title: Psychometric Characteristics of a Patient Reported Outcome Measure on Ego-Integrity and Despair among Cancer Patients.
abstract: To evaluate psychometric characteristics of a questionnaire (the Northwestern Ego-integrity Scale (NEIS)) on ego-integrity (the experience of wholeness and meaning in life, even in spite of negative experiences) and despair (the experience of regret about the life one has led, and feelings of sadness, failure and hopelessness) among cancer patients.
  
  
  
  Cancer patients (n = 164) completed patient reported outcome measures on ego-integrity and despair (NEIS), psychological distress, anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), and quality of life (EORTC QLQ-C30 (cancer survivors, n = 57) or EORTC QLQ-C15-PAL (advanced cancer patients, n = 107)). Confirmatory Factor Analysis was used to assess construct validity. Cronbach's alpha was used to assess internal consistency. Convergent validity was tested based on a priori defined hypotheses: a higher level of ego-integrity was expected to be related to a higher level of quality of life, and lower levels of distress, depression and anxiety; a higher level of despair was expected to be related to a lower level of quality of life, and higher levels of distress, depression and anxiety.
  
  
  
  The majority of all items (94.5%) of the NEIS were completed by patients and single item missing rate was below 2%. The two subscales, labeled as Ego-integrity (5 items) and Despair (4 items) had acceptable internal consistency (Cronbach's alpha .72 and .61, respectively). The Ego-integrity subscale was not significantly associated with quality of life, distress, anxiety, or depression. The Despair subscale correlated significantly (p <.001) with quality of life (r = -.29), distress (r = .44), anxiety (r = .47) and depression (r = .32).
  
  
  
  The NEIS has good psychometric characteristics to assess ego-integrity and despair among cancer patients.
authors.affiliation: Department of Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands.
authors.forename: Gitta
authors.initials: G
authors.lastname: Kleijn
authors.affiliation: Department of Spiritual Care, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Lenneke
authors.initials: L
authors.lastname: Post
authors.affiliation: Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Birgit I
authors.initials: BI
authors.lastname: Witte
authors.affiliation: Department of Mental Health, University of Twente, Enschede, The Netherlands.
authors.forename: Ernst T
authors.initials: ET
authors.lastname: Bohlmeijer
authors.affiliation: Department of Mental Health, University of Twente, Enschede, The Netherlands.
authors.forename: Gerben J
authors.initials: GJ
authors.lastname: Westerhof
authors.affiliation: Department of Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands.
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
authors.affiliation: Department of Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands.|Department of Otolaryngology / Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Irma M
authors.initials: IM
authors.lastname: Verdonck-de Leeuw
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004532:Ego; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D000071066:Patient Reported Outcome Measures; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life; D012649:Self Concept