Development and Validation of the Socio-Ecological Scale for Identifying Delays in Treatment for Breast Cancer Patients

Abstract Background: The study was aimed at measuring the factors contributing to the delayed presentation of breast cancer patients within the socio-ecological context by developing a scale. Methods: The study objectives were measured by developing the items on the basis of a five-point Likert-based scale named the Socio-Ecological Scale for Breast Cancer Patients (SES-BCP). The dimensionality of the measure and internal consistency were determined by collecting data from 350 breast cancer patients of five main hospitals in three main cities (Lahore, Multan, and Faisalabad) in the Punjab province of Pakistan. A simple random sampling technique was employed, and socio-demographic factors were kept in consideration. The confirmatory factor analysis was applied for the factor structure in the study by using a structural equation model. Results: With the distinctive five factors of the SES-BCP, a total of 51 items were confirmed in the final scale with sound psychometric properties. Conclusions: It can be concluded that this scale is a valuable addition to assess the underlying factors of delayed presentation in patients with breast cancer in the context of socio-ecological model in Pakistan.