Psychometric Characteristics of a Patient Reported Outcome Measure on Ego-Integrity and Despair among Cancer Patients

Abstract

PurposeTo 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.MethodsCancer 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.ResultsThe 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).ConclusionThe NEIS has good psychometric characteristics to assess ego-integrity and despair among cancer patients.

The efficacy of Life Review Therapy combined with Memory Specificity Training (LRT-MST) targeting cancer patients in palliative care: A randomized controlled trial

“…The Dutch version of the Northwestern Ego-integrity Scale (NEIS) [ 34 – 37 ] was used. This is an 15-item questionnaire reflecting Erikson’s conception of the eight developmental phase in a person’s life [ 13 ].…”

Transcending the Suffering in Cancer: Impact of a Spiritual Life Review Intervention on Spiritual Re-Evaluation, Spiritual Growth and Psycho-Spiritual Wellbeing

“…Primary patient reported outcome measurements were the SAIL for measuring spirituality and spiritual growth (Spiritual Attitudes and Involvement List, 26 items, item score range 1-6; three dimensions, seven subscales: connectedness to an inner strength (meaningfulness, trust, acceptance); connectedness with the environment (caring for others, connectedness with nature); connectedness with the transcendent (transcendent experiences, spiritual activities) (de Jager Meezenbroek et al 2012)); and the Dutch RYFF (scales of psycho-spiritual wellbeing, 49 items, item score range 1-6; two dimensions, eight subscales: psychological wellbeing (positive relations, autonomy, environmental mastery, personal growth, purpose in life, and self-acceptance) spiritual wellbeing (inner strength, relationship with a higher power) (van Dierendonck 2004)). The secondary outcome measurement was the NEIS, for measuring ego-integrity, or the experience of wholeness and meaning in life, even in spite of negative experiences (Northwestern Ego Integrity Scale, 9 items, item score range 1-6; two subscales: ego integrity and despair (Kleijn et al 2016)).…”

Declining mental health among disadvantaged Americans

“…[We are aware of only two attempts to measure despair. One measure was developed to capture regret and hopelessness at the end of life ( 12 , 13 ) and the other, the “behavioral ‘despair’ test,” to identify potential antidepressants by forcing rats to remain afloat in a small space ( 14 ). Neither measure is appropriate for the present study.]…”