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Initial validation of a scale to measure purposelessness, understimulation, and boredom in cancer patients: Toward a redefinition of depression in advanced disease

Published online by Cambridge University Press:  29 April 2003

STEVEN D. PASSIK ,
ALICE INMAN ,
KENNETH KIRSH ,
DALE THEOBALD  and
PAMELA DICKERSON
STEVEN D. PASSIK
Affiliation:
Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentucky, Lexington, Kentucky
ALICE INMAN
Affiliation:
Community Cancer Care, Inc., Indianapolis, Indiana
KENNETH KIRSH
Affiliation:
Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentucky, Lexington, Kentucky
DALE THEOBALD
Affiliation:
Community Cancer Care, Inc., Indianapolis, Indiana
PAMELA DICKERSON
Affiliation:
Community Cancer Care, Inc., Indianapolis, Indiana
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Abstract

Objective: The problem of boredom in people with cancer has received little research attention, and yet clinical experience suggests that it has the potential to profoundly affect quality of life in those patients. We were interested in developing a Purposelessness, Understimulation, and Boredom (PUB) Scale to identify this problem and to begin to differentiate it from depression.

Methods: Cancer patients and professionals were interviewed using a semi-structured format to elicit their perceptions of the incidence, causes, scope, and consequences of boredom. From their responses, 45 questions were developed, edited for clarity, and piloted. A total of 100 cancer patients were recruited to participate in the study. Preliminary validation of the PUB using a cross-sectional survey of the measure was conducted. Other instruments used for purposes of convergent and divergent validity included the Functional Assessment of Cancer Therapy Scale–Anemia, Zung Self-Rating Depression Scale, Boredom Proneness Scale, Leisure Boredom Scale, Cancer Behavior Inventory, Systems of Belief Inventory, and the Eastern Cooperative Oncology Group Performance Status Scale.

Results: The average age of the sample was 62.37 years (SD = 13.43) and was comprised of 60 women (60.00%) and 40 men (40.00%). The results of a factor analysis on the 45 initial items (selected on the basis of professional and patient interviews) created a two-factor scale. The eight items from the strongest factor (items 1, 2, 3, 4, 5, 6, 9, 10) seemed to best tap the construct that could be deemed as overt boredom whereas the six items of the second factor (items 36, 38, 39, 42, 44, 45) seemed to tap the construct of boredom related to meaning and spirituality. Total scale internal consistency, when all 14 items were included in the analysis, yielded a coefficient alpha of 0.84 and good test–retest reliability at 2 weeks (r = .80, p < .001). The novel 14-item PUB Scale was significantly correlated to other measures of boredom; the Boredom Proneness Scale (r = −.588, p < .001) and the Leisure Boredom Scale (r = .576, p < .001).

Significance of results: The PUB Scale was found to be a statistically viable tool with the ability to detect boredom and differentiate it from depression. In many respects this work is in concert with much of the current research and clinical effort going on in psycho-oncology that defines components of distress that in sum, redefines depression in advanced cancer.

Keywords

BoredomScaleCancerDepression
Type
Research Article
Information
Palliative & Supportive Care , Volume 1 , Issue 1 , March 2003 , pp. 41 - 50
Copyright
© 2003 Cambridge University Press

