COVID-19 Practical and Psychosocial Experiences Self-report Questionnaire

Abstract

The COVID-19 Practical and Psychosocial Experiences (COVID-PPE) Self-report Questionnaire, developed by Saez‑Clarke et al. (2023), is a comprehensive self-report measure. Its primary purpose is to assess the full spectrum of positive and negative psychosocial impacts stemming from the COVID-19 pandemic on cancer survivors, particularly those receiving primary or surveillance care.

Initially comprising 43 items across seven provisional subscales based on Face Validity, the measure was refined through extensive psychometric evaluation using calibration Exploratory Factor Analysis (EFA), validation Confirmatory Factor Analysis (CFA), and post-hoc CFA on distinct samples of US-based cancer survivors. The resulting measure exists in 37-item and 43-item versions, organized around two higher-order constructs: Risk Factors (RF), which includes five lower-order subscales, and Protective Factors (PF), which includes four lower-order subscales. Initial results provided documentation of the instrument’s internal consistency.

Keywords

Anxiety Symptoms, Cancer Survivors, COVID-19, Depression Symptoms, Disruptions to Daily Activities and Social Interactions, Face Validity, Financial Hardship, Health Care Disruptions, Pandemic, Perceived Benefits, Perceived Stress Management Skills, Protective Factors, Provider Satisfaction, Psychosocial Experiences, Quality of Life, Risk Factors, Social Support.

Authors

Saez‑Clarke, Estefany, Otto, Amy K., Prinsloo, Sarah, Natori, Akina, Wagner, Richard W., Gomez, Telma I., Ochoa, Jewel M., Tworoger, Shelley S., Ulrich, Cornelia M., Hathaway, Cassandra A., Peoples, Anita R., Antoni, Michael H., Bower, Julienne E., Cohen, Lorenzo, Penedo, Frank J.

Purpose

The core purpose of the COVID-PPE Questionnaire is to provide a standardized tool for quantifying the hypothesized impact of the COVID-19 pandemic specifically on cancer survivors. The measure is designed to differentiate between factors that increase vulnerability (Risk Factors) and those that foster resilience (Protective Factors).

The assessed domains cover critical areas of life affected by the pandemic, including levels of psychological distress (e.g., anxiety and depression symptoms), disruptions to medical care and daily life, perceived financial strain, and the availability of social and coping resources such as perceived benefits and social support.

Construct

The COVID-PPE Questionnaire measures the overarching construct of COVID-19 related psychosocial experiences, conceptualized as two primary, higher-order factors that capture the dual impact of a global health crisis:

• Risk Factors (RF): This component assesses negative outcomes and challenges faced by cancer survivors, encompassing five lower-order subscales:

  • Anxiety Symptoms

  • Depression Symptoms

  • Health Care Disruptions

  • Disruptions to Daily Activities and Social Interactions

  • Financial Hardship

• Protective Factors (PF): This component assesses positive psychological adaptation and resources utilized during the pandemic, comprising four lower-order subscales:

  • Perceived Benefits

  • Provider Satisfaction

  • Perceived Stress Management Skills

  • Social Support

Validity

Formal validity data, such as criterion or construct validity utilizing external established measures, is currently unavailable in the source documentation. However, initial item composition and subscale grouping were based on Face Validity, ensuring that the content of the items appeared relevant and appropriate for measuring the psychosocial consequences of the pandemic in the target population.

Reliability

The scale developers assessed the reliability of the COVID-PPE through Internal Consistency measures, using both Cronbach’s alpha (α) and McDonald’s omega (ω). The findings demonstrated varied levels of consistency across the subscales:

• Acceptable Consistency: Seven of the subscales exhibited acceptable internal consistency, with alpha coefficients ranging from α = 0.726 to 0.895, and omega coefficients ranging from ω = 0.802 to 0.895.

• Poor or Questionable Consistency: The remaining two subscales showed poorer or questionable internal consistency, with alpha coefficients falling between α = 0.599 and 0.681, and omega coefficients between ω = 0.586 and 0.692.

