Development and psychometric testing of a breast cancer patient-profiling questionnaire

Figures & data

Table 1 The validated version (Italian) and translation in English of the ALGA-BC questionnaire

Factors	Questions (English version)	Questions (Italian version)	Possible answers					Reversequestions
GSRH	Compared to others your age, would you say your health is …	Rispetto alla sua età, considera il suo stato di salute come …	Very poor	Poor	Neither poor nor good	Good	Very good	Reverse
	In general, would you say your health is …	In generale, considera il suo stato di salute come …	Very poor	Poor	Neither poor nor good	Good	Very good	Reverse
Perceived physical health (in the last 4 weeks)	Did you feel tired?	Si è sentito stanco?	Never	Rarely	Sometimes	Often	Always
	Did you feel weak?	Si è sentito debole?	Never	Rarely	Sometimes	Often	Always
	Did pain interfere with your daily activities?	La fatica ha interferito con le sue attività quotidiane?	Never	Rarely	Sometimes	Often	Always
	How often were you limited in doing either your work or other daily activities?	Si è sentito limitato nello svolgere il suo lavoro o le atre attività quotidiane?	Never	Rarely	Sometimes	Often	Always
	Did you experience pain?	Ha avuto dolore?	Never	Rarely	Sometimes	Often	Always
	Did you have trouble sleeping?	Ha avuto difficoltà a dormire?	Never	Rarely	Sometimes	Often	Always
	How often were you limited in pursuing your hobbies or other leisure time activities?	Si è sentito limitato nel praticare i suoi passatempi o altre attività di divertimento o svago?	Never	Rarely	Sometimes	Often	Always
	Did you need to rest?	Ha avuto bisogno di riposo?	Never	Rarely	Sometimes	Often	Always
Anxiety	How anxious do you feel AT THE MOMENT?	Quanto si sente ansioso in questo momento?	Not anxious at all	A little	Moderately	Very anxious	Extremely anxious
	How anxious do you USUALLY feel?	Quanto si sente ansioso di solito?	Not anxious at all	A little	Moderately	Very anxious	Extremely anxious
Self-efficacy	Can you handle unforeseen situations thanks to your resourcefulness?	Ritiene di essere in grado di saper affrontare situazioni impreviste grazie alla sua intraprendenza?	Never	Rarely	Sometimes	Often	Always	Reverse
	Are you confident that you could deal efficiently with unexpected events?	Ritiene di essere in grado di saper affrontare in modo efficace eventi imprevisti?	Never	Rarely	Sometimes	Often	Always	Reverse
	Are you certain that you can accomplish your goals?	E’ sicuro di poter realizzare i suoi obiettivi?	Never	Rarely	Sometimes	Often	Always	Reverse
	Can you manage to solve difficult problems if you try hard enough?	Riesce a risolvere problemi difficili se ci prova abbastanza seriamente?	Never	Rarely	Sometimes	Often	Always	Reverse
	Can you remain calm when facing difficulties because you can rely on your coping abilities?	Ritiene di essere in grado di saper restare calmo nell’affrontare le difficoltà, perché ha fiducia nelle sue capacità di fronteggiarle?	Never	Rarely	Sometimes	Often	Always	Reverse
	If someone opposes you, can you find the means and ways to get what you want?	Se qualcuno la contrasta, riesce a trovare il modo o il sistema per ottenere ciò che vuole?	Never	Rarely	Sometimes	Often	Always	Reverse
Cognitive closure	When you face a problem, do you decide what to do without hesitation and without thinking too much?	Quando deve risolvere un problema, non ci pensa troppo sopra e decide senza esitare?	Never	Rarely	Sometimes	Often	Always	Reverse
	Do you prefer to decide for the first available solution, rather than reflecting for a long time on a decision?	Preferisce decidere per la prima soluzione disponibile, piuttosto che riflettere a lungo sulla decisione da prendere?	Never	Rarely	Sometimes	Often	Always	Reverse
	When you resolve a problem, do you try to not lose time by considering the different points of view?	Quando deve risolvere un problema, in genere non perde tempo a considerare i diversi punti di vista?	Never	Rarely	Sometimes	Often	Always	Reverse
Memory (in the last 4 weeks)	Did you experience completely forgetting to do things you said you would do, and things you planned to do?	Le capita di dimenticare completamente di fare cose che avrebbe dovuto fare o che ha in progetto di fare?	Never	Rarely	Sometimes	Often	Always
	Did you forget when something happened; for example, whether it was yesterday or last week?	Ha dimenticato quando si è verificato un certo avvenimento (per esempio se è accaduto ieri oppure la settimana scorsa)?	Never	Rarely	Sometimes	Often	Always
	When talking to someone, did you forget what you have just said? Maybe saying “what was I talking about?”	Parlando con qualcuno, le è capitato di dimenticare ciò che ha appena detto? Dicendo, ad esempio, “di che cosa stavamo parlando”?	Never	Rarely	Sometimes	Often	Always
	Did you check whether you have remembered to do something that you should have done?	Ha controllato se ha fatto ciò che avrebbe dovuto fare?	Never	Rarely	Sometimes	Often	Always
Body image (in the last 4 weeks) Sexual life (in the last 4 weeks)	Did you find it difficult to look at yourself naked?	Ha avuto difficoltà a guardarsi nudo?	Never	Rarely	Sometimes	Often	Always
	Have you been dissatisfied with your body?	Si è sentito insoddisfatto del suo corpo?	Never	Rarely	Sometimes	Often	Always
	To what extent were you sexually active? (with or without intercourse)	In che misura è stato sessualmente attivo (con o senza rapporti sessuali completi)?	Never	Rarely	Sometimes	Often	Always	Reverse
	To what extent were you interested in sex?	In che misura ha provato interesse per il sesso?	Never	Rarely	Sometimes	Often	Always	Reverse

