OPENNESS TO DISCUSS CANCER IN THE NUCLEAR FAMILY - SCALE, DEVELOPMENT, AND VALIDATION

Objective: To describe the development and validation of a scale for a ssessing 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 St udy 2, a longitudinal study, 133 patients with cancer in the head and neck were tested at four points in time: just before treatment, 6 week s, 13 weeks, and 52 weeks after treatment. Study 2 aimed to confirm th e factor structure established in Study 1, to test for construct valid ity in a new population, to test the psychometric properties of the Op enness Scale, and to test the scale's sensitivity to change. Results: In Study 1, a one-factor solution was revealed, resulting in a scale o f eight items. In Study 2, the factor structure found in Study 1 was c onfirmed. In line with theoretical expectations, subjects who perceive d their communication about cancer as more open showed more positive r ehabilitation outcomes especially at 13 weeks after treatment (less un certainty, fewer negative feelings, more control, higher self-esteem, fewer psychological and physical complaints). Furthermore, more open c ommunication related with more support by family members and more disc ussion with the partner. The scale was found to be stable over time. C onclusions: 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.