Factor Analysis

The structure of the COVID-PPE Questionnaire was rigorously tested using both exploratory and confirmatory factor analysis techniques across three distinct samples of cancer survivors.

Exploratory Factor Analysis (EFA):

• For the Risk Factors (RF) component, the RF-EFA Model 3 was identified as the strongest solution, demonstrating the best fit indices, including the lowest Root Mean Square Residual (RMSR) of 0.02 and a Bayesian Information Criterion (BIC) of 2345.94. Inter-factor correlations for this model ranged moderately to strongly (0.35 to 0.71), aligning closely with the hypothesized subscale structure.

• For the Protective Factors (PF) component, the four-factor model (PF-EFA Model 3) was the preferred choice, successfully accounting for 60.0% of the total variance.

Confirmatory Factor Analysis (CFA):

The Confirmatory Factor Analysis (CFA) for the Protective Factors (PF) component yielded mixed results regarding model fit. The model statistics were reported as: χ²(82) = 1790.186, p < 0.001. While the Tucker-Lewis Index (TLI = 0.945), Root Mean Square Error of Approximation (RMSEA) = 0.064 (90%CI 0.061–0.066), and Standardized Root Mean Square Residual (SRMR = 0.044) indicated good fit, the Comparative Fit Index (CFI) was relatively low at 0.57, suggesting areas for further refinement in the model structure.

Instrument

Test Type: Original Inventory/Questionnaire

Format: Items are rated on a 5-point Likert-type scale (0 = Strongly Disagree, 4 = Strongly Agree). The administration method is electronic.

Language Available: English

Population Group: Human (Male, Female)

Age Group: Adulthood (18 years & older)

Population Details: Respondents are cancer survivors located in the United States, typically undergoing primary or surveillance care for an adult cancer diagnosis.

Test Methodology: Test Validity, Test Reliability, Internal Consistency, Factor Analysis, Confirmatory Factor Analysis, Exploratory Factor Analysis.

Number of Items: The scale has two versions resulting from the factor analyses: a 37-item version and a 43-item version.

Factors and Subscales:

• Risk Factors (RF):

  • Anxiety Symptoms

  • Depression Symptoms

  • Health Care Disruptions

  • Disruptions to Daily Activities and Social Interactions

  • Financial Hardship

• Protective Factors (PF):

  • Perceived Benefits

  • Provider Satisfaction

  • Perceived Stress Management Skills

  • Social Support

Keywords

Anxiety Symptoms, Cancer Survivors, COVID-19, Depression Symptoms, Disruptions to Daily Activities and Social Interactions, Face Validity, Financial Hardship, Health Care Disruptions, Pandemic, Perceived Benefits, Perceived Stress Management Skills, Protective Factors, Provider Satisfaction, Psychosocial Experiences, Quality of Life, Risk Factors, Social Support.

Authors

Lead Author: Saez‑Clarke, Estefany

Author ORCID Identifier: N/A

Affiliation Email addresses: [email protected]

Correspondence Author: Cohen, Lorenzo

Correspondence Address: University of Texas M.D. Anderson Cancer Center, Department of Palliative, Rehabilitation and Integrative Medicine, Houston, Texas, United States.

Permissions & Fee and Test Year

Permissions: Contact Corresponding Author.

Commercial: No

Fee: No

Test Year: 2023

References

Saez-Clarke, E., Otto, A. K., Prinsloo, S., Natori, A., Wagner, R. W., Gomez, T. I., Ochoa, J. M., Tworoger, S. S., Ulrich, C. M., Hathaway, C. A., Peoples, A. R., Antoni, M. H., Bower, J. E., Cohen, L., & Penedo, F. J. (2023). Development and initial psychometric evaluation of a COVID-related psychosocial experiences questionnaire for cancer survivors. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 32(12), 3475–3494. The original publication can be accessed via DOI: https://doi.org/10.1007/s11136-023-03456-4

Items of the COVID-19 Practical and Psychosocial Experiences Self-report Questionnaire

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

No data is Available.