ArticlePDF AvailableLiterature Review

Understanding and Evaluating Survey Research

Section Editors: Jeannine M . Brant, Marilyn L. Haas-Haseman, Steven H. Wei, and Rita Wickham
Understanding and Evaluating
Survey Research
From Winona State University, Rochester,
Author's disclosures of potential conflicts of
interest are found at the end of this article.
Correspondence to: Julie Ponto, PhD, APRN,
AGCNS-BC, AOCNS®, Winona State University,
Graduate Programs in Nursing, 859 30th Avenue
South East, Rochester, MN 55904.
© 2015 Harborside Press®
variety of methodo-
logic approaches ex-
ist for individuals in-
terested in conducting
research. Selection of a research
approach depends on a number of
factors, including the purpose of
the research, the type of research
questions to be answered, and the
availability of resources. The pur-
pose of this article is to describe
survey research as one approach
to the conduct of research so that
the reader can critically evaluate
the appropriateness of the con-
clusions from studies employing
survey research.
Survey research is defined as
“the collection of information from
a sample of individuals through their
responses to questions” (Check &
Schutt, 2012, p. 160). This type of re-
search allows for a variety of methods
to recruit participants, collect data,
and utilize various methods of instru-
mentation. Survey research can use
quantitative research strategies (e.g.,
using questionnaires with numerical-
ly rated items), qualitative research
strategies (e.g., using open-ended
questions), or both strategies (i.e.,
mixed methods). As it is often used to
describe and explore human behav-
ior, surveys are therefore frequently
used in social and psychological re-
search (Singleton & Straits, 2009).
Information has been obtained
from individuals and groups through
the use of survey research for de-
cades. It can range from asking a few
targeted questions of individuals on
a street corner to obtain information
related to behaviors and preferences,
to a more rigorous study using mul-
tiple valid and reliable instruments.
Common examples of less rigorous
surveys include marketing or politi-
cal surveys of consumer patterns and
public opinion polls.
Survey research has historically
included large population-based data
collection. The primary purpose of
this type of survey research was to ob-
tain information describing charac-
teristics of a large sample of individu-
als of interest relatively quickly. Large
census surveys obtaining information
reflecting demographic and personal
characteristics and consumer feed-
back surveys are prime examples.
These surveys were often provided
through the mail and were intended
to describe demographic characteris-
tics of individuals or obtain opinions
on which to base programs or prod-
ucts for a population or group.J Adv Pract Oncol 2015;6:168–171
More recently, survey research has developed
into a rigorous approach to research, with scientifi-
cally tested strategies detailing who to include (rep-
resentative sample), what and how to distribute
(survey method), and when to initiate the survey
and follow up with nonresponders (reducing non-
response error), in order to ensure a high-quality
research process and outcome. Currently, the term
“survey” can reflect a range of research aims, sam-
pling and recruitment strategies, data collection in-
struments, and methods of survey administration.
Given this range of options in the conduct of
survey research, it is imperative for the consumer/
reader of survey research to understand the poten-
tial for bias in survey research as well as the tested
techniques for reducing bias, in order to draw ap-
propriate conclusions about the information re-
ported in this manner. Common types of error in
research, along with the sources of error and strat-
egies for reducing error as described throughout
this article, are summarized in the Table.
The goal of sampling strategies in survey re-
search is to obtain a sucient sample that is rep-
resentative of the population of interest. It is often
not feasible to collect data from an entire popula-
tion of interest (e.g., all individuals with lung can-
cer); therefore, a subset of the population or sample
is used to estimate the population responses (e.g.,
individuals with lung cancer currently receiving
treatment). A large random sample increases the
likelihood that the responses from the sample will
accurately reflect the entire population. In order
to accurately draw conclusions about the popu-
lation, the sample must include individuals with
characteristics similar to the population.
