Further validation of the patient roles and responsibilities scale

Background: The Patient Roles and Responsibilities Scale (PRRS) measures the impact of cancer and treatment on 'real world' functioning such as caregiving and financial responsibilities. It was developed and validated in advanced cancer but with the intention to be sufficiently generic and appropriate for use in all cancers and stages. Here we further investigate the psychometric performance of the PPRS when completed by people three years after cancer diagnosis, treated with curative intent. Methods: This is a secondary analysis of data collected during the HORIZONS Programme, a prospective longitudinal cohort study of the impact of cancer and treatment on everyday life. Data analysed were from the 36-month timepoint and included the PRRS alongside the Work and Social Adjustment Scale, the Quality of Life in Adult Cancer Survivors and the EORTC QLQ-C30. Internal consistency was assessed using Cronbach's alpha, criterion and convergent validity through correlation with other quality-of-life measures, and construct validity using confirmatory factor analysis (CFA). Results: Data from 1077 participants (453 breast, 388 gynaecological, 236 non-Hodgkin lymphoma) were included in the analysis. Cronbach's alpha was 0.91 for the PRRS-16 and 0.69-0.92 for the subscales. The measure showed the predicted pattern of correlation with validation measures r = |0.58-0.82|. All CFA goodness-of-fit criteria were met, indicating an acceptable fit for the three-factor model, though correlations between factors were stronger than expected. Conclusion: This study provides further evidence of the reliability and validity of the PRRS and its performance and appropriateness for use in cancer groups other than those previously validated.