title: Cancer Treatment Survey (CaTS): development and validation of a new instrument to measure patients' preparation for chemotherapy and radiotherapy.
abstract: OBJECTIVE
  Cancer patients experience high levels of pre-treatment anxiety. Chemotherapy and radiotherapy are threatening medical procedures. Preparation for these procedures should include the provision of sensory and procedural information, and addressing fears. The aim of this study was to develop a cancer treatment survey (CaTS) to assess the preparation for chemotherapy and radiotherapy in cancer patients.
  
  
  METHODS
  Drawing on evidence for how to prepare patients for threatening procedures, items were generated by psychosocial/clinical experts and pilot tested with cancer patients. The 36-item draft CaTS was administered to 192 cancer patients commencing chemotherapy for lymphoma, breast or colon cancer. Participants also completed the Hospital Anxiety and Depression Scale (HADS) and basic medical and demographic information was recorded.
  
  
  RESULTS
  A systematic process of item selection removed 11 items. Factor analysis indicated a two-factor solution, with 11 items representing sensory/psychological concerns and 14 items representing procedural concerns. The two subscales demonstrated excellent internal reliability with Cronbach's alpha both over 0.90 and the average inter-item correlation for each scale exceeded 0.30. Divergent validity was established for both CaTS subscales with the HADS-A and-T (all r<0.30). Younger participants (under 65 years of age) had significantly greater procedural concerns (p = 0.001; medium effect).
  
  
  CONCLUSIONS
  The CaTS is a two factor, 25-item measure that assesses sensory/psychological concerns and procedural concerns relating to cancer treatment. The instrument provides a reliable and valid outcome measure for interventions to prepare cancer patients for chemotherapy and radiotherapy.
authors.affiliation: Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. penelope.schofield@petermac.org
authors.forename: Penelope
authors.initials: P
authors.lastname: Schofield
authors.forename: Karla
authors.initials: K
authors.lastname: Gough
authors.forename: Anna
authors.initials: A
authors.lastname: Ugalde
authors.forename: Mariko
authors.initials: M
authors.lastname: Carey
authors.forename: Sanchia
authors.initials: S
authors.lastname: Aranda
authors.forename: Rob
authors.initials: R
authors.lastname: Sanson-Fisher
mesh_terms: D000368:Aged; D001007:Anxiety; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy; D003110:Colonic Neoplasms / Q000523:psychology / Q000628:therapy; D003863:Depression; D004358:Drug Therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D011594:Psychometrics / Q000295:instrumentation; D011878:Radiotherapy / Q000523:psychology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires