[Psychometric Evaluation of a Single-Item-Screener for Sleep Disturbances]. / Psychometrische Überprüfung eines Ein-Item-Screeners für Schlafbeschwerden.

OBJECTIVE: Sleep disturbances are one of the most prevalent health complaints in the general population. Thus, the need for validated screening instruments and prevention measures is high. The aim of the current study is to evaluate a potential single-item screening instrument and therefore, contribute to an improved early detection. METHODS: Data from Saxony Longitudinal Study (SLS) is being analyzed. Based on data of 32nd wave (n=321, 172 women, 149 men, M age=48.42, SD=0.64), the G-Score Item #3 ("Have you had the following complaints in the last 12 months? Please indicate how often they occurred. - sleeplessness"), a potential screening instrument, is psychometrically evaluated. A Receiver Operating Characteristic (ROC)-Analysis is calculated to assess the predictive validity of the G-Score Item #3. RESULTS: Retestreliability for the G-Score Item #3 is 0.70 (p<0.001). Correlation with the Jenkins Sleep Scale (JSS) was r=0.79 (p<0.01). The area under the curve (AUC) is 0.92, providing evidence for a very good predictive validity. DISCUSSION AND CONCLUSION: This study provides evidence for the use of the G-Score Item #3 as a screening instrument for sleep disturbances by showing good psychometric properties and brevity.

Variables associated with oral health-related self-efficacy - results of a cross-sectional study.

BACKGROUND: Oral health-related self-efficacy (OH-SE) is pivotal for oral health and is associated with other oral-health related variables, such as dental fear and anxiety (DF/A) and dental hygiene behaviors (DHB). This study attempts to analyze associations between OH-SE and oral healthrelated variables in a German population to extend previous research by analyzing whether OH-SE can be predicted by these variables, as this might contribute to the development of treatment interventions. METHODS: OH-SE, DF/A, oral health-related quality of life (OHRQoL), self-perceived dental condition, satisfaction with general health, DHB, and socioeconomic status were assessed as a part of the Saxon Longitudinal Study in an adult sample (n = 309, 56.3% female, all Saxon secondary school 8th graders in 1987). The associations of OH-SE with these variables were examined by means of correlation, multiple linear regression analyses, and group comparisons. Significance (p), standardized regression coefficients (ß), and effect size (Cohen's d) were calculated. RESULTS: The correlation analyses revealed increased OH-SE to be accompanied by low levels of DF/A, high levels of OHRQoL, high levels of self-perceived dental condition, increased satisfaction with general health and socioeconomic status (all r ≥ 0.142; all p ≤ 0.013). In the regression analysis, OH-SE was mainly predicted by self-perceived dental condition and satisfaction with general health (R2 = 0.157) as well as by daily frequency of toothbrushing, OHRQoL, and socioeconomic status on a trend-level basis. In the group comparisons OH-SE was lower in participants with moderate for manifest DF/A and higher in individuals with higher OHRQoL, better self-perceived dental condition, increased satisfaction with general health, increased daily frequency of toothbrushing, more dental appointments, and above-average socioeconomic status (trend level; all t ≥ 1.57; p ≤ 0.059). CONCLUSIONS: In this cross-sectional study, high levels of OH-SE were mainly predicted by general health as well as self-perceived dental condition. It was also associated with decreased DF/A, increased DHB, higher OHRQoL, and higher socioeconomic status. Future research should analyze these associations in longitudinal designs to address whether interventions focusing on adherence to good DHB improve (dental) health and thus OH-SE. This might be a promising approach, particularly in relation to the treatment of DF/A.

[Internal Migration and Mental Health - Relevant Factors 20 and 30 years after Unification: Results of a Longitudinal Study in German]. / Binnenmigration und psychische Gesundheit in der Sächsischen Längsschnittstudie ­ Relevante Faktoren 20 und 30 Jahre nach der Wiedervereinigung.

