Development and validation of the Communication and Attitudinal Self-Efficacy scale for cancer (CASE-cancer)

Patient Educ Couns. 2005 Jun;57(3):333-41. doi: 10.1016/j.pec.2004.09.005.


We sought to develop a reliable and valid measure of patient self-efficacy within the context of productive communication and positive attitude for cancer patients. A set of 19 potential items for the Communication and Attitudinal Self-Efficacy scale for cancer (CASE-cancer) was pilot tested with 50 cancer patients. Based on the pilot test, item valence was made consistent (i.e., all items worded positively) and the response scale was simplified. The CASE-cancer was then administered to 127 persons receiving cancer treatment at general oncology clinics in Shreveport, Louisiana and Chicago, Illinois. Psychometric analyses revealed three 4-item factors: understanding and participating in care, maintaining a positive attitude, and seeking and obtaining information. The CASE-cancer proved to have high internal consistency and construct validity. Moreover, scale items performed similarly across literacy levels. The CASE-cancer is a psychometrically-sound tool that may provide new information on important mediating factors of cancer care. Our two-step approach to presenting response options may also provide a model for helping lower literate patients more accurately respond to survey items.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adaptation, Psychological
  • Attitude to Health*
  • Chicago
  • Communication*
  • Comprehension
  • Educational Status
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Internal-External Control
  • Louisiana
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Neoplasms / therapy
  • Patient Education as Topic
  • Patient Participation / psychology
  • Patient-Centered Care
  • Pilot Projects
  • Professional-Patient Relations
  • Psychometrics
  • Self Efficacy*
  • Sick Role
  • Socioeconomic Factors
  • Surveys and Questionnaires / standards*