It is therefore necessary to correctly identify
the population of interest (e.g., individuals with
lung cancer currently receiving treatment vs. all
individuals with lung cancer). The sample will
ideally include individuals who reflect the intend-
ed population in terms of all characteristics of the
population (e.g., sex, socioeconomic characteris-
tics, symptom experience) and contain a similar
distribution of individuals with those character-
istics. As discussed by Mady Stovall beginning on
page 162, Fujimori et al. (2014), for example, were
interested in the population of oncologists. The
authors obtained a sample of oncologists from two
hospitals in Japan. These participants may or may
not have similar characteristics to all oncologists
in Japan.
Participant recruitment strategies can aect
the adequacy and representativeness of the sam-
ple obtained. Using diverse recruitment strategies
can help improve the size of the sample and help
ensure adequate coverage of the intended popula-
tion. For example, if a survey researcher intends
to obtain a sample of individuals with breast can-
cer representative of all individuals with breast
cancer in the United States, the researcher would
want to use recruitment strategies that would re-
cruit both women and men, individuals from ru-
ral and urban settings, individuals receiving and
not receiving active treatment, and so on. Because
of the diculty in obtaining samples representa-
tive of a large population, researchers may focus
Table. Sources of Error in Survey Research and Strategies to Reduce Error
Type of error Source of error Strategies to reduce error
Coverage error Unknown or zero chance of individuals in the
population being included in the sample
Multimode design
Sampling error Individuals included in the sample do
not represent the characteristics of the
Clearly identified population of interest; diverse
participant recruitment strategies; large, random
Questions/instruments do not accurately
reflect the topic of interest; questionnaires/
interviews do not evoke truthful answers
Valid, reliable instruments; pretest questions; user-
friendly graphics, visual characteristics
Lack of response from all individuals in
User-friendly survey design; follow-up procedures
for nonresponders
Note. Information from Dillman et al. (2014), Singleton & Straits (2009), Check & Schutt (2012).
the population of interest to a subset of individu-
als (e.g., women with stage III or IV breast can-
cer). Large census surveys require extremely large
samples to adequately represent the characteris-
tics of the population because they are intended to
represent the entire population.
Survey research may use a variety of data col-
lection methods with the most common being
questionnaires and interviews. Questionnaires
may be self-administered or administered by a
professional, may be administered individually or
in a group, and typically include a series of items
reflecting the research aims. Questionnaires may
include demographic questions in addition to val-
id and reliable research instruments (Costanzo,
Stawski, Ry, Coe, & Almeida, 2012; DuBenske et
al., 2014; Ponto, Ellington, Mellon, & Beck, 2010).
It is helpful to the reader when authors describe
the contents of the survey questionnaire so that
the reader can interpret and evaluate the poten-
tial for errors of validity (e.g., items or instruments
that do not measure what they are intended to
measure) and reliability (e.g., items or instruments
that do not measure a construct consistently).
Helpful examples of articles that describe the sur-
vey instruments exist in the literature (Buerhaus
et al., 2012).
Questionnaires may be in paper form and
mailed to participants, delivered in an electronic
format via email or an Internet-based program
such as SurveyMonkey, or a combination of both,
giving the participant the option to choose which
method is preferred (Ponto et al., 2010). Using a
combination of methods of survey administration
can help to ensure better sample coverage (i.e., all
individuals in the population having a chance of
inclusion in the sample) therefore reducing cover-
age error (Dillman, Smyth, & Christian, 2014; Sin-
gleton & Strait, 2009). For example, if a researcher
were to only use an Internet-delivered question-
naire, individuals without access to a computer
would be excluded from participation. Self-ad-
ministered mailed, group, or Internet-based ques-
tionnaires are relatively low cost and practical for
a large sample (Check & Schutt, 2012).
Dillman et al. (2014) have described and tested
a tailored design method for survey research. Im-
proving the visual appeal and graphics of surveys
by using a font size appropriate for the respon-
dents, ordering items logically without creating
unintended response bias, and arranging items
clearly on each page can increase the response
rate to electronic questionnaires. Attending to
these and other issues in electronic questionnaires
can help reduce measurement error (i.e., lack of
validity or reliability) and help ensure a better re-
sponse rate.
