Version 1 | Version 2—Expert feedback | Version 3—Round 1—Cognitive interviews—patients | Version 4—Round 2 Cognitive interviews—patients | Version 5 (Field-test version)—Expert feedback | ||||
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These questions ask about how your breast cancer and/or its treatment has affected you NOTE: If you had breast cancer surgery on both breasts, please answer thinking about the side (i.e., breast and/or arm) that causes you more difficulty or concern | REVISE | These questions ask about how your breast cancer and/or its treatment has affected you Please answer each question based on how you look and feel TODAY NOTE: If you had breast cancer surgery on both breasts, please answer thinking about the side (i.e., breast and/or arm) that causes you more difficulty or concern | RETAIN | Â | RETAIN | Â | REVISE | These questions ask about how your breast cancer and/or its treatment has affected you Please answer each question based on the PAST WEEK |
How much do you experience pain and/or unpleasant sensations (e.g., pressure, tightness) in your breast area? | REVISE | How much bodily pain do you experience? | REVISE | How much pain do you experience? | RETAIN | Â | REVISE | How much pain did you feel? Did pain interfere with your daily activities? |
Do you experience any unpleasant symptoms? | REVISE | Do you experience any unpleasant symptoms (e.g., nausea, hot flashes, tingling or numbness in hands or feet)? | RETAIN | Â | REVISE | Did you experience any unpleasant symptoms? Did unpleasant symptoms interfere with your daily activities? | ||
How much feeling do you have in your breast area? | RETAIN | Â | RETAIN | Â | RETAIN | Â | REVISE | How much feeling (sensation) do you have in your breast area? |
How self-conscious are you about how your breast area looks? | RETAIN | Â | RETAIN | Â | RETAIN | Â | RETAIN | Â |
How similar (closely matched) are your breasts? | RETAIN | Â | REVISE | How similar are your breasts? NOTE: If you had a double mastectomy without breast reconstruction (i.e., you do not have breasts), please skip this question | REVISE | How similar (i.e., closely matched in size and shape) are your breasts? | REVISE | How closely matched (i.e., in size and shape) are your breasts? |
How much distress (e.g., anxiety, worry, sadness) do you feel because of breast cancer? | RETAIN | Â | REVISE | How much emotional distress do you experience? | REVISE | How much emotional distress (e.g., anxiety, worry) do you experience? | REVISE | How much emotional distress (e.g., anxiety, worry) did you experience? Did emotional distress (e.g., anxiety, worry) interfere with your daily activities? |
How difficult is it for you to keep up with your usual roles and responsibilities (e.g., work, caring for others, social activities)? | RETAIN |  | REVISE | How difficult is it for you to keep up with your usual activities? | REVISE | How difficult is it for you to keep up with your usual activities (e.g., work, housework, caring for self or others, social life)? | REVISE | How difficult was it for you to keep up with your usual activities (e.g., work, housework, caring for self or others)? Was it difficult for you to keep up with your usual activities (e.g., work, housework, caring for self or others)? |
How difficult is it for you to lift or move your arm? | RETAIN | Â | RETAIN | Â | RETAIN | Â | REVISE | How difficult is it for you to lift or move your arm? Did difficulty lifting or moving your arm interfere with your daily activities? NOTE: If both of your arms were affected by breast cancer treatment, please answer thinking of the arm that causes you more difficulty or concern |
How tired do you feel? | REVISE | How tired (i.e., fatigue) do you feel? | REVISE | How much fatigue do you feel? | RETAIN | Â | REVISE | How tired did you feel? Did feeling tired interfere with your daily activities? |
How difficult is it for you to do activities that use your abdomen (e.g., get out of bed, make bed)? | REVISE | Did you have breast reconstruction using your abdomen (i.e., TRAM or DIEP flap)? If yes, please answer the following question How difficult is it for you to do activities that use your abdomen (e.g., get out of bed, lift a heavy object)? | REVISE | Did you have breast reconstruction using your own skin and fat (i.e., abdomen, back, thigh)? If yes, please answer the following question Do you experience problems at the donor site where fat and skin were taken? | RETAIN | Â | DROP | Â |
 | NEW | How much nausea do you experience? | RETAIN |  | RETAIN |  | REVISE | Did you experience any nausea? Did nausea interfere with your daily activities? |
 | NEW | How much neuropathy (i.e., tingling or numbness in your hands or feet) do you experience? | RETAIN |  | RETAIN |  | REVISE | Did you experience any neuropathy (i.e., tingling or numbness) in your hands or feet? Did neuropathy (i.e., tingling or numbness) in your hands or feet interfere with your daily activities? |
 | NEW | Did your breast cancer treatment include radiation therapy? If yes, please answer the following question How does the radiated skin on your breast area look (e.g., change in colour or texture)? | REVISE | How does your radiated breast area look and feel? | REVISE | How does your radiated breast area look and feel (e.g., colour, texture, tightness)? | REVISE | How does your radiated breast area look? How does your radiated breast area feel (e.g., texture, itchy)? |