Note: The last column indicates which are the questions whose scores must be reversed for the analysis.

Abbreviations: ALGA-BC, ALGA-Breast Cancer; GSRH, global self-rated health.

Table 2 Demographic characteristics of the two samples (breast cancer patients versus healthy subjects)

	Patients		Controls
	n	%	n	%
Age
<20 years	1	1	4	1
20–24 years	0	0	72	10
25–29 years	1	1	103	14
30–39 years	13	13	172	24
40–49 years	29	29	171	23
50–60 years	35	35	150	21
>60 years	20	20	58	8
Marital status
Single	7	7	214	29
Unmarried partner	7	7	111	15
Married	67	67	357	49
Separated or divorced	12	12	42	6
Widow	7	7	6	1
Educational level
Elementary school	10	10	0	0
Middle school	13	13	6	1
High school	52	52	71	55
University	23	23	398	10
PhD/specialization	2	2	255	35

Figure 1 The research process starting from the development of the questionnaire to data collection and analysis.

Figure 2 The eight factors included in the ALGA-Breast Cancer (ALGA-BC) questionnaire.

Table 3 Median and interquartile range of factors

	n	Variable	Median	Lower quartile	Upper quartile	P-values
Marital status
Married/living with partners	74 (74%)	Physical state	2.88	2.38	3.38
		Self-efficacy	3.00	2.17	3.67
		Memory-attention	1.75	1.25	2.50
		Anxiety	6.00	4.50	7.00
		Body image	2.00	1.50	3.00
		Cognitive closure	3.00	2.00	3.33
		GSRH	2.00	1.50	2.75
		Sexual life	3.00	2.00	4.00
Single/divorced/widow	26 (26%)	Physical state	2.44	2.00	3.38
		Self-efficacy	2.83	2.17	3.50
		Memory-attention	2.00	1.25	2.75
		Anxiety	4.50	2.50	7.00
		Body image	2.00	1.00	3.00
		Cognitive closure	3.17	2.00	4.00
		GSRH	2.00	1.50	2.25
		Sexual life	3.50	3.00	4.50
Educational level
High school	75 (75%)	Perceived physical health	3.00	2.38	3.50	0.02
		Self-efficacy	3.00	2.17	3.67
		Memory	1.75	1.25	2.50
		Anxiety	6.00	3.50	7.00
		Body image	2.00	1.00	3.00
		Cognitive closure	3.00	2.00	3.67
		GSRH	2.00	1.50	2.75
		Sexual life	3.00	2.00	4.00
At least university	25 (25%)	Perceived physical health	2.38	1.63	2.88
		Self-efficacy	2.67	2.00	3.75
		Memory	1.88	1.38	3.13
		Anxiety	5.25	4.50	6.50
		Body image	2.00	1.50	2.75
		Cognitive closure	2.67	2.17	3.83
		GSRH	2.00	1.00	2.50
		Sexual life	3.00	2.50	4.00
Children
Yes	84 (84%)	Perceived physical health	2.88	2.25	3.50
		Self-efficacy	3.00	2.17	3.67