Aim The aim of the present study was to determine the relevant factors in the mental health of people who experienced internal migration in comparison with people who did not. Methods Data from a longitudinal study in Saxony were used to compare the psychological distress of individuals who migrated internally with that of those who did not in 2010 and 2020. Bootstrapping-based mediation analysis was applied to examine possible mediators between internal migration and mental health.Results Individuals who experienced internal migration reported less mental distress compared to those who did not in 2010, but not in 2020, but these effects disappeared after including covariates and mediators. Important mediators in 2010 were life situation, political solidarity with FRG, winner of German Unification and job security; in 2020, these were threat of old-age poverty and experiences with system.Discussion Internal migration influences mental distress through different factors. Especially the current life circumstances play a crucial role.

Psychosocial aftercare of adolescent and young adult cancer survivors in Germany: Awareness, utilisation, satisfaction and associated factors.

AIM: This study systematically assesses the awareness of, utilisation of and satisfaction with psychosocial care for adolescents and young adult (AYA) cancer survivors in aftercare. METHODS: Survivors between 18 and 39 years were surveyed in aftercare. Awareness of, utilisation of and satisfaction with psychological counselling (PC), social-legal counselling (SLC) and other psychosocial care (OPC) were measured using self-developed questionnaires. Multivariate analyses were conducted to determine factors correlated with awareness and use of psychosocial care. RESULTS: Five hundred and fourteen survivors participated; the mean age at diagnosis was 29.6 years (SD = 6.14). 54% of cancer survivors were aware of PC, 45% of SLC and 24% of OPC. Those who possessed knowledge about these services used it to a considerable extent (63%-74%), and the majority (66%-75%) was highly satisfied. No common factors could be found that increase the likelihood of being aware of these three services (R2  = 0.028-0.138). Female gender (OR = 2.08-2.18) and high anxiety (OR = 1.19-1.38) were identified as common factors that increase the likelihood of utilising psychosocial services (R2  = 0.160-0.395). CONCLUSION: AYA who are aware of psychosocial services in aftercare are motivated to use them and express high satisfaction with use. For the utilisation of psychosocial services, anxiety and female gender can be identified as common factors. The visibility of psychosocial services for aftercare should be increased given the high number of unaware AYA survivors. The active and repeated addressing of psychosocial issues and regular provision of information (e.g., written guides on survivorship) by caregivers should be made a standard of care for AYA cancer survivors.

The long-lasting impact of unemployment on life satisfaction: results of a longitudinal study over 20 years in East Germany.

BACKGROUND: Economic disruption in East Germany at the time of reunification (1990) resulted in a noticeable increase in unemployment. The present study provides data from a German cohort for over 20 years. The aim was to examine how the frequency of experiencing unemployment affects life satisfaction and whether their relationship changes over time. METHODS: In the Saxon Longitudinal Study, an age-homogeneous sample was surveyed annually from 1987 to 2016. Since 1996, 355 people (54% female) have been examined for issues related to unemployment. Life satisfaction was measured with both the Global Satisfaction with Life Scale and the Questions on Life SatisfactionModules questionnaire. RESULTS: In 1996, the participants were 23 years old and 50% of the sample was affected by unemployment. At all 16 different measuring points, participants who were never unemployed indicated higher life satisfaction than those who were once unemployed. The repeatedly unemployed consistently reported the lowest values of life satisfaction. In each year, there were significant differences with small to medium effect sizes. CONCLUSION: Our results support the notion that the adverse effects of unemployment on life satisfaction increase with the time spent unemployed. In 2016, only 2% of the cohort were currently unemployed, but differences between people with and without unemployment experience still exist. This indicates that the negative effect of the unemployment experience will last for a very long time. To the best of our knowledge, this is the first study that demonstrates the effect so persistently at so many measurement points for over 20 years.

Sexuality and cancer in adolescents and young adults - a comparison between reproductive cancer patients and patients with non-reproductive cancer.

