title: The Cancer Loneliness Scale and Cancer-related Negative Social Expectations Scale: development and validation.
abstract: Loneliness is a known risk factor for poor mental and physical health outcomes and quality of life in the general population, and preliminary research suggests that loneliness is linked to poorer health outcomes in cancer patients as well. Various aspects of the cancer experience contribute to patients feeling alone and misunderstood. Furthermore, loneliness theory suggests that negative social expectations, which may specifically relate to the cancer experience, precipitate and sustain loneliness. Cancer-specific tools are needed to assess key constructs of this theory. In the current study, we developed and tested measures of (1) loneliness attributed to cancer (i.e., cancer-related loneliness) and (2) negative social expectations related to cancer.
  
  
  
  First, we developed the items for the measures based on theory, prior research, and expert feedback. Next, we assessed the measures' psychometric properties (i.e., internal consistency and construct validity) in a diverse sample of cancer patients.
  
  
  
  The final products included a 7-item unidimensional Cancer Loneliness Scale and a 5-item unidimensional Cancer-related Negative Social Expectations Scale. Evidence of excellent reliability and validity was found for both measures.
  
  
  
  The resulting measures have both clinical and research utility.
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, 780 Welch Road, MC 5776, Palo Alto, CA, 94304, USA. rnadams@stanford.edu.
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Adams
authors.affiliation: Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Mosher
authors.affiliation: Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Rand
authors.affiliation: Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
authors.forename: Adam T
authors.initials: AT
authors.lastname: Hirsh
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine and School of Public Health, 410 W. Tenth St., Suite 3000, Indianapolis, IN, 46202, USA.
authors.forename: Patrick O
authors.initials: PO
authors.lastname: Monahan
authors.affiliation: Department of Medicine, Indiana University School of Medicine, 535 Barnhill Drive, Indiana Cancer Pavilion, Suite 446, Indianapolis, IN, 46202, USA.
authors.forename: Rafat
authors.initials: R
authors.lastname: Abonour
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, 46202, USA.|VA HSR&D Center for Health Information and Communication, Indianapolis, IN, 46202, USA.|Regenstrief Institute, Inc. (RF), 1101 West Tenth Street, RF 221, Indianapolis, IN, 46202, USA.
authors.forename: Kurt
authors.initials: K
authors.lastname: Kroenke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008132:Loneliness / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D011594:Psychometrics / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D055815:Young Adult
keywords: Cancer; Loneliness; Measurement; Oncology; Scale development; Social expectations