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References

REFERENCES

Ahmed, S.M.S. (1990). Psychometric properties of the boredom proneness scale. Perceptual and Motor Skills, 71, 963–966.CrossRefGoogle Scholar
Angelino, A.F. & Treisman, G.J. (2001). Major depression and demoralization in cancer patients: Diagnostic and treatment considerations. Supportive Care in Cancer, 9, 344–349.CrossRefGoogle Scholar
Brady, M., Cella, D., Mo, F., Bonomi, A.E., Tulsky, D.S., Lloyd, S.R., Deasy, S., Cobleigh, M., & Shiomoto, G. (1997). Reliability and validity of the functional assessment of cancer therapy breast quality of life instrument. Journal of Clinical Oncology, 15, 974–986.CrossRefGoogle Scholar
Cella, D., Bonomi, A., Lloyd, & S., et al. (1995). Reliability and validity of the functional assessment of cancer therapy–lung (FACT-L) quality of life instrument. Lung Cancer, 12, 199–220.CrossRefGoogle Scholar
Cella, D., Tulsky, D., Gray, & G., et al. (1993). The functional assessment of cancer therapy scale: Development and validation of the general measure. Journal of Clinical Oncology, 11, 570–579.CrossRefGoogle Scholar
Chochinov, H.M. (2002). Dignity-conserving care—A new model for palliative care: helping the patient feel valued. Journal of the American Medical Association, 287, 2253–2260.CrossRefGoogle Scholar
Derogatis, L.R., Morrow, G.R., & Fetting, J. (1983). Prevalence of psychiatric disorders among cancer patients. Journal of the American Medical Association, 249, 751–757.CrossRefGoogle Scholar
Dugan, W., McDonald, M., Passik, S., Rosenfeld, B., Theobald, D., & Edgerton, S. (1998). Use of the Zung Self-Rating Depression Scale in Cancer Patients: Feasibility as a screening tool. Psycho-Oncology, 7, 483–493.3.0.CO;2-M>CrossRefGoogle Scholar
Eastern Cooperative Oncology Group. (1983). Functional assessment scale. In Clinical Oncology: A Functional Approach, Rubin, P. (ed.), pp. 210–231. New York: American Cancer Society.
Farmer, R. & Sundberg, N.D. (1986). Boredom proneness: The development and correlates of a new scale. Journal of Personality Assessment, 50, 4–17.CrossRefGoogle Scholar
Fenichel, O. (1951). On the psychology of boredom. In Organization and Pathology of Thought, Rapaport, D. (ed.), pp. 349–361. New York: Columbia University Press.CrossRef
Frankl, V.E. (1946). Man's Search for Meaning. New York: Washington Square Press.
Greenson, R. (1953). On boredom. Journal of the American Psychiatric Association, 1, 7–21.CrossRefGoogle Scholar
Holland, J.C., Kash, K.M., Passik, & S.D., et al. (1998). A brief spiritual beliefs inventory for use in quality of life research in life-threatening illness. Psycho-Oncology, 7, 460–469.3.0.CO;2-R>CrossRefGoogle Scholar
Hosier, A.Q. (1987). Functions of boredom: Treatment implications. Psychotherapy Patient, 3(3–4), 43–54.Google Scholar
Iso-Ahola, S.E. & Weissinger, E. (1990). Perceptions of boredom in leisure: Conceptualization, reliability and validity of the leisure boredom scale. Journal of Leisure Research, 22, 1–17.CrossRefGoogle Scholar
McKenna, R.J., Wellisch, D., & Fawzy, F.I. (1995). Rehabilitation and supportive care of the cancer patient. In American Cancer Society Textbook of Clinical Oncology, Murphy, G.P., Laurence, W., & Lenhard, R.E. (eds.), pp. 635–654. Atlanta, GA: American Cancer Society.
Merluzzi, T.V. & Martinez, S.M.A. (1997). Assessment of self-efficacy and coping with cancer: Development and validation of the cancer behavior inventory. Health Psychology, 16, 163–170.CrossRefGoogle Scholar
Nelson, C.J., Rosenfeld, B., Breitbart, W., & Galietta, M. (2002). Spirituality, religion, and depression in the terminally ill. Psychosomatics, 43, 213–220.CrossRefGoogle Scholar
Passik, S.D., Lundberg, J.C., Rosenfeld, & B., et al. (2000). Factor analysis of the Zung Self-Rating Depression Scale in a large ambulatory oncology sample. Psychosomatics, 41, 121–127.CrossRefGoogle Scholar
Passik, S.D., Theobald, D., Donaghy, K., Heminger, E., & Dugan, W.M. (1998). Why we do what we do: The importance of psycho-oncology and quality-of-life research to the practising oncologist. Specialist Medicine Oncology, 20(3), 46–52.Google Scholar
Portenoy, R.R. & Bruera, I. (1998). Preface to the series. In Topics in Palliative Care, Portenoy, R.K., & Bruera, E. (eds.), Vol. 3, pp. vii–viii. New York: Oxford University Press.
Portenoy, R.K., Thaler, H.T., Kornblith, & A.B., et al. (1994). The Memorial Symptom Assessment Scale: An instrument for the evaluation of symptom prevalence, characteristics and distress. European Journal of Cancer, 30A, 1326–1336.CrossRefGoogle Scholar
Porter, M.R., Musselman, D.L., McDaniel, J.S., & Nemeroff, C.B. (1998). From sadness to major depression: Assessment and management in patients with cancer. In Topics in Palliative Care, Portenoy, R.K., & Bruera, E. (eds.), Vol. 3, pp. 191–212. New York: Oxford University Press.
Smith, R.P. (1981). Boredom: A review. Human Factors, 23, 329–340.CrossRefGoogle Scholar
Tabachnick, B. & Fidell, L. (2000). Using Multivariate Statistics, 4th ed. Needham Heights, MA: Allyn & Bacon.
Tate, D., Forchheimer, M., Maynard, & F., et al. (1993). Comparing two measures of depression in spinal cord injury. Rehabilitation Psychology, 38, 53–61.CrossRefGoogle Scholar
Winstead-Fry, P. & Schultz, A. (1997). Psychometric analysis of the functional assessment of cancer therapy-general (FACT-G) scale in a rural sample. Cancer, 79, 2446–2452.3.0.CO;2-Q>CrossRefGoogle Scholar
Yellen, S.B., Cella, D.F., Webster, & K., et al. (1997). Measuring fatigue and other anemia-related symptoms with the functional assessment of cancer therapy (FACT) measurement system. Journal of Pain and Symptom Management, 13, 63–74.CrossRefGoogle Scholar
Zung, W.W.K. (1965). A self-rating depression scale. Archives of General Psychiatry, 12, 63–70.CrossRefGoogle Scholar