BACKGROUND: Sexuality is an important aspect of quality of life for adolescent and young adults that remains understudied in cancer patients. Most current knowledge about how cancer and cancer treatments can affect patients' sexuality pertains to reproductive cancer patients (breast, gynecological, male reproductive organs), whereas only little is known about how the disease affects the sex lives of patients with other types of cancer. This study examined sexual satisfaction and sexual supportive care needs among adolescent and young adult cancer patients, with a particular focus on how the type of cancer a person has is associated with these issues differently. METHODS: Five hundred seventy-seven (n = 424 females, 73.5%) patients between 18 and 39 years of age at diagnosis and representing all major tumor entities completed the standardized questionnaire. The analysis addressed the following topics: sexual satisfaction (Life Satisfaction Questionnaire), sexual supportive care needs (Supportive Care Needs Survey), and changes in sexuality (Questions on Life Satisfaction Modules). These topics were tested by mean differences between reproductive and non-reproductive cancer, equivalence testing and regression analyses. RESULTS: About one third of the patients reported being dissatisfied with their sexuality and having supportive care needs in this area. Changes in sexuality were significantly more common in women with reproductive cancers than in those who had other types of cancer (t = - 2.693, p = .007), while both groups had equivalence in scores for sexual satisfaction and sexual supportive care needs. Reproductive cancers are not more associated with deterioration of sexual satisfaction (R2 = .002, p = .243), changes in sexuality (R2 = .006, p = .070) or increased sexual supportive care needs than non-reproductive cancers (R2 = .004, p = .131). CONCLUSIONS: The results indicate that about a third of adolescents and young adults with both reproductive but also with non-reproductive cancer experience sexual dissatisfaction in similar measure. An equal percentage of these patients also express a desire to receive supportive care in this area. Consequently, health care professionals should address issues of sexuality and cancer as a matter of routine when caring for young adults even when patients have a non-reproductive cancer.

Anxiety and depression in young adult German cancer patients: Time course and associated factors.

OBJECTIVE: Cancer in young adulthood is a nonnormative and critical life event. The experience of having cancer can have a strong impact on the mental health of young adults. This study investigated anxiety and depression in young adult cancer patients, examining changes over time and determining associated factors. METHODS: Young cancer patients (18-39 years at time of diagnosis, diagnosis less than 4 years) were examined. Anxiety and depression were measured at two time points (t2 = 12 months after t1) using the Hospital Anxiety and Depression Scale (HADS). Regression analyses were conducted to determine whether sociodemographic, medical, and/or psychosocial factors (social support, adjustment to the illness, unmet supportive care needs) were associated with patients' anxiety and depression. RESULTS: Five hundred fourteen young cancer patients (mean age 29.6 years, 75.1% women) completed both questionnaires. A higher proportion showed elevated levels of anxiety (t1: 42.2%; t2: 45.3%) than of depression (t1: 16.9%; t2: 17.7%), and no significant changes in anxiety and depression levels over time were observed. Psychosocial factors explained a major proportion of the variances for anxiety and depression levels at both time points (adjusted R2 between.50 and.59). Furthermore, significant associations were found for anxiety (t1) with gender (women↑); anxiety (t2) and depression (t2) with sick leave (sick leave yes↑); depression (t2) with time since diagnosis (longer time↑). CONCLUSION: Psychological distress among adolescents and young adults (AYA) manifests particularly as anxiety. Strong associations between anxiety/depression and psychosocial factors, as well as the stability of psychological distress over time, clearly illustrate the need for psycho-oncological care in this patient group.

Perceived social support and associations with health-related quality of life in young versus older adult patients with haematological malignancies.

