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Cancer Coping Questionnaire

Cancer Coping Questionnaire

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Purpose

The Cancer Coping Questionnaire (CCQ) was designed to measure levels of cognitive, behavioral, emotional and interpersonal coping as cancer patients undergo various therapies to treat cancer diagnosis.

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Cancer Coping Questionnaire

Acronym CCQ

Area of Assessment

Stress & Coping
Life Participation
Social Relationships

Assessment Type

Patient Reported Outcomes

Cost

Free

Actual Cost

$0.00

Cost Description

Cost of equipment

Populations

Key Descriptions

  • 21-item self-report questionnaire designed to measure level of coping over the last week
  • All participants answer the first 14 questions (Items 1-14), which make up the Total Individual Scale. The Total Individual Scale is divided into 4 subscales: Coping, Positive Focus, Diversion, and Planning
  • Only participants with partners answer the last 7 questions (Items 15-21), which make up the Interpersonal Scale.
  • Item scores range from 4 (very often) to 1 (not at all) where Maximum Total Score = 84 and Minimum Total Score = 21
  • Higher CCQ scores are meant to signify better coping. Higher scores are associated with better adjustments to Adjuvant Psychological Therapy (APT) techniques - i.e. patients with higher scores have incorporated these techniques more often in the last week

Number of Items

21

Equipment Required

  • Writing utensil
  • Computer (optional)

Time to Administer

5-10 minutes

Required Training

No Training

Required Training Description

The CCQ should be administered by a trained clinician

Age Ranges

Adult

18 - 74

years

Instrument Reviewers

Brigid Brennan, SPT, Duke University Doctor of Physical Therapy

Kenneth Broeker, SPT, Duke University Doctor of Physical Therapy

Daniela Ortiz, SPT, Duke University Doctor of Physical Therapy

Benjamin Luzar, SPT, Duke University Doctor of Physical Therapy

Lauren Wheeler, SPT, Duke University Doctor of Physical Therapy

Hannah White, SPT, Duke University Doctor of Physical Therapy

Jennifer Burns, Shirley Ryan AbilityLab

ICF Domain

Participation
Activity

Measurement Domain

Emotion

Considerations

The results will be more robust and reliable if the Total Individual Scale is used and not subscales.

Cancer

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Normative Data

Mixed Cancer: (Moorey et al., 2003; n = 42, Mean Age = 55 years)

  • Mean CCQ total = 32.61 (8.58)
  • Mean CCQ interpersonal = 16.41 (6.66)

Women with Breast Cancer: (Moorey et al., 2003; n = 50, Mean Age = 53 years)

  • Mean CCQ total = 33.27 (9.12)
  • Mean CCQ interpersonal = 13.16 (4.39)

Referred to Psycho-Oncology: (Moorey et al., 2003; n = 48, Mean Age = 51 years)

  • Mean CCQ total = 28.06 (8.97)
  • Mean CCQ interpersonal = 13.42 (5.74)

Test/Retest Reliability

Women with Breast Cancer: (Moorey et al.; n = 25)

  • Excellent test-retest reliability for the Total Individual CCQ (ICC = 0.90)
  • Excellent test-retest reliability for the Diversion subscale (ICC = 0.81)
  • Adequate test-retest reliability for the Positive Focus subscale (ICC = 0.67)

Women with Breast Cancer with Partners: (Moorey et al; n = 19)

  • Excellent test-retest reliability for the Interpersonal Scale (ICC = 0.84)

Internal Consistency

Women with Breast Cancer (Moorey et al. n = 25)

  • Excellent internal consistency of Total Individual CCQ (Cronbach’s alpha = 0.87)

Women with Breast Cancer with Partners (Moorey et al. n = 19)

  • Excellent internal consistency for the Interpersonal Scale (Cronbach’s alpha = 0.82)

Construct Validity

Convergent validity

Mixed Cancer (Moorey et al. n = 140)

  • Adequate convergent validity between the CCQ Total score and the Active Behavioural Coping method of the Coping Response Indices (CRI) (correlation coefficient = 0.61)
  • Adequate convergent validity between the CCQ Total score and most CRI “focus of coping” subscales: Logical Analysis (0.31); Information Seeking (0.33); Problem Solving (0.43); and Affective Regulation (0.53)

Referred to Psycho-Oncology: (Moorey et al.; n = 48)

  • Excellent convergent validity between Fighting Spirit in the Mental Adjustment to Cancer Scale (MAC) and CCQ Total Individual Score (0.66)
  • Adequate convergent validity between Fighting Spirit in the Mental Adjustment to Cancer Scale (MAC) and CCQ Interpersonal Scale (0.40)

 

Discriminant validity

Mixed Cancer: (Moorey et al.; n = 140)

  • Adequate discriminant validity of CCQ Total Individaul Scale with the Depression score of the Hospital Anxiety and Depression Scale (HADS-D) (correlation coefficient = -0.32)
  • Poor discriminant validity of CCQ Total Individual Scale with HADS-Anxiety (correlation coefficient = -0.05)

Women with Breast Cancer (Moorey et al. n = 25)

  • Adequate discriminant validity between Helplessness/Hopelessness subscale of Mental Adjustment to Cancer Scale (MAC) with CCQ positive focus (-0.35) and Planning (-0.31) subscales

Referred to Psycho-Oncology: (Moorey et al.; n = 48)

  • Adequate discriminant validity between the MAC helplessness/hopelessness subscale with the CCQ Individual Score (-0.56)

Content Validity

Content validity was assessed by five members of the Psychological Medicine Unit at the Royal Marsden Hospital who were familiar with the nature of APT. “They were asked to judge the degree to which the behaviours described in the CCQ (1) would change as a result of APT on a scale from +2 (maximum increase) to 2 (maximum decrease). Mean ratings for adaptive coping strategies was +1.27 and for maladaptive coping strategies -1.05 (p.333).” Ambiguous questions were reviewed with 5 raters and four items were excluded from the questionnaire. Wording of the questions and response format were addressed and five questions were added after this meeting. The article states that “although the wording of the questions changed with the development of the CCQ, the skills addressed remained the same as in this original version. It was therefore not necessary to repeat this assessment of content validity in the second version of CCQ." (Moorey et al., 2003; p. 333)

Face Validity

"In the development of the questionnaire attention has been paid to the face validity of the instrument (through modifying it in response to reactions from therapists familiar with the therapy). The longer 41 item questionnaire has been reduced to 21 items on the basis of factor analysis. It is a brief and  ‘user  friendly’  instrument  which  can  be completed by any patients with cancer, but which includes items specific to Adjuvant Psychological Therapy” (Moorey et al., 2003; p. 339)

Bibliography

The Cancer Coping Questionnaire: a self-rating scale for measuring the impact of adjuvant psychological therapy on coping behaviour. Moorey, S, Frampton, S and Greer, S. Psycho-oncology. 2003 JUN 28; 12(4): 331–344.  doi: 10.1002/pon.646

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