title: The self-rating score (SRS) versus the examiner rating score (ERS) in measuring helplessness in healthy individuals and in patients with benign breast disease and breast cancer: a prospective case-control study in Finland.
abstract: BACKGROUND
  The self-rating score (SRS) versus examiner rating score (ERS) in measuring helplessness in healthy study subjects (HSS) and in patients with benign breast disease (BBD) and breast cancer (BC) has not been yet compared in a prospective study. We, therefore, investigated SRS versus ERS in 115 patients.
  
  
  METHODS
  In an extension of the Kuopio Breast Cancer Study 115 women with breast symptoms were evaluated for hopelessness versus helplessness before any diagnostic procedures were carried-out.
  
  
  RESULTS
  The SRS and the ERS for hopelessness were highly significantly positively correlated in the HSS, BBD and BC groups. The weighted kappa values for hopelessness between the SRS and the ERS in the HSS, BBD and BC groups were also statistically significant. There was also a significant positive correlation between the SRS and the ERS for helplessness in the HSS, BBD and BC groups. The weighted and unweighted kappa-values for hopelessness versus helplessness for the SRS in the HSS, BBD and BC groups were statistically significant. The Spearman correlation coefficients and both weighted and unweighted kappa values for hopelessness versus helplessness in the ERS in the HSS, BBD and BC groups were statistically significant.
  
  
  CONCLUSIONS
  The results of this study support a specific link between hopelessness and helplessness attitude characteristics by SRS and ERS. This finding is of clinical importance, since in the BC and BBD groups, hopelessness/helplessness might be associated with a delay in BC diagnosis and have a negative impact on the adjustment and well-being of patients.
authors.affiliation: Surgery, School of Medicine, University of Eastern Finland, Kuopio, Finland Department of Surgery, Kuopio University Hospital, Kuopio, Finland matti.eskelinen@kuh.fi.
authors.forename: Matti
authors.initials: M
authors.lastname: Eskelinen
authors.affiliation: Surgery, School of Medicine, University of Eastern Finland, Kuopio, Finland Department of Surgery, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Riika
authors.initials: R
authors.lastname: Korhonen
authors.affiliation: Science Service Center, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Tuomas
authors.initials: T
authors.lastname: Selander
authors.affiliation: Psychiatry, School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Paula
authors.initials: P
authors.lastname: Ollonen
mesh_terms: D000328:Adult; D000368:Aged; D001941:Breast Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Helplessness; breast disease; examiner rating; hopelessness; self rating