A scale for measuring feelings of support and security regarding cancer care in a region of Japan: A potential new endpoint of cancer care

Context: Having a sense of security about the availability of care is important for cancer patients and their families. Objectives: To develop a scale for the general population to evaluate feelings of support and security regarding cancer care, and to identify factors associated with a sense of security. Methods: A cross-sectional anonymous questionnaire was administered to 8000 subjects in four areas of Japan. Sense of security was measured using five statements and using a seven-point Likert scale: "If I get cancer 1) I would feel secure in receiving cancer treatment, 2) my pain would be well relieved, 3) medical staff will adequately respond to my concerns and pain, 4) I would feel secure as a variety of medical care services are available, and 5) I would feel secure in receiving care at home." We performed an exploratory factor analysis as well as uni- and multivariate analyses to examine factors associated with such a sense of security. Results: The five items regarding sense of security were aggregated into one factor, and Cronbach's α was 0.91. In the Yamagata area where palliative care services were not available, the sense of security was significantly lower than in the other three regions. Female gender (P = 0.035), older age (P < 0.001), and having cancer (P < 0.001) were significantly associated with a strong sense of security. Conclusion: A new scale that evaluates sense of security with regard to cancer care was developed. Future studies should examine whether establishing a regional health care system that provides quality palliative care could improve the sense of security of the general population.