Measuring Self-Efficacy to Request Cancer-Related Work Accommodations: Development and Validation of a Brief Survey Instrument.

Abstract

Objective: Access to work accommodations, such as time off to attend medical appointments, is a key predictor of cancer-related job loss. We aimed to develop and validate a measure of self-efficacy to request and obtain work accommodations related to diagnosis of breast cancer and need for treatment.

Methods: The 5-item Self-efficacy to Ask for Work Accommodations (SAWA) tool was adapted from a scale that measures self-efficacy in patient-physician interactions. English-speaking, employed women, aged 18-64, who were undergoing treatment for stage I-III breast cancer completed surveys during treatment (chemotherapy, radiation, and/or < 60 days since surgery) and 4 months after its completion. Post-treatment surveys were the primary validation dataset; analyses were repeated using baseline data to further evaluate validity/reliability. Psychometric analyses included internal consistency, principal component factor analysis, convergent and divergent validity, and test-retest reliability (in a subset of patients, 2 weeks after post-treatment surveys).

Results: Among 362 participants, the SAWA measure had a Cronbach's alpha of 0.93, indicating high scale reliability. Factor analysis revealed one summary measure which could be divided into two subscales. Overall, the SAWA demonstrated convergent and divergent validity based on the hypothesized variables. Similar patterns were observed when analyses were repeated using baseline survey data. In the test-retest subset, the Pearson correlation between SAWA assessed 4 months post-treatment versus retest 2 weeks later was 0.79.

Conclusions: The SAWA is a validated survey instrument that can be used to measure self-efficacy in employed cancer patients to ask for and obtain employment accommodations.