		Memory	1.75	1.25	2.75
		Anxiety	6.00	4.00	7.00	0.007
		Body image	2.00	1.50	3.00
		Cognitive closure	3.00	2.00	3.67
		GSRH	2.00	1.50	2.75
		Sexual life	3.00	2.00	4.00
No	16 (16%)	Perceived physical health	2.31	1.56	3.38
		Self-efficacy	2.75	2.17	3.58
		Memory	2.00	1.25	2.50
		Anxiety	4.50	2.75	6.00
		Body image	2.00	1.00	2.75
		Cognitive closure	3.33	2.17	4.00
		GSRH	1.63	1.25	2.25
		Sexual life	3.25	2.75	4.00
Psychological treatments
Yes	16 (16%)	Perceived physical health	3.06	2.00	3.75
		Self-efficacy	3.00	2.42	3.75
		Memory	2.75	1.75	3.13	0.015
		Anxiety	7.00	4.50	8.75	0.003
		Body image	2.75	2.00	3.75	0.007
		Cognitive closure	2.50	1.67	4.17
		GSRH	2.25	1.50	2.63
		Sexual life	3.50	3.00	4.00
No	81 (81%)	Perceived physical health	2.75	2.13	3.38
		Self-efficacy	2.83	2.17	3.67
		Memory	1.75	1.25	2.50
		Anxiety	5.50	3.50	6.50
		Body image	2.00	1.00	3.00
		Cognitive closure	3.00	2.33	3.67
		GSRH	2.00	1.50	2.75
		Sexual life	3.00	2.00	4.00
Smoking
Yes	14 (14%)	Perceived physical health	2.75	2.13	3.63
		Self-efficacy	3.00	2.67	3.50	0.002
		Memory	1.75	1.25	2.50
		Anxiety	5.75	3.50	7.00
		Body image	2.75	2.00	4.00
		Cognitive closure	3.50	3.00	4.33	0.03
		GSRH	2.00	1.50	2.75
		Sexual life	3.00	2.50	4.00
No	76 (76%)	Perceived physical health	2.88	2.00	3.50
		Self-efficacy	3.17	2.17	3.83
		Memory	2.00	1.25	2.75
		Anxiety	6.00	4.50	7.00
		Body image	2.00	1.50	3.00
		Cognitive closure	2.67	2.00	3.67
		GSRH	2.00	1.50	2.75
		Sexual life	3.00	2.00	4.00
Ex-smoker (?)	10 (10%)	Perceived physical health	2.75	2.63	3.00
		Self-efficacy	2.00	1.50	2.33
		Memory	1.50	1.25	2.50
		Anxiety	4.50	2.00	6.00
		Body image	1.75	1.00	3.00
		Cognitive closure	3.00	2.00	3.33
		GSRH	1.88	1.50	2.25
		Sexual life	3.75	3.00	4.00
Physical activity
Yes	36 (36%)	Perceived physical health	2.69	2.00	3.38
		Self-efficacy	3.08	2.00	3.75
		Memory	2.00	1.50	2.75
		Anxiety	6.25	4.50	7.25
		Body image	2.50	1.50	3.00
		Cognitive closure	3.00	2.00	3.83
		GSRH	1.88	1.25	2.38
		Sexual life	3.00	2.50	3.50
No	64 (64%)	Perceived physical health	2.88	2.25	3.63
		Self-efficacy	2.83	2.17	3.50
		Memory	1.75	1.25	2.50
		Anxiety	5.00	3.00	7.00
		Body image	2.00	1.00	3.00
		Cognitive closure	3.00	2.33	3.67
		GSRH	2.00	1.50	2.75
		Sexual life	3.00	2.00	4.00
