The Flourishing Scale: Psychometric Properties in Breast Cancer Patients.

BACKGROUND/OBJECTIVE: Promoting well-being is a key goal of cancer care, and it needs to be assessed using appropriate instruments. Flourishing is considered part of psychological well-being and it is commonly assessed with the Flourishing Scale (FS). To our knowledge, no studies have analyzed the psychometric properties of the FS in breast cancer patients. Our aim here was to provide validity evidence for use of the FS in this context. METHOD: Participants were 217 Spanish women with breast cancer who completed the FS and other scales assessing positive psychology constructs (life satisfaction, positive affect, resilience, self-esteem, optimism) and indicators of psychological maladjustment (negative affect, depression, anxiety, and stress). The internal structure of the FS was analyzed using confirmatory factor analysis (CFA). We calculated the average variance extracted (AVE) to evaluate convergent validity, and both McDonald's omega and Cronbach's alpha coefficients to estimate reliability. Item analysis was performed by computing corrected item-total correlations. Validity evidence based on relationships with other variables was obtained through Pearson correlation analysis, controlling for age and cancer stage. RESULTS: The CFA supported a single-factor structure, with adequate goodness-of-fit indices (CFI = 0.997, NNFI = 0.996, RMSEA = 0.069, and SRMR = 0.047) and standardized factor loadings ranging from 0.70 to 0.87. The value of the AVE was 0.63, and the reliability coefficient obtained with both procedures was 0.91. Corrected item-total correlations ranged from .62 to .78. Correlation analysis showed direct and strong associations between the FS score and scores on positive psychology constructs (range from 0.43 to 0.74), the strongest correlations being with positive affect and life satisfaction. The FS score was inversely correlated with scores on depression, anxiety, stress, negative affect, and pessimism (range from -0.14 to -0.52), the strongest association being with stress. DISCUSSION: The FS is a useful tool for exploring well-being in the breast cancer context, providing useful information for psychological assessment.

Life Satisfaction and Character Strengths in Women With Breast Cancer: Zest and Hope as Predictors.

BACKGROUND: Empirical evidence shows that life satisfaction is positively related to character strengths, and although this association has been observed in different populations, it is scarce in breast cancer patients. This study analyzes the relationship between character strengths and life satisfaction in Spanish women diagnosed with breast cancer. METHODS: A sample of 117 women completed the Satisfaction with Life Scale (SWLS) and the Spanish version of the VIA Inventory of Strengths (VIA-IS). Correlation analysis and regression modeling were performed to determine which strengths predict life satisfaction. RESULTS: The results of the correlation analysis showed that 15 strengths were positively and significantly associated with life satisfaction, with the highest correlations corresponding to zest, hope, curiosity, social intelligence, love, gratitude, and judgment. Regression modeling indicated that of these, zest and hope were key strengths for predicting life satisfaction. CONCLUSIONS: These findings suggest that intervention programs based on the development of zest and hope could help to improve life satisfaction and, therefore, the psychological well-being of women with breast cancer.

Development and psychometric properties of the Stressors in Breast Cancer Scale.

Background: A 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. Aims: The aim of this study was to develop the Stressors in Breast Cancer Scale (SBCS). Method: A 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. Results: Validity 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. Discussion: The 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 perceived stress scale (pss-10) with breast cancer patients.

Breast cancer diagnosis is one of the most difficult events that a woman can experience during her life and it usually produces high levels of stress. Global measures of perceived stress are useful for screening and for comparing stress levels between cancer patients and other clinical and nonclinical populations. One such instrument that is widely used is the Perceived Stress Scale (pss-10), but its psychometric properties have scarcely been analysed with breast cancer patients. The aim of this study was to provide validity evidence regarding the use of the 10-item version of the pss-10 as a tool for measuring perceived stress in this context. Participants were 215 Spanish breast cancer patients who completed the PSS-10 and the DASS-21, a measure of affective distress (depression, anxiety, and stress). The internal structure of the PSS-10 was examined through confirmatory factor analysis (CFA), and the reliability of test scores was estimated using McDonald's omega coefficient. Validity evidence based on relationships with other variables was also obtained using correlation analysis. The CFA supported a correlated two-factor structure: perceived helplessness (six negatively worded items) and perceived self-efficacy (four positively worded items). Reliability coefficients for scores on these two factors were 0.87 and 0.73, respectively. Scores on affective distress (DASS-21) were strongly and positively correlated with perceived helplessness and moderately and negatively correlated with perceived self-efficacy. The PSS-10 is an adequate tool for measuring perceived stress in the breast cancer context and it may be useful for identifying women at risk of psychological maladjustment.

The Satisfaction with Life Scale in breast cancer patients: Psychometric properties.

BACKGROUND/OBJECTIVE: This study aims to analyze the psychometric properties of the Satisfaction with Life Scale (SWLS), examining the reliability of scale scores and providing validity evidence for its use with breast cancer patients. We provide validity evidence based on internal structure and on relationships with positive psychological variables and other variables indicative of psychological adjustment. METHOD: Participants were 222 Spanish women with a diagnosis of breast cancer. They completed the SWLS and a battery of questionnaires measuring positive and negative affect, self-esteem, resilience, emotional intelligence, flourishing, optimism, depression, anxiety, and stress. RESULTS: Confirmatory factor analysis supported a single-factor structure for the SWLS, S-B χ2 (5) = 7.36, p = .19, CFI = .99, NNFI = .99, RMSEA = .046. The reliability of test scores estimated with McDonald's omega yielded a value of .80. Validity evidence was provided by a positive correlation between SWLS scores and positive affect, self-esteem, resilience, emotional intelligence (specifically, clarity and repair), flourishing, and optimism (range: .24, .69), and by a negative correlation with negative affect, pessimism, depression, anxiety, and stress (range: -.25, -.59). CONCLUSIONS: The Spanish version of the SWLS showed satisfactory psychometric properties and it is an appropriate measure for use in the breast cancer context.

ANTECEDENTES/OBJETIVO: El objetivo deestudio es examinar las propiedades psicométricas de la Escala de Satisfacción con la Vida (SWLS), analizando la fiabilidad de sus puntuaciones y aportando evidencias para su uso en pacientes con cáncer de mama. Se proporcionan evidencias de validez basadas en la estructura interna y en la relación con otras variables psicológicas positivas y con otras indicativas de ajuste psicológico. MÉTODO: Han participado 222 mujeres españolas diagnosticadas de cáncer de mama, que cumplimentaron la SWLS y medidas de afecto positivo y negativo, autoestima, resiliencia, inteligencia emocional, florecimiento, optimismo, depresión, ansiedad y estrés. RESULTADOS: El análisis factorial confirmatorio indicó una estructura unidimensional, S-B χ2(5) = 7,36, p = 0,19, CFI = 0,99, NNFI = 0,99, RMSEA = 0,046. La fiabilidad de las puntuaciones estimadas con omega de McDonald fue de 0,80. Las evidencias de validez mostraron correlaciones positivas entre las puntuaciones de SWLS y afecto positivo, autoestima, inteligencia emocional (específicamente, claridad y reparación), florecimiento y optimismo (rango 0,24 0,69), así como correlaciones negativas con afecto negativo, pesimismo, depresión, ansiedad, y estrés (rango -0,25 - 0,59). CONCLUSIONES: La versión española de la SWLS muestra adecuadas propiedades psicométricas, siendo una medida apropiada para utilizarla en pacientes de cáncer de mama.