Measuring psychological consequences of screening: Adaptation of the psychological consequences questionnaire into Dutch

Objective: To assess the psychometric properties of a Dutch adaptation of an originally Australian instrument measuring the psychological impact of breast cancer screening. Methods: The three subscales (emotional, physical, social) of the Psychological Consequences Questionnaire (PCQ) underwent formal linguistic and cultural translation. A total of 524 women under intensive surveillance because of increased breast cancer risk were asked to complete the questionnaire at 2 months prior to screening, at the day of the screening visit preceding the screening, and 1-4 weeks after screening. Acceptability, score distribution, internal consistency, scale structure, responsiveness to change and construct validity were analysed. Results: Response rates were high (98-94%) and there were very few missing answers and non-unique answers. All scales had Cronbach's alpha s > 0.70. The physical and social subscale showed ceiling effects. The item-own scale correlations were only slightly higher than the corresponding item-other scale correlations. Factor analysis showed that the assumed three separate subscales were replicated in our study. Pre- and post-screening effect sizes for the emotional scale were larger than for the other two scales. All PCQ scales correlated with the scales of two other psychological measures (p <= 0.01). The emotional scale and the total PCQ score were able to differentiate between subgroups varying in affective risk perception (p <= 0.01). Conclusion: The Dutch PCQ is useful in measuring psychological impact among women under intensive surveillance because of high breast cancer risk.