Conducting interviews is another approach to
data collection used in survey research. Interviews
may be conducted by phone, computer, or in per-
son and have the benefit of visually identifying the
nonverbal response(s) of the interviewee and sub-
sequently being able to clarify the intended ques-
tion. An interviewer can use probing comments
to obtain more information about a question or
topic and can request clarification of an unclear
response (Singleton & Strait, 2009). Interviews
can be costly and time intensive, and therefore are
relatively impractical for large samples.
Some authors advocate for using mixed meth-
ods for survey research when no one method is
adequate to address the planned research aims,
to reduce the potential for measurement and non-
response error, and to better tailor the study meth-
ods to the intended sample (Dillman et al., 2014;
Singleton & Strait, 2009). For example, a mixed
methods survey research approach may begin with
distributing a questionnaire and following up with
telephone interviews to clarify unclear survey re-
sponses (Singleton & Straits, 2009). Mixed meth-
ods might also be used when visual or auditory
deficits preclude an individual from completing a
questionnaire or participating in an interview.
Fujimori et al. (2014) described the use of sur-
vey research in a study of the eect of communi-
cation skills training for oncologists on oncologist
and patient outcomes (e.g., oncologist’s perfor-
mance and confidence and patient’s distress, sat-
isfaction, and trust). A sample of 30 oncologists
from two hospitals was obtained and though the
authors provided a power analysis concluding an
adequate number of oncologist participants to
detect dierences between baseline and follow-
up scores, the conclusions of the study may not
be generalizable to a broader population of on-
cologists. Oncologists were randomized to either
an intervention group (i.e., communication skills
training) or a control group (i.e., no training).
Fujimori et al. (2014) chose a quantitative
approach to collect data from oncologist and pa-
tient participants regarding the study outcome
variables. Self-report numeric ratings were used
to measure oncologist confidence and patient
distress, satisfaction, and trust. Oncologist confi-
dence was measured using two instruments each
using 10-point Likert rating scales. The Hospital
Anxiety and Depression Scale (HADS) was used
to measure patient distress and has demonstrated
validity and reliability in a number of populations
including individuals with cancer (Bjelland, Dahl,
Haug, & Neckelmann, 2002). Patient satisfaction
and trust were measured using 0 to 10 numeric
rating scales. Numeric observer ratings were used
to measure oncologist performance of commu-
nication skills based on a videotaped interaction
with a standardized patient. Participants com-
pleted the same questionnaires at baseline and
The authors clearly describe what data were
collected from all participants. Providing addi-
tional information about the manner in which
questionnaires were distributed (i.e., electronic,
mail), the setting in which data were collected
(e.g., home, clinic), and the design of the survey
instruments (e.g., visual appeal, format, content,
arrangement of items) would assist the reader in
drawing conclusions about the potential for mea-
surement and nonresponse error. The authors de-
scribe conducting a follow-up phone call or mail
inquiry for nonresponders, using the Dillman et al.
(2014) tailored design for survey research follow-
up may have reduced nonresponse error.
Survey research is a useful and legitimate
approach to research that has clear benefits in
helping to describe and explore variables and
constructs of interest. Survey research, like all re-
search, has the potential for a variety of sources
of error, but several strategies exist to reduce the
potential for error. Advanced practitioners aware
of the potential sources of error and strategies to
improve survey research can better determine
how and whether the conclusions from a survey
research study apply to practice. l
The author has no potential conflicts of inter-
est to disclose.
Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002).
The validity of the Hospital Anxiety and Depression
Scale: An updated literature review. Journal of Psycho-
somatic Research, 52, 69–77.
Buerhaus, P. I., DesRoches, C., Applebaum, S., Hess, R., Nor-
man, L. D., & Donelan, K. (2012). Are nurses ready for
health care reform? A decade of survey research. Nursing
Economics, 30, 318–330.
Check, J., & Schutt, R. K. (2012). Survey research. In J. Check
& R. K. Schutt (Eds.). Research methods in education. (pp.
159–185). Thousand Oaks, CA: Sage Publications.
Costanzo, E. S., Stawski, R. S., Ry, C. D., Coe, C. L., & Al-
meida, D. M. (2012). Cancer survivors’ responses to daily
stressors: Implications for quality of life. Health Psychol-
ogy, 31, 360–370.
Dillman, D. A., Smyth, J. D., & Christian, L. M. (2014). Internet,
phone, mail, and mixed-mode surveys: The tailored design
method (4th ed). Hoboken, NJ: John Wiley & Sons, Inc.
DuBenske, L. L., Gustafson, D. H., Namkoong, K. H., Atwood,
R. P., Brown, R. L., Chih, M. Y.,…Cleary, J. (2014). CHESS
improves cancer caregivers’ burden and mood: Results of
an eHealth RCT. Health Psychology, 33, 1261–1272. http://
Fujimori, M., Shirai, Y., Asai, M., Kubota, K., Katsumata, N., &
Uchitomi, Y. (2014). Eect of communication skills train-
ing program for oncologists based on patient preferences
for communication when receiving bad news: A random-
ized controlled trial. Journal of Clinical Oncology, 32,
Ponto, J. A., Ellington, L., Mellon, S., & Beck, S. L. (2010).
Predictors of adjustment and growth in women with
recurrent ovarian cancer. Oncology Nursing Forum, 37,
Singleton, R. A., & Straits, B. C. (2009). Approaches to social
research (5th ed.). New York: Oxford University Press.
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In the digital age, technological advances impact EFL language instruction in Indonesia. After examining the current and future demands of education, prospective educators need to attain the minimum standards to fulfill students' needs in the twenty-first century. Multimodal texts in education are one way to solve today's pedagogical needs. The current study explores pre-service teachers' perceptions of their performance in utilizing multimodal texts in micro­teaching classes. Data were collected from the 6th-semester students from the English Language Education Study Program, the Faculty of Cultural Studies, Universitas Brawijaya, Indonesia. This research applied mixed methods, combining data collection from observation, questionnaires as primary sources, and a focus group discussion (FGD) to support the data. Then, the questionnaire data were analyzed quantitatively, and data from the FGD were coded and analyzed using thematic analysis. The finding shows that the pre-service teachers applied five types of multimodal texts in microteaching classes. In addition, although most of them perceive positively toward the use of multimodal texts in their teaching practice, there are still challenges in implementing digital-based multimodal texts, such as limited access to digital applications and confusion in integrating digital applications into learning activities.Persepsi guru pra-kerja terhadap implementasi teks multimodal di kelas microteachingDi era digital, kemajuan teknologi berdampak pada pengajaran Bahasa Inggris di Indonesia. Setelah melihat tuntutan pendidikan saat ini dan masa depan, calon pendidik perlu mencapai standar minimum untuk memenuhi kebutuhan siswa di abad kedua puluh satu. Teks multimodal dalam pendidikan merupakan salah satu cara untuk menjawab kebutuhan pedagogis saat ini. Studi saat ini mengeksplorasi persepsi calon guru tentang kinerja mereka dalam memanfaatkan teks multimodal di kelas microteaching. Data dikumpulkan dari mahasiswa semester 6 Program Studi Pendidikan Bahasa Inggris, Fakultas Ilmu Budaya, Universitas Brawijaya, Indonesia. Penelitian ini menggunakan metode campuran, menggabungkan pengumpulan data dari observasi, kuesioner sebagai sumber data utama, dan Focus Group Discussion (FGD) untuk mendukung data. Kemudian data kuesioner dianalisis secara kuantitatif, dan data hasil FGD diberi kode dan dianalisis menggunakan analisis tematik. Temuan menunjukkan bahwa calon guru menerapkan lima jenis teks multimodal di kelas microteaching. Selain itu, meskipun sebagian besar dari mereka berpersepsi positif terhadap penggunaan teks multimodal dalam praktik pengajaran, masih ditemukan beberapa tantangan dalam mengimplementasikan teks multimodal berbasis digital, seperti keterbatasan akses ke aplikasi digital dan kebingungan dalam mengintegrasikan aplikasi digital ke dalam bentuk kegiatan pembelajaran.
... Une étude quantitative descriptive transversale, prenant la forme d'un sondage en ligne, a été réalisée auprès de médecins de famille de la province de Québec. La recherche par sondage a l'avantage de rejoindre un grand nombre de répondant de manière à obtenir des informations rapidement sur un sujet donné (Fortin et Gagnon, 2016;Ponto, 2015). ...
