Source: Dingley, C., & Roux, G. (2014). Therole of inner strength in quality of life and self-management inwomen survivors of cancer. Research in Nursing & Health,37(1), 32-41.
Introduction
Dingley and Roux (2014) studied inner strength, depressionsymptoms, and selected demographic variables to predict quality oflife (QOL) and self-management in women survivors of cancer. Thispredictive correlational study was conducted with a conveniencesample of 107 women with cancer. “The strongest predictors of QOLwere depressive symptoms, inner strength, and time since diagnosis.The strongest predictors of self-management were depressivesymptoms and inner strength” (Dingley & Roux, 2014, p. 32).
Relevant Study Results
Selected instruments used to measure the study variables in theDingley and Roux (2014) study are presented in this section with afocus on reliability testing.
“Depression. The Center for EpidemiologicalStudies Depression Scale (CES-D; Radloff, 1977) was used to assessdepressive symptomatology. The CES-D is one of the most widely usedself-report instruments for epidemiologic studies of depression andhas been used in primary care, psychiatric, and related clinicaland forensic settings. The 20-item instrument measures depressiveaffect, somatic symptoms, positive affect, and interpersonalrelations. For each experience related to depression, therespondent selects the value (0, 1, 2, or 3) that best describeshow frequently the experience occurred during the previous week.Total scores of 15 to 21 indicate mild to moderate depressivesymptoms; scores over 21 indicate the respondent has experiencedmajor depressive symptoms. Cronbach’s alpha in this study was0.90.
Inner strength. The Inner StrengthQuestionnaire (ISQ) is a 27-item self-report instrument written ata fourth grade level (by Flesch Kincaid Grade Index). Respondentsare asked to indicate their level of agreement with each itemstatement using a 5-point Likert-type scale (strongly agree, agree,slightly agree, disagree, strongly disagree). The ISQ assesses fourfactors representing dimensions of the theory (i.e., Anguish andSearching, Connectedness, Engagement, and Movement). Total scorescan be calculated, as well as scores for each subscale. The maximumpossible total score is 135, with higher scores indicating a higherpresence of inner strength. Each sub-scale of the ISQ had aCronbach’s alpha > 0.80 (Anguish and Searching 0.85,Connectedness 0.95, Engagement 0.85, and Movement 0.83). Internalconsistency reliability of the total ISQ was ? = 0.91. Cronbach’salpha for the present study was 0.89.
Quality of life and spiritual well-being. Thetool selected to measure QOL was the Functional Assessment ofCancer Therapy—Spiritual WELL-Being (FACTSp), one instrument fromthe FACIT Measurement System, a collection of QOL questionnairestargeted at the management of chronic illness. The FACITmeasurement system is considered appropriate for use with patientswith any form of cancer as well as other chronic illness conditions(e.g., HIV/AIDS, multiple sclerosis) and in the general populationusing a slightly modified version. The FACT-Sp incorporates thedomain of spiritual well-being (SpWB) in addition to the fourprimary domains of physical (PWB), social/family (SWB), emotional(EWB), and functional well-being (FWB). The SpWB scale is 12questions that measure a sense of meaning and peace and the role offaith in illness… The SpWB had a Cronbach’s alpha of 0.93 in thestudy sample. Cronbach’s alphas for the subscales were PWB = 0.85,SWB = 0.80, EWB = 0.79, FWB = 0.88, and SpWB = 0.83” (Dingley &Roux, 2014, pp. 35-36).
Based on the information provided from the Dingley and Roux(2014) study, which scale has the lowest reliability or Cronbach’salpha coefficient? What random error did this scale have for thisstudy? Was this a study strength or weakness?