Personal history of cancer
Yes	10 (10%)	Perceived physical health	3.50	2.00	3.75
		Self-efficacy	3.67	3.17	3.83
		Memory	2.75	1.75	2.75
		Anxiety	6.50	4.50	6.50
		Body image	2.50	1.50	4.00
		Cognitive closure	2.67	2.00	3.00
		GSRH	2.50	2.00	2.75	0.07
		Sexual life	3.00	3.00	4.00
No	90 (90%)	Perceived physical health	2.75	2.13	3.38
		Self-efficacy	2.83	2.17	3.67
		Memory	1.75	1.25	2.50
		Anxiety	5.50	4.00	7.00
		Body image	2.00	1.50	3.00
		Cognitive closure	3.00	2.33	4.00
		GSRH	2.00	1.50	2.50
		Sexual life	3.00	2.00	4.00
Age
≤40 years	15	Perceived physical health	3.00	1.75	3.75
		Self-efficacy	3.00	2.00	3.67
		Memory	2.00	1.25	3.50
		Anxiety	5.00	2.50	6.50
		Body image	2.00	1.50	2.50
		Cognitive closure	2.67	2.00	3.33	0.02
		GSRH	2.00	1.50	2.50
		Sexual life	3.00	2.50	4.00
50 years	29	Perceived physical health	2.75	2.38	3.50
		Self-efficacy	3.17	2.00	3.67
		Memory	2.00	1.50	2.50
		Anxiety	5.00	4.00	6.50
		Body image	2.50	1.50	3.50
		Cognitive closure	2.67	2.00	3.33
		GSRH	2.00	1.25	2.50
		Sexual life	3.00	2.00	3.50
60 years	35	Perceived physical health	2.88	2.00	3.38
		Self-efficacy	2.67	2.17	3.50
		Memory	1.63	1.25	2.50
		Anxiety	6.00	4.50	7.00
		Body image	2.00	1.00	3.00
		Cognitive closure	3.33	2.67	4.00
		GSRH	2.00	1.50	2.75
		Sexual life	3.00	2.00	4.00
≥70 years	20	Perceived physical health	2.75	2.44	3.50
		Self-efficacy	2.92	2.42	3.83
		Memory	1.63	1.00	2.63
		Anxiety	6.25	3.50	7.75
		Body image	2.00	1.00	3.00
		Cognitive closure	2.83	2.33	4.33
		GSRH	1.88	1.25	2.88
		Sexual life	3.00	1.50	4.00

Abbreviation: GSRH, global self-rated health.

Table 4 Comparison between patients and healthy subjects

Variable	Median	Lower quartile	Upper quartile	P-values
Cases (n=100)
Physical state	2.9	2.1	3.4	0.0003
Self-efficacy	3.0	2.2	3.7	<0.0001
Memory-attention	1.8	1.3	2.5	0.197
Body image	2.0	1.5	3.0	0.751
Cognitive closure	3.0	2.0	3.7	<0.0001
GSRH	2.0	1.5	2.8	<0.0001
Sexual life	3.0	2.0	4.0	0.002
Anxiety	2.0	1.3	3.0	<0.0001
Rumination	5.5	4.0	7.0	0.017
Controls (n=730)
Physical state	2.5	2.0	3.0
Self-efficacy	2.2	2.0	2.5
Memory-attention	2.0	1.5	2.5
Body image	2.0	1.5	3.0
Cognitive closure	3.3	3.0	4.0
GSRH	1.5	1.0	2.0
Sexual life	2.5	2.0	3.0
Anxiety	3.5	2.0	5.0
Rumination	1.7	1.3	2.7

Abbreviation: GSRH, global self-rated health.