BACKGROUND: This study compared the perceived social support of young and older adult cancer patients, examining possible influencing factors as well as associations with health-related quality of life. METHODS: A total of 179 young patients (18-39 years) and 200 older adult patients (> 70 years) with haematological malignancies completed questionnaires on their perceived social support (ISSS-8, scales: Positive Support and Detrimental Interactions, range 0-16) and health-related quality of life (EORTC QLQ-C30). Tests for mean differences, correlations and regression analyses to determine associated variables of social support were performed. RESULTS: No difference was reported between young (M = 13.40, SD = 2.81) and older adult patients (M = 13.04, SD = 3.82; p = .313) for Positive Support. However, young patients (M = 4.16, SD = 3.10) reported having had more Detrimental Interactions than older patients did (M = 1.63, SD = 2.42; p < .001, Cohen's d = .910). Comparison of the EORTC QLQ-C30 Function scales showed poorer outcomes for young patients on Emotional, Cognitive and Social Functions and a higher outcome on Physical Function compared with older adult patients. Regression analyses indicated that age (young vs. older adult patients) significantly explained proportions of variance in all models, with young age having a negative impact on Emotional, Cognitive and Social Functions and a positive impact on Physical and Role Functions compared with old age. Significant associations between Detrimental Interactions and all the scales examined except Cognitive Function were found. CONCLUSIONS: The difference in negative perceptions of social support in young vs. older adult patients and its impact on health-related quality of life emphasises the necessity of differentiating between positive and negative social support. Negative interactions should be addressed through psychosocial care, particularly with young cancer patients.

[Are We Really as Happy as We Think We are? A Critical Examination of Work Satisfaction in a University Pediatric Hospital]. / Sind wir wirklich so glücklich, wie wir es glauben? Eine kritische Untersuchung der Arbeitszufriedenheit an einer Universitätskinderklinik.

GOALS: Despite numerous reported deficits and an increasingly tense working environment in German hospitals, employees themselves often assess their job satisfaction as being high to very high. Hence, the board of directors does not have important arguments for sustainable improvement of working conditions. This discrepancy between working conditions and subjective satisfaction was the motivation for this work. METHODS: Data were acquired via an attitude survey at the University Hospital for Children and Adolescents Leipzig, with employees sub-divided into medical, nursing and administrative/technical staff. The subjective satisfaction was examined by means of classical global ratings almost exclusively used by companies vs. the much more modern cognitive-emotional concept of the 'Schweizer Modell' describing qualitative job satisfaction. In addition, working hours, work-related effects on mental health, willingness to quit the job and actual dropout rate were compared. RESULTS: A rather high level of job satisfaction was revealed while interpreting the classical global ratings. In contrast, the qualitative analysis showed that only 1 in 4 employees was really satisfied with his or her job, amongst doctors even only 1 in 10. Altogether there are four categories of satisfaction. Significant differences between occupational categories were seen when stratifying the data according to age profiles and the evaluation of the consequences of psychological job strain. These differences were not seen in willingness to quit the job. CONCLUSION: Reports of high job satisfaction in hospitals in numerous publications can be mostly explained by employees who are resignedly satisfied. This is the psychodynamic outcome of strain compensating. This is not measurable with the concept of classical global ratings. Furthermore, the constructively dissatisfied employees, who are an often-underestimated resource for companies, are neglected. The reduction of strain in these people then mostly results in job changes.

Psychometric properties of the fatigue questionnaire EORTC QLQ-FA12 and proposal of a cut-off value for young adults with cancer.

BACKGROUND: Young adult patients with cancer have to deal with their disease in an eventful phase of life. A common side effect of cancer and its treatment is cancer-related fatigue (CRF), a phenomenon which can thwart successful coping with developmental tasks. The aims of this study were to assess the psychometric properties of the EORTC QLQ-FA12, a new instrument for assessing physical, emotional and cognitive fatigue, in young adults with cancer, and to propose a cut-off value that indicates a need for further more specific diagnostics. METHODS: In a sample of young adults who were first diagnosed with cancer between the ages of 18 and 39 years old, we assess the composite and item reliabilities as well as discriminant validity of the subscales for the EORTC QLQ-FA12. We also discuss two possible ways to calculate a summarizing score when conducting a receiver operating characteristic (ROC) analysis to find the cut-off value. RESULTS: The EORTC QLQ-FA12 fit the sample (CFI = 0.96, SRMR = 0.04), had discriminant validity regarding its subscales and every subscale showed convergent validity (composite reliabilities were 0.92 for physical, 0.89 for emotional and 0.74 for cognitive fatigue). The sum of the first ten items with a range of 0 to 30 revealed a cut-off value of twelve or more with 91% sensitivity and 77% specificity. CONCLUSION: The new instrument EORTC QLQ-FA12 is able to distinguish between physical, emotional, and cognitive fatigue in young adult patients. It enables us to study different concepts of general fatigue without the need for additional items, and can be used as a screening instrument for young adults. Future research should investigate the multidimensional character of CRF.

[The G-Score - a Short Questionnaire for the Measurement of Subjective Physical Health]. / Der G-Score ­ ein Screeninginstrument zur Erfassung der subjektiven körperlichen Gesundheit.

AIM: The measurement of subjective physical health is important in clinical settings as well as for research purposes. In the present paper, the psychometric properties of the G-Score, a 4 item screening questionnaire for the self-assessment of one's physical health, is explored. METHODS: The Objectivity, validity and reliability were estimated. Moreover, an item analysis and a suitable cut-off-value for the differentiation between healthy and presumably ill subjects were conducted. Data from the Saxony Longitudinal Study ("Sächsische Längsschnittstudie") 1998-2013 were analysed (N=324-417 healthy individuals). RESULTS: The objectivity of the G-Score is estimated as very good. As a cut off for the differentiation between healthy and presumably ill subjects, a G-Score of 4 is suggested. The content validity is slightly lacking. Correlations with associated and non-associated constructs hint an interaction of physical with psychological discomfort. A good predictive validity of the instrument is assessed. Reliability estimates show acceptably good results. This indicates a high sensitivity for changes in the measured construct. CONCLUSION: Putting all results into consideration, a use of the G-Score as a screening questionnaire in research is recommended. However, more psychometric investigations with representative samples and objective comparative data should be carried out.

[Development of a Short Version of the Bielefeld Partnership Expectations Questionnaire (BFPE)]. / Entwicklung einer Kurzversion des Bielefelder Fragebogens zu Partnerschaftserwartungen (BFPE-12).

The Bielefeld Partnership Expectations Questionnaire (BFPE) is a self-rating instrument of partner related attachment. Besides the assessment of the dimensions fear of rejection, readiness for self-disclosure, and conscious need for care, individuals can be classified according to 5 different attachment patterns. Using data from a representative German survey (N=1768), an explorative factor analysis revealed a short version comprising 12 items. Confirmatory factor analysis using two datasets (N=1768 and N=801) supported the 3-factor-structure (RMSEA<0.08, CFI>0.93). Subscales of the short version were highly correlated with the corresponding scales of the long version (r=0,799-0,914). Furthermore, the classifications of 5 attachment patterns strongly converged (κ=0,659). The short version can be recommended as a substitute of the long version in clinical and non-clinical studies.

[Psychometric evaluation of the German version of the Health Regulatory Focus Scale]. / Psychometrische Überprüfung der deutschen Version der Health Regulatory Focus Scale.

Psychometric evaluation of the German version of the Health Regulatory Focus Scale Objectives: This study examines the psychometric properties of the German version of the Health Regulatory Focus Scale (HRFS), which measures health-related promotion- and prevention-based motivation. METHODS: The study is based on data from the 28th (N = 332) and 29th survey wave (N = 253) of the Saxony Longitudinal Study. It examines item characteristics, factorial, convergent and prognostic validity as well as the influence of sociodemographic variables. RESULTS: The psychometric properties of the German version are excellent, after removal of Item 5. A two-factor structure as well as good validity were confirmed. CONCLUSION: The shortened German version of the HRFS is well suited to capturing the health related regulatory focus of this test and makes it useful in the area of health promotion and prevention.

