Measuring double awareness in patients with advanced cancer: A preliminary scale development study

Mairead H. McConnell, Melissa Miljanovski, Gary Rodin, Mary Frances O’Connor

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background. Individuals with advanced cancer face the challenge of living meaningfully while also preparing for end of life. The ability to sustain this duality, called “double awareness,” may reflect optimal psychological adaptation, but no psychometric scale exists to measure this construct. Objectives. The purpose of this study was to develop a novel scale to measure double awareness in patients living with advanced cancer. Methods. Guided by best practices for scale development, this study addresses the first three of nine steps in instrument development, including domain clarification and item generation, establishment of content validity of the items, and pre-testing of the items with patients. Results. Instrument development resulted in a 41-item measure with two dimensions titled “life engagement” and “death contemplation.” Items retained in the measure displayed face validity and were found to be both acceptable by patients and relevant to their lived experience. Significance of results. The results of this scale development study will allow for full validation of the measure and future use in clinical and research settings. This novel measure of double awareness will have clinical utility and relevance in a variety of settings where patients with advanced cancer are treated.

Original languageEnglish (US)
Pages (from-to)1226-1231
Number of pages6
JournalPalliative and Supportive Care
Volume22
Issue number5
DOIs
StatePublished - Oct 1 2024
Externally publishedYes

Keywords

  • Advanced cancer
  • Death contemplation
  • Double awareness
  • End of life
  • Life engagement
  • Living with cancer
  • Meaning
  • Oncology
  • Palliative care
  • Scale development

ASJC Scopus subject areas

  • General Nursing
  • Clinical Psychology
  • Psychiatry and Mental health

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