on the internal structure of the SBCS was obtained through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), following a cross-validation strategy. The CFA supported a second-order factor model with five dimensions: physical appearance and sex strains, health and daily difficulties, interpersonal relationship strains, healthcare strains, and worries and concerns about the future. This structure was invariant across two groups distinguished by time from cancer diagnosis (less than 3 and 3 years or more from diagnosis). Reliability, based on McDonald’s omega and Cronbach’s alpha coefficients, ranged from 0.83 to 0.89 for factor scores, and reached 0.95 for total scores. Validity evidence was also provided by correlations with depression, anxiety, perceived stress, and perceived health and quality of life.DiscussionThe results support the use of the SBCS for measuring stress as a stimulus in the breast cancer context. Implications for clinical practice and research are discussed.

Psychometric properties of the Depression Anxiety Stress Scales (DASS-21) in women with breast cancer

“…It is worth noting here that the strongest correlations were those between general psychological distress (DASS-21 total score) and worries about the future and the SBCS total score. This is consistent with previous research showing that cancer survivors who experience concerns or fears about the future, often referred to as Damocles syndrome, tend to manifest greater psychological distress 7,17 . These worries about the future in breast cancer patients should therefore be a target of intervention by psycho-oncologists, as they seem to be one of the most important concerns affecting these women.…”

“…Stressors in Breast Cancer Scale (SBCS) 17 , which consists of 24 items assessing breast cancer-speci c stressors. The scale is divided into ve subscales: physical appearance and sex strains, health and daily di culties, interpersonal relationship strains, healthcare strains, and worries and concerns about the future.…”

Psychometric evaluation of the Chinese version of the stressors in breast cancer scale: a translation and validation study

“…According to the EFA, the contribution of the five factors extracted in this study to the cumulative variance was 67.95%, and the factor loadings were 0.59 to 0.92, indicating that the items can well reflect the stress of This study examined the reliability of the Chinese version of the SBCS in terms of internal consistency, splithalf reliability, and test-retest reliability. The Cronbach's alpha coefficient was 0.938, which was slightly lower than the English version's 0.95 [23]. The split-half reliability was 0.853 and the test-retest reliability was 0.855, indicating that the scale has good internal consistency reliability and good time stability.…”

“…Cerezo developed this scale in 2023 to assess stressors in breast cancer patients [23]. The scale consists of 24 items in 5 dimensions (physical appearance and sex strains, health and daily difficulties, interpersonal relationship strains, healthcare strains, and worries and concerns about the future).…”

“…Stress is often assessed by self-report measures, and researchers have developed several stress assessment tools specific to the cancer context, such as the Questionnaire for Stress in Cancer Patients (QSC-R23) [21], the Newly Diagnosed Breast Cancer Symptoms Stress Scale (NDBCSS) [22], and the Stressors in Breast Cancer Scale (SBCS) [23].The QSC-R23 is a 23-item scale for assessing cancer-related daily stressors, and its psychometric properties have been examined in different cancer populations, such as breast, hematological oncology, gynecological, thyroid, and urological cancers [24,25]. However, its use is limited to German-speaking patients because to our knowledge, no psychometric information exists on its translation into English [26].…”