Life situation and psychosocial care of adolescent and young adult (AYA) cancer patients - study protocol of a 12-month prospective longitudinal study.

BACKGROUND: In recent years, there has been an increased research focus on adolescent and young adult (AYA) cancer patients. Few longitudinal studies have taken into consideration the specifics of their life situation and the status of psychosocial care services for this population. Our ongoing study aims to determine the psychosocial life and supportive care situation of AYA cancer patients, to describe risk groups, and to develop recommendations for their psycho-oncological care and support. METHODS: The AYA-Leipzig study (AYA-LE) is a German prospective, longitudinal, study examining AYAs´ life situation (e.g. psychological distress, quality of life) and psychosocial care (e.g. evaluation and preferences, support needs) using two measurement points, namely, upon acute treatment completion (baseline) and 12 months later. N = 577 AYA cancer patients aged between 18 and 39 years at diagnosis, and representing all major tumor entities fill out a standardized questionnaire (online or by post), mainly based on validated instruments. AYA-specific concerns (e.g. family planning, sexual and reproductive health, social support, health behavior) will explicitly be considered. Participants are recruited in 16 German acute care hospitals, four rehabilitation clinics, and from two German state tumor registries. DISCUSSION: In summary, our longitudinal study will create a large database encompassing all malignant tumor entities and including detailed information about the distress and quality of life, specific problems, and specific support needs of AYA cancer patients at two different points in time post-diagnosis. The information we gather about existing psychosocial care and patient preferences and desires concerning psycho-oncological care will be used to develop recommendations for psycho-oncological care providers.

How do young adults with cancer perceive social support? A qualitative study.

The social support of adolescents and young adults (AYA) has been studied very little. 18 interviews were conducted and evaluated with content analysis (inter-rater reliability = 0.87). All of the young adult cancer patients interviewed reported having received social support from at least two people (family, friends, and/or partner). Forms of emotional and instrumental support were more often reported than informational support. 12 participants described having received nonhelpful support, especially in areas of dealing with their situation, limited social participation, and distancing of friends. The participants considered social exchanges with other young adult cancer patients an important source of social support. AYA cancer patient networking should be improved.

[Cancer and Career? - A Qualitative Study of Job Status of Young Adult Cancer Survivors]. / Krebs und Karriere? ­ Eine qualitative Untersuchung zur beruflichen Situation und Integration junger Erwachsener mit Krebs.

Purpose: To examine the impact of cancer on work and education for AYA. Collect information about AYA's return to work/return to study. Methods: 18 AYA (10 female) aged 18 to 39 (m=27 years) at time of diagnosis completed a semi-structured interview. Qualitative content analysis was used to generate results. Results: 11 of 18 AYA had already returned to work/study. Flexible structures and emotional support of colleagues and managers were reported being helpful. 10 AYA planed or had already reduced job tasks, hours of work or further education. This was mostly compelled by physical disabilities due to cancer or treatment. Most AYA asked for more support within the social insurance system. Conclusions: Cancer often leads to changes in work or education. More social and vocational counseling to support AYA's rehabilitation process seems to be necessary.

The LIFE-Adult-Study: objectives and design of a population-based cohort study with 10,000 deeply phenotyped adults in Germany.

