title: Psychometric investigation of benefit finding among long-term cancer survivors using the Medical Expenditure Panel Survey.
abstract: OBJECTIVE
  Benefit finding has been shown to be beneficial for people with cancer and may be an indication that one is coping adequately with the stress of cancer. This study evaluated the psychometric properties of a four-item benefit finding measure from the cancer survivorship supplement of the Medical Expenditure Panel Survey (MEPS).
  
  
  METHODS
  Long-term survivors (5-10 years post-diagnosis) of breast, prostate, colorectal or lung cancer or melanoma (n = 594) completed the MEPS cancer supplement survey in 2013. Four items asked about benefit finding after the cancer: stronger person, coping better, positive changes and having healthier habits. Information on sociodemographics, disease and activity limitations after the cancer was also collected. We examined factor structure, reliability (Kuder-Richardson 20) and validity.
  
  
  RESULTS
  The four benefit finding items did not appear to measure one factor. Three of the benefit finding items (stronger person, coping better, positive changes) were related to gender, receipt of chemotherapy and activity limitations but not cancer stage, time since diagnosis or income. Having healthier habits was unrelated to any sociodemographic or disease variable.
  
  
  CONCLUSIONS
  Three of the items (stronger person, coping better, positive changes) appeared to have validity as they were related to variables that literature has shown are related to benefit finding. However, having healthier habits is likely measuring a separate but related construct. This short instrument may be used in future studies assessing benefit finding post cancer; however, the four items should be analyzed separately.
authors.affiliation: Group Health Research Institute, Seattle, WA, USA. Electronic address: wu.582@osu.edu.
authors.forename: Salene M W
authors.initials: SM
authors.lastname: Jones
authors.affiliation: Group Health Research Institute, Seattle, WA, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ziebell
authors.affiliation: Group Health Research Institute, Seattle, WA, USA.
authors.forename: Rod
authors.initials: R
authors.lastname: Walker
authors.affiliation: Harvard Medical School, Department Population Medicine, 133 Brookline Avenue, 6th Floor, Boston, MA 02215, USA.
authors.forename: Larissa
authors.initials: L
authors.lastname: Nekhlyudov
authors.affiliation: Department of Family Medicine and Colorado Health Outcomes Program, School of Medicine, University of Colorado, USA; Department of Community and Behavior Health, School of Public Health, University of Colorado, USA; Kaiser Permanente Colorado, Denver, CO, USA.
authors.forename: Borsika A
authors.initials: BA
authors.lastname: Rabin
authors.affiliation: LIVESTRONG Foundation, Austin, TX, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Nutt
authors.affiliation: Group Health Research Institute, Seattle, WA, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Fujii
authors.affiliation: Group Health Research Institute, Seattle, WA, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Chubak
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011594:Psychometrics / Q000295:instrumentation*; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D014481:United States
keywords: Benefit finding; Cancer; Posttraumatic growth; Psychometric