DSS item for the article: Emotional distress, coping, and social support: A network analysis of risk and resources in persons with cancer

The Distress Screening System comprises 52 items that relate to six psycho-social domains of human functioning: depression, anxiety, social support, coping efficacy, satisfaction with care, and functional status. Item development for the DSS followed a meticulous methodology of first examining measures of each domain that demonstrated high quality psychometric properties. Items with high factor loadings were identified by a team of researchers with expertise in measurement. Those items were used as a springboard for constructing DSS items with the goals of including items that were uniformly clear, used low literacy language and sufficiently general to be applicable to any disease state. An initial list of items was given to a panel of experts in health psychology, who assessed the them on content validity, clarity, and utility in medical settings. This process resulted in a 52-item measure and for each item, patients rated the frequency of experiencing what was described in the item on a five-point Likert-type scale ranging 1 (“not at all”) to 5 (“almost always”) based on the past seven days.