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The exponential growth of ChatGPT, a product of OpenAI, represents a watershed moment in the annals of consumer applications. ChatGPT has emerged as an exceptionally potent and versatile tool, capable of generating content in multiple languages, thereby ushering in an era of AI democratisation. The ramifications of this expansion have reverberated across the echelons of mass media and within the hallowed domains of digital marketing. The advent of AI applications, adept at producing an array of content elements ranging from advertising copies to visual artistry, has engendered a sense of trepidation among professionals within the digital marketing arena. The prevailing concerns revolve around the prospective transformation, if not obsolescence, of conventional roles such as copywriters, designers, and content creators.This research undertakes a comprehensive analysis of the biases exhibited by digital marketing professionals vis-a-vis the widespread adoption of AI applications, with specific attention directed towards ChatGPT. Employing a hybrid research paradigm (quantitative online surveys + qualitative in-depth interviews) augmented by the application of the Implicit Association Test, a neuroscientific instrument, this study seeks to discern the nuanced preferences of these professionals. Its principal objective is to discern the intricate web of factors that undergird professionals' perceptual dispositions towards AI tools, particularly in terms of their alignment with or deviation from these tools. This investigation was executed in Berlin, Germany - a city that has etched its prominence as a citadel of innovation and entrepreneurship. Renowned for its vibrant startup ecosystem and dynamic business milieu, Berlin emerges as an apt crucible for the conduct of this study. The hypotheses propounded in this study pivot upon the axis of job-related anxiety and its salient connections with professionals' perceptions of AI within the purview of digital marketing. The research endeavors to elucidate the following key questions: Is there a discernible correlation between aversion to ChatGPT and the magnitude of job-related anxiety experienced by professionals who harbor apprehensions regarding the escalating automation within the industry? Can a discernible correlation be identified between age and the depth of aversion to ChatGPT, thereby postulating that diverse age cohorts may manifest varying propensities of aversion to this technology? Is there an identifiable connection between professionals' perceptions of ChatGPT and their level of experience with specialised tools, thereby hinting at the possibility that experience may engender either a favourable or unfavourable perspective of this technology? Does a discernible correlation exist between the negative perception of ChatGPT and the perceived job insecurity among professionals with regards to their capacity to deliver effective outcomes within the context of this technology? The culmination of this research yields a panoramic understanding of how the perceptual fabric of digital marketing professionals is interwoven with the tapestry of their generational experiences. The diversity of perspectives regarding AI technologies within the digital marketing domain surfaces as a pivotal theme, and the role of age in shaping these perceptions becomes manifest. Generation X, the torchbearers of a bygone industrial era transitioning to the digital epoch, tend to harbour scepticism and aversion towards AI applications, especially ChatGPT. This scepticism finds its roots in the historical trajectory of their lives, where they grappled with the uncertainties accompanying technological advancements and their impact on employment. For Generation X professionals, the specter of "falling behind" looms large, a sentiment stemming from what they perceive as an abandonment of their generation within the technological landscape. Conversely, Generation Y, colloquially known as millennials, manifests a diverse range of attitudes. Although they generally exhibit positive inclinations towards AI technologies, vestiges of apprehension endure. Their concerns orbit around the long-term ramifications of process automation and the potential relegation of human labour to a mere vestige in the face of burgeoning AI capabilities. The effervescent Generation Z, raised in the (arguably) digital, exudes a palpable acceptance of AI technologies. With a proclivity for valuing these AI tools, their inherent technological familiarity empowers them to adapt nimbly and efficiently. To the Generation Z, AI stands as an indispensable ally within the digital terrain. The denouement of this study, now complete, is emblematic of an enriched comprehension of the multilayered perceptions harbored by digital marketing professionals. Examining correlations between aversion, age, experience, and perceived job security in the presence of AI tools has yielded profound insights into the trajectory of AI within the marketing domain. The ascendancy of AI, epitomised by ChatGPT, is redefining the topography of digital marketing and content generation. As professionals grapple with the advent of AI, their predispositions and biases assume a central role in integrating these technologies into the industry. This study illuminates the diverse generational attitudes toward AI technologies in digital marketing and explicates the factors that fashion these perceptions. The findings herein assume a crucial role in elucidating the ever-evolving dynamics of the field and the imminent future of AI within the industry.
