Psychometric properties of Liverpool Stoicism Scale (LSS) in a cohort of patients with resected cancer in adjuvant treatment

Abstract

Título: Propiedades psicométricas de la Liverpool Stoicism Scale (LSS) en una cohorte de pacientes con cáncer resecado en tratamiento adyuvante. Resumen: El estoicismo se ha utilizado para describir una amplia gama de comportamientos frente a la enfermedad que van desde el silencio a la resistencia a la adversidad. Este estudio tiene dos objetivos: 1) analizar las propiedades psicométricas de la versión española del LSS; 2) evaluar la relación entre estoicismo, género, edad y el modelo de los cinco grandes factores de personalidad. NEOcoping es un estudio prospectivo, multicéntri-co, observacional, no-intervencionista. Los pacientes fueron reclutados consecutivamente en 13 hospitales universitarios de España. Se aplicó la Liverpool Stoicism Scale (LSS) y el Big Five Inventory (BFI-10). Participaron 443 pacientes (250 mujeres) con una edad media de 59,8 años (SD =12,3). El cáncer de colon y mama fueron los más frecuentes. A nivel de escala total, la puntuación media de la LSS fue inferior a la muestra Británica. La estructura propuesta en cuatro factores proporciona un buen ajuste a los datos, y las puntuaciones en las escalas derivadas presentan fiabilidades aceptables. El rasgo de personalidad de introversión fue capaz de predecir el 4,1% de la variancia de estoicismo (p<,001). Aunque debe ser mejorada, la LSS presenta globalmente unas propiedades psicométricas aceptables para evaluar el estoicismo en pacientes españoles con cáncer resecado. Palabras clave: Actitud; estoicismo; cáncer; estudio psicométrico; personalidad; afrontamiento.Abstract: Stoicism has been used to describe a wide range of behaviors in the face of disease that go from silence, resistance to the adversity, or 'to make the best of a bad disease'. This study pursued two objectives: 1) analyze the psychometric properties of the Spanish version of the LSS; 2) assess the relation between stoicism and gender, age, and the five-factor personality model. NEOcoping is a prospective, multicenter, observational, non-interventionist study. Patients were recruited consecutively at thirteen Spanish teaching hospitals. The following scales were administered: Liverpool Stoicism Scale (LSS) and Big Five Inventory (BFI-10). A total of 443 patients (250 females) with a mean age of 59.8 years (SD =12.3) were enrolled. Colon cancer was the most common, followed by breast cancer. At the total-scale level, mean LSS was lower than the originally reported British sample. The four-factor structure fitted the data well, had a clear interpretation, and the derived scales showed acceptable reliabilities. The personality trait of introversion predicted 4.1% of the variance of stoicism (p<.001). Even though it needs to be improved, the LSS scale demonstrates acceptable psychometric properties to appraise stoicism in the Spanish population with resected cancer.

Investigating the role of psychological flexibility, masculine self‐esteem and stoicism as predictors of psychological distress and quality of life in men living with prostate cancer

“…In current health discourse, it is associated with not complaining about adversity or having a “stiff upper lip.” It is associated with older men and is linked to coping with pain (Cairncross, Magee, & Askham, ). Older men may adopt this coping strategy because they find it harder to identify and express their emotions (Calderón et al, ). Stoicism is often conceptualised as a traditional defining characteristic of masculinity, closely aligned with emotional restraint and self‐reliance, that can be used to maintain an appearance of strength in the face of adversity (Chambers, Foley, et al, ; Chambers, Hyde, et al, ; Pathak et al, ).…”

Exploring Intraindividual Profiles for Home Buildings Based on Architectural Compositional Elements and Psychological Health Factors: A Transdisciplinary Approach

“…The BFI-10 has psychometric properties that are comparable to those of the original BFI [92]. This questionnaire has been used with the Spanish population in contexts related to health [94] and the environment [95]. Subscales Cronbach's alpha ranged from 0.62 to 0.66 in the present study (note that each dimension is composed of two items).…”

Stoic attitude in patients with cancer from the NEOcoping study: Cross-sectional study

“…It contains 20 items, including lack of emotional involvement, dislike for openly expressing emotion, and the ability to withstand emotion. The Spanish version was translated and validated by our group [ 6 ]. Responses were recorded on a 5-point Likert scale ranging from strongly disagree to strongly agree , yielding a sum score of between 20 and 100.…”

“…Higher scores indicate greater stoicism. The scale has good internal consistency (Cronbach’s alpha = 0.83) [ 6 ].…”

“…For Spiers, stoic traits would be adaptive in the area of health, as they would increase self-efficacy by perceiving one’s own limits and prompting the adoption of proactive measures to control symptoms through the use of reason [ 3 , 4 ]. Some studies have shown that stoicism would be very sensitive to the health setting, and this could have implications for the patient’s treatment and prognosis [ 5 , 6 ]. Maintaining a stoic attitude towards pain and knowing one’s own limits could be particularly beneficial for the patient and allow them to adopt a more adaptive coping style [ 3 ], or conversely, the stoic attitude could restrict attempts at medical intervention if the patient does not report their real clinical situation (i. e., the patient feels pain, but does not show it).…”