title: A scale for measuring feelings of support and security regarding cancer care in a region of Japan: a potential new endpoint of cancer care.
abstract: BACKGROUND
  Having a sense of security about the availability of care is important for cancer patients and their families.
  
  
  OBJECTIVE
  To develop a scale for the general population to evaluate feelings of support and security regarding cancer care, and to identify factors associated with a sense of security.
  
  
  METHODS
  A cross-sectional anonymous questionnaire was administered to 8000 subjects in four areas of Japan. Sense of security was measured using five statements and using a seven-point Likert scale: "If I get cancer 1) I would feel secure in receiving cancer treatment, 2) my pain would be well relieved, 3) medical staff will adequately respond to my concerns and pain, 4) I would feel secure as a variety of medical care services are available, and 5) I would feel secure in receiving care at home." We performed an exploratory factor analysis as well as uni- and multivariate analyses to examine factors associated with such a sense of security.
  
  
  RESULTS
  The five items regarding sense of security were aggregated into one factor, and Cronbach's α was 0.91. In the Yamagata area where palliative care services were not available, the sense of security was significantly lower than in the other three regions. Female gender (P=0.035), older age (P<0.001), and having cancer (P<0.001) were significantly associated with a strong sense of security.
  
  
  CONCLUSIONS
  A new scale that evaluates sense of security with regard to cancer care was developed. Future studies should examine whether establishing a regional health care system that provides quality palliative care could improve the sense of security of the general population.
authors.affiliation: Department of Gerontological Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan. igarashi.gh@tmd.ac.jp
authors.forename: Ayumi
authors.initials: A
authors.lastname: Igarashi
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.forename: Nobuya
authors.initials: N
authors.lastname: Akizuki
authors.forename: Miki
authors.initials: M
authors.lastname: Akiyama
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Shirahige
authors.forename: Kenji
authors.initials: K
authors.lastname: Eguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D023381:Endpoint Determination / Q000379:methods* / Q000523:psychology; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D010166:Palliative Care / Q000523:psychology / Q000706:statistics & numerical data; D015995:Prevalence; D012944:Social Support; D011795:Surveys and Questionnaires