Risk Indicator of Poor Adaptation (RIPA) for Psychological Screening in Oncology: Development and Validation

Abstract

Background: The literature emphasizes the use of screening tools to identify patients with distress due difficulties in adjusting to cancer. This paper presents the development and validation of the RIPA scale, structured on the assumption that identifying risk factors could allow a preventive referring of patients for psychosocial support. Methods: The literature was examined to identify predictors of psychological adjustment to cancer. The most frequent were used to develop an instrument with risk indicators - social support (SS), distress, coping and illness perception (IP), whose items were based on previously validated scales. The RIPA was administered in 300 patients with cancer and submitted to exploratory factor analysis. Findings: The analysis indicated the retention of five factors. After the principal axis factoring, 27 items were kept and grouped in the following factors: emotional SS (n=6; ?=0.84), instrumental SS (n=4; ?=0.90), active coping (n=5; ?=0.71), IP (n=5; ?=0.78) and distress (n=8; ?=0.90). Discussion: The instrument demonstrated good psychometric qualities. Future studies need to establish scores, predictive validity, sensitivity and specificity levels.