The Female Self-Advocacy in Cancer Survivorship Scale: A validation study.
Teresa L Hagan, Susan M Cohen, Margaret Q Rosenzweig and 3 others
PMID 29117439WHAT IT FOUND
A 20-item scale for female cancer survivors measures three self-advocacy areas: informed decision making, communicating with providers, and strength from relationships.
Higher scores mean more self-advocacy skill, not better outcomes.
Key findings
01The FSACS Scale was reduced from 57 items to 20 items across three subscales: informed decision making, communicating with providers, and connected strength.
02Women farther from diagnosis did not score higher on all self-advocacy subscales; only the informed decision-making subscale was higher than in women within one year of diagnosis.
03The communication subscale was negatively correlated with symptom severity and interference, and positively correlated with hospital and emergency visits.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional and self-reported, so it shows associations at one time point, not that self-advocacy causes better or worse outcomes. The response rate from the tumor registry was 17.3%, and women who refused were older, more likely to be from a racial minority, and less educated than women who participated. The sample was mostly White, married, college-educated, and had a median household income of at least $50,000, so it may not represent all female cancer survivors. The communication subscale had items that cross-loaded on another factor and the authors said it needs further refinement. There was no gold standard measure of self-advocacy, and the scale was tested against other questionnaires rather than observed care. Using the scale was not tested in clinical care, so it does not show that assessment changes outcomes.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read higher self-advocacy scores as proof that a woman is managing symptoms better or using health care appropriately. The study measured correlations at one time point, and higher scores on some subscales were also positively correlated with hospital and emergency visits.