The Institute of Medicine (IOM) and National Cancer Comprehensive Network (NCCN) now require integration of psychosocial care into the treatment of cancer patients to identify, monitor, and treat psychosocial distress. Despite the widespread use of Patient Reported Outcomes (PRO) for these purposes, no gold standard PRO for assessing distress exists for psycho-oncology research and clinical practice. This study examined the reliability, validity, and preliminary treatment effects of the Outcome Questionnaire, a PRO never before been used or validated with heterogeneous cancer patients. Adult cancer survivors were recruited nationwide to participate in an online support group (N=187) and randomly assigned to a treatment or wait-list condition in a longitudinal randomized controlled trial. The OQ Total Score demonstrated excellent reliability (ïƒ¡ï€ = 0.92). However, the subscales varied in the quality of their reliability ratings. Convergent validity was demonstrated, but divergent validity was not adequately shown. Three new significant factors were identified through exploratory factor analysis. For preliminary treatment effects in the online support group study, it was shown that those with a worse perceived health status F (1, 90) = 7.48, p = 0.008 and those who engaged more with the online support group improved over time F (1, 59) = 6.00, p = 0.018. These findings suggest mixed support for the implementation of the OQ as a PRO in a chronic disease sample. Generally, if the OQ is to be used as is within a cancer population, the Total Score may be interpreted as both reliable and valid and able to demonstrate treatment effects in a cancer population, but the subscale scores should not be interpreted.

LLU Discipline

Clinical Psychology




School of Science and Technology

First Advisor

Owen, Jason E.

Second Advisor

Bantum, Erin

Third Advisor

Boyd, Kendal C.

Fourth Advisor

Vermeersch, David

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded

January 2012

Date (Title Page)




Library of Congress/MESH Subject Headings

Cancer; Quality of Health Care;

Subject - Local

Outcome questionnaire; Cancer; Psychosocial care; Patient Report Outcomes



Page Count

101 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses & Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives