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Refining and supplementing candidate measures of psychological well-being for the NIH PROMIS®: qualitative results from a mixed cancer sample

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Abstract

Purpose

The Patient-Reported Outcomes Measurement Information System (PROMIS) is a National Institutes of Health initiative designed to improve patient-reported outcomes using state-of-the-art psychometric methods. The aim of this study is to describe qualitative efforts to identify and refine items from psychological well-being subdomains for future testing, psychometric evaluation, and inclusion within PROMIS.

Method

Seventy-two items from eight existing measures of positive affect, life satisfaction, meaning & purpose, and general self-efficacy were reviewed, and 48 new items were identified or written where content was lacking. Cognitive interviews were conducted in patients with cancer (n = 20; 5 interviews per item) to evaluate comprehensibility, clarity, and response options of candidate items.

Results

A Lexile analysis confirmed that all items were written at the sixth grade reading level or below. A majority of patients demonstrated good understanding and logic for all items; however, nine items were identified as “moderately difficult” or “difficult” to answer. Patients reported a strong preference for confidence versus frequency response options for general self-efficacy items.

Conclusions

Altogether, 108 items were sufficiently comprehensible and clear (34 positive affect, 10 life satisfaction, 44 meaning & purpose, 20 general self-efficacy). Future research will examine the psychometric properties of the proposed item banks for further refinement and validation as PROMIS measures.

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Acknowledgements

The authors would like to thank Ms. Helena Correia, the Director of Translations for the Department of Medical Social Sciences at the Northwestern University Feinberg School of Medicine, for her work conducting the translatability review in support of this manuscript.

Funding

Research reported in this publication was supported by the National Cancer Institute of the NIH under Award Number K07CA158008.

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Correspondence to John M. Salsman.

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The authors have no significant financial disclosures or conflicts of interest to report.

Ethical approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional review board of Northwestern University and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all participants in the study.

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Salsman, J.M., Park, C.L., Hahn, E.A. et al. Refining and supplementing candidate measures of psychological well-being for the NIH PROMIS®: qualitative results from a mixed cancer sample. Qual Life Res 27, 2471–2476 (2018). https://doi.org/10.1007/s11136-018-1896-2

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