BACKGROUND: The LIFE-Adult-Study is a population-based cohort study, which has recently completed the baseline examination of 10,000 randomly selected participants from Leipzig, a major city with 550,000 inhabitants in the east of Germany. It is the first study of this kind and size in an urban population in the eastern part of Germany. The study is conducted by the Leipzig Research Centre for Civilization Diseases (LIFE). Our objective is to investigate prevalences, early onset markers, genetic predispositions, and the role of lifestyle factors of major civilization diseases, with primary focus on metabolic and vascular diseases, heart function, cognitive impairment, brain function, depression, sleep disorders and vigilance dysregulation, retinal and optic nerve degeneration, and allergies. METHODS/DESIGN: The study covers a main age range from 40-79 years with particular deep phenotyping in elderly participants above the age of 60. The baseline examination was conducted from August 2011 to November 2014. All participants underwent an extensive core assessment programme (5-6 h) including structured interviews, questionnaires, physical examinations, and biospecimen collection. Participants over 60 underwent two additional assessment programmes (3-4 h each) on two separate visits including deeper cognitive testing, brain magnetic resonance imaging, diagnostic interviews for depression, and electroencephalography. DISCUSSION: The participation rate was 33 %. The assessment programme was accepted well and completely passed by almost all participants. Biomarker analyses have already been performed in all participants. Genotype, transcriptome and metabolome analyses have been conducted in subgroups. The first follow-up examination will commence in 2016.

The core self-evaluation scale: psychometric properties of the german version in a representative sample.

The Core Self-Evaluation Scale (CSES) is an economical self-reporting instrument that assesses fundamental evaluations of self-worthiness and capabilities. The broad aims of this study were to test the CSES's psychometric properties. The study is based on a representative survey of the German general population. Confirmatory factor analyses were conducted for different models with 1, 2, and 4 latent factors. The CSES was found to be reliable and valid, as it correlated as expected with measures of depression, anxiety, quality of life, self-report health status, and pain. A 2-factor model with 2 related factors (r = -.62) showed the best model fit. Furthermore, the CSES was measurement invariant across gender and age. In general, males had higher values of positive self-evaluations and lower negative self-evaluations than females. It is concluded that the CSES is a useful tool for assessing resource-oriented personality constructs.

[The extension of the Leipzig questionnaire of motives to have a child (LKM) for use in oncology--test construction and psychometric review]. / Erweiterung des Leipziger Fragebogens zu Kinderwunschmotiven (LKM) für den Einsatz in der Onkologie--Testkonstruktion und psychometrische Überprüfung.

Many young cancer patients had not completed family planning at the time of diagnosis. A cancer disease may change procreative attitudes and the development of specific motivations of having a child (for and against) is possible. This paper addresses the extension of the Leipzig questionnaire on motives for wanting children (LKM) in the context of cancer. Specific motivations of cancer patients are presented and test-statistically verified. Based on previous findings and a qualitative questioning (patients, professionals) items for specific motivations were developed and pre-tested. The revised version (20 items) was tested on a sample of 175 young cancer patients. Good to adequate item discrimination parameter and reliability (α=0.86) were shown. The factor analysis revealed the 2 scales "PRO - motivations for having children after cancer" and "CON - motivations against having children after cancer". These additional scales of specific motivations allow for a reliable and economical measure of motivations to have a child in young cancer patients. In the future the scales can be also used for other serious physical disease in young adulthood.

The quality of life questionnaire EQ-5D-5L: psychometric properties and normative values for the general German population.

PURPOSE: The health state classifier EQ-5D of the EuroQoL group has been expanded to a 5-level instrument (EQ-5D-5L), but studies on psychometric properties of this new instrument, applied to the general population, are rare. METHODS: A sample of 2,469 subjects, representatively selected from the German general population, was asked to fill in the EQ-5D-5L and several other questionnaires. Crude sum scores of the EQ-5D-5L were calculated and compared with scores derived from two sets of utilities, one from a German and one from a UK sample. RESULTS: The mean sum score (0-100 scale) was 91.5. Males reported better health states than females, and there was a nearly linear age trend. The list of the 45 most frequent health patterns (those with at least 0.2 % of the respondents) showed that almost half of the participants (47.5 %) responded being in the optimal health state, indicating a ceiling effect. Correlations between EQ-5D-5L scores and other questionnaires were very similar for all three scoring systems of the EQ-5D-5L. Finally, normative scores are given on the basis of sum scores. CONCLUSIONS: The applicability of the EQ-5D-5L in the general population is limited because of the skewness. Sum scores are useful because of their simplicity, international generalizability, and construct validity.