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Purpose: The aim of this study was to identify the effects of a communication skills training (CST) program for oncologists, developed based on patient preferences regarding oncologists' communication. Participants and methods: Thirty oncologists were randomly assigned to either an intervention group (IG; 2-day CST workshop) or control group (CG). Participants were assessed on their communication performance during simulated consultation and their confidence in communicating with patients at baseline and follow-up. A total of 1,192 patients (response rate, 84.6%) who had consultations with the participating oncologists at baseline and/or follow-up were assessed regarding their distress using the Hospital Anxiety and Depression Scale, satisfaction with the consultation, and trust in their oncologist after the consultation. Results: At the follow-up survey, the performance scores of the IG had improved significantly, in terms of their emotional support (P = .011), setting up a supportive environment (P = .002), and ability to deliver information (P = .001), compared with those of the CG. Oncologists in the IG were rated higher at follow-up than those in the CG in terms of their confidence in themselves (P = .001). Patients who met with oncologists after they had undergone the CST were significantly less depressed than those who met with oncologists in the CG (P = .027). However, the CST program did not affect patient satisfaction with oncologists' style of communication. Conclusion: A CST program based on patient preferences is effective for both oncologists and patients with cancer. Oncologists should consider CST as an approach to enhancing their communication skills.
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Objective: Informal caregivers (family and friends) of people with cancer are often unprepared for their caregiving role, leading to increased burden or distress. Comprehensive Health Enhancement Support System (CHESS) is a Web-based lung cancer information, communication, and coaching system for caregivers. This randomized trial reports the impact on caregiver burden, disruptiveness, and mood of providing caregivers access to CHESS versus the Internet with a list of recommended lung cancer websites. Methods: A total of 285 informal caregivers of patients with advanced nonsmall cell lung cancer were randomly assigned to a comparison group that received Internet or a treatment group that received Internet and CHESS. Caregivers were provided a computer and Internet service if needed. Written surveys were completed at pretest and during the intervention period bimonthly for up to 24 months. Analyses of covariance (ANCOVAs) compared the intervention's effect on caregivers' disruptiveness and burden (CQOLI-C), and negative mood (combined Anxiety, Depression, and Anger scales of the POMS) at 6 months, controlling for blocking variables (site, caregiver's race, and relationship to patient) and the given outcome at pretest. Results: Caregivers randomized to CHESS reported lower burden, t(84) = 2.36, p = .021, d = .39, and negative mood, t(86) = 2.82, p = .006, d = .44, than those in the Internet group. The effect on disruptiveness was not significant. Conclusions: Although caring for someone with a terminal illness will always exact a toll on caregivers, eHealth interventions like CHESS may improve caregivers' understanding and coping skills and, as a result, ease their burden and mood.
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As health care delivery organizations react to the changes brought about by public and private sector reform initiatives, RNs can anticipate that, in addition to intended outcomes, there will be unpredictable pressures and unintended consequences arising from reform. Biennial national surveys of RNs conducted over the past decade have explored various changes in the nursing workforce, quality of the workplace environment, staffing and payment policies, and RNs' views of health policy, including their expectations of health reform. The latest survey results offer a picture of RNs' capacity to practice successfully in a care delivery environment that, over the current decade, is expected to emphasize teams, care coordination, and become driven increasingly by payment incentives that reward quality, safety, and efficiency. If RNs are provided with strong clinical leadership, participate in developing an achievable vision of the future, and if supported to take risks and innovate to improve the quality and efficiency of care delivery, then the profession is likely to thrive rather than struggle during the health reform years that lie ahead. Increasing the education and preparation of nursing leaders, and particularly unit-level managers, will be increasingly vital for nursing to prosper in the future.
