title: Psychosocial consequences of cancer cachexia: the development of an item bank.
abstract: BACKGROUND
  Cancer cachexia syndrome (CCS) is often accompanied by psychosocial consequences (PSC). To alleviate PSC, a systematic assessment method is required. Currently, few assessment tools are available (e.g., Functional Assessment of Anorexia/Cachexia Therapy). There is no systematic assessment tool that captures the PSC of CCS.
  
  
  OBJECTIVE
  To develop a pilot item bank to assess the PSC of CCS.
  
  
  METHODS
  A total of 132 questions, generated from patient answers in a previous study, were reduced to 121 items by content analysis and evaluation by multidisciplinary experts (doctor, nutritionists, and nurses). In our two-step, cross-sectional study, patients, judged by staff to have PSC of CCS, were included, and the questions were randomly allocated to the patients. Questions were evaluated for understandability and triggering emotions, and patients were asked to provide a response using a four-point Likert scale. Subsequently, problematic questions were revised, reformulated, and retested.
  
  
  RESULTS
  A total of 20 patients with a variety of tumor types participated. Of the 121 questions, 31 had to be reformulated after Step 1 and were retested in Step 2, after which seven were again evaluated as not being perfectly comprehensible. In Step 1, 22 questions were found to trigger emotions, but no item required remodeling. Item performance using the Likert scale revealed no consistent floor or ceiling effects. Our final pilot question bank comprised 117 questions.
  
  
  CONCLUSIONS
  The final item bank contains questions that are understood and accepted by the patients. This item bank now needs to be developed into a measurement tool that groups items into domains and can be used in future research studies.
authors.affiliation: Oncological Palliative Medicine, Section Oncology, Department of Internal Medicine and Palliative Care Centre, Cantonal Hospital, St. Gallen, Switzerland.
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Häne
authors.forename: Rolf
authors.initials: R
authors.lastname: Oberholzer
authors.forename: Jochen
authors.initials: J
authors.lastname: Walker
authors.forename: Jane B
authors.initials: JB
authors.lastname: Hopkinson
authors.forename: Susanne
authors.initials: S
authors.lastname: de Wolf-Linder
authors.forename: Florian
authors.initials: F
authors.lastname: Strasser
mesh_terms: D000368:Aged; D002100:Cachexia / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D011584:Psychology; D011594:Psychometrics / Q000379:methods*; D011788:Quality of Life; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Cancer cachexia syndrome; assessment tool; item bank; psychosocial consequences