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This study examined cancer survivors' experience of and responses to challenges and stressors associated with everyday living. The impact of daily stressors on quality of life concerns and cortisol patterns was also investigated. Participants included 111 cancer survivors who participated in a national telephone diary study of daily experiences (National Study of Daily Experiences). Their responses were compared with those of 111 sociodemographically matched participants with no cancer history using a multilevel modeling approach. Over an 8-day period, participants completed a daily inventory of the occurrence and impact of stressful events, affect, and physical symptoms. Salivary cortisol was sampled four times per day, and indices of awakening response (cortisol awakening response), diurnal slope, and overall output (area under the curve) were examined. Cancer survivors experienced similar numbers and types of stressful events as the comparison group. Although appraisals were largely comparable, cancer survivors showed a modest tendency to perceive stressors as more severe and disruptive, particularly those involving interpersonal tensions. The occurrence of stressors was associated with increased negative affect, decreased positive affect, and increased physical symptoms, but little change in cortisol. Relative to the comparison group, cancer survivors showed less pronounced changes in positive affect and cortisol output when stressors occurred, but a greater increase in negative affect in response to interpersonal conflicts. Findings indicate that cancer survivors show a resilient ability to respond to day-to-day stressors and challenges. However, daily stressors can have a significant impact on survivors' mood and physical symptoms and therefore may be an important intervention target.
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To analyze predictors of adjustment and growth in women who had experienced recurrent ovarian cancer using components of the Resiliency Model of Family Stress, Adjustment, and Adaptation as a conceptual framework. Cross-sectional.Setting: Participants were recruited from national cancer advocacy groups. 60 married or partnered women with recurrent ovarian cancer. Participants completed an online or paper survey. Independent variables included demographic and illness variables and meaning of illness. Outcome variables were psychological adjustment and post-traumatic growth. A model of five predictor variables (younger age, fewer years in the relationship, poorer performance status, greater symptom distress, and more negative meaning) accounted for 64% of the variance in adjustment but did not predict post-traumatic growth. This study supports the use of a model of adjustment that includes demographic, illness, and appraisal variables for women with recurrent ovarian cancer. Symptom distress and poorer performance status were the most significant predictors of adjustment. Younger age and fewer years in the relationship also predicted poorer adjustment. Nurses have the knowledge and skills to influence the predictors of adjustment to recurrent ovarian cancer, particularly symptom distress and poor performance status. Nurses who recognize the predictors of poorer adjustment can anticipate problems and intervene to improve adjustment for women.
To review the literature of the validity of the Hospital Anxiety and Depression Scale (HADS). A review of the 747 identified papers that used HADS was performed to address the following questions: (I) How are the factor structure, discriminant validity and the internal consistency of HADS? (II) How does HADS perform as a case finder for anxiety disorders and depression? (III) How does HADS agree with other self-rating instruments used to rate anxiety and depression? Most factor analyses demonstrated a two-factor solution in good accordance with the HADS subscales for Anxiety (HADS-A) and Depression (HADS-D), respectively. The correlations between the two subscales varied from.40 to.74 (mean.56). Cronbach's alpha for HADS-A varied from.68 to.93 (mean.83) and for HADS-D from.67 to.90 (mean.82). In most studies an optimal balance between sensitivity and specificity was achieved when caseness was defined by a score of 8 or above on both HADS-A and HADS-D. The sensitivity and specificity for both HADS-A and HADS-D of approximately 0.80 were very similar to the sensitivity and specificity achieved by the General Health Questionnaire (GHQ). Correlations between HADS and other commonly used questionnaires were in the range.49 to.83. HADS was found to perform well in assessing the symptom severity and caseness of anxiety disorders and depression in both somatic, psychiatric and primary care patients and in the general population.
The validity of the Hospital Anxiety and Depression Scale. An updated literature review.
  • Ingvar Bjelland
  • Alv A Dahl
  • Tone Tangen Haug
  • Dag Neckelmann
Internet, phone, mail, and mixed-mode surveys: The tailored design method
  • D A Dillman
  • J D Smyth
  • L M Christian
Dillman, D. A., Smyth, J. D., & Christian, L. M. (2014). Internet, phone, mail, and mixed-mode surveys: The tailored design method (4th ed). Hoboken, NJ: John Wiley & Sons, Inc.