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Table 5 PROMIS Physical Function Short Form 10b cognitive debriefing summary Table (N = 15)

From: Content validity of the National Comprehensive Cancer Network – Functional Assessment of Cancer Therapy – Breast Cancer Symptom Index (NFBSI-16) and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Short Form with advanced breast cancer patients

Item, instruction, or response option

Number of patients (n,%)a

Exemplary quotes demonstrating patient understanding of instruction or item concept

Instructions: Please respond to each question or statement by marking one box per row.

 Item was understood by patient

14/14 (100%)

“It says read each question or the statement and mark, and marking one box per row. It means it’s asking me to read the question and mark one box on my answers.”

 Concept was experienced by patient

Item 1: Are you able to do chores such as vacuuming or yard work?

 Item was understood by patient

15/15 (100.0%)

“Unable to do, number 1. Q: Okay, and why do you choose unable to do? A: Because vacuuming, I can vacuum only if I’m in my wheelchair or walker, and then yard work, it is too hot to do yard work.… Chores, ah, washing dishes, cooking, vacuuming, mopping, dish, ah, laundry.”

 Concept was experienced by patient

14/15 (93.3%)

Item 2: Are you able to get in and out of a car?

 Item was understood by patient

14/14 (100.0%)

“Okay, like if you go to the grocery store, can you get in that car? Can you put all your groceries in your car, can you get in without need assistance? I don’t need any assistance to get in and I don’t need any assistance to get out.”

 Concept was experienced by patient

11/14 (78.6%)

Item 3: Are you able to go up and down stairs at a normal pace?

 Item was understood by patient

15/15 (100.0%)

“Are you able to go up and down stairs at a normal pace? Um, going down is okay. Going up, it’s very difficult. Q: What is it about going up that is difficult? A: I can’t breathe. Q: … in this question what does a normal pace mean to you? A: Just walking at a, um, normal speed.”

 Concept was experienced by patient

13/15 (86.7%)

Item 4: Are you able to run errands and shop?

 Item was understood by patient

13/13 (100.0%)

“Run errands and shop, uh, go to the cleaners, put gas in their car, go do this, go do that, and do the groceries. You just don’t have it in you.”

 Concept was experienced by patient

12/15 (80.0%)

Item 5: Are you able to bend down and pick up clothing from the floor?

 Item was understood by patient

15/15 (100.0%)

“We’re going to go with some difficulty on that depending on how far away the floor is. I actually have little grabbers that I keep in different rooms of the house so that I can reach down and grab things with.… if I have to physically bend down and pick it up it’s more of a challenge for me to grab it and get up. Um, if it’s rounded up and if I can just reach down a little easier I can grab it that way. But if it’s something flat on the floor it’s just a, a nuisance for me. It’s, it’s kind of midrange. I can do it, but do I want to do it? No.”

 Concept was experienced by patient

12/14 (85.7%)

Item 6: Are you able to lift 10 pounds (5 kg) above your shoulder?

 Item was understood by patient

11/11 (100.0%)

“Either pick up from a table or something that’s handed to me and then raise it up maybe to a shelf or, or move it from one position to another that really wouldn’t be above my shoulders but, um, just moving that object from where it was to where it’s going to. Not necessarily like a bench press or something like that like raising weights.”

 Concept was experienced by patient

11/12 (91.7%)

Item 7: Does your health now limit you in doing vigorous activities, such as running, lifting heavy objects, participating in strenuous sports?

 Item was understood by patient

13/14 (92.9%)

“I cannot run, I cannot lift anything, and I cannot participate in sports, so I cannot do any of that.”

 Concept was experienced by patient

13/15 (86.7%)

Item 8: Does your health now limit you in bathing or dressing yourself?

 Item was understood by patient

13/13 (100.0%)

“Because you need help with helping wash your back and sometimes pulling up pants or zipping objects.”

 Concept was experienced by patient

13/14 (92.9%)

Item 9: Does your health now limit you in putting a trash bag outside?

 Item was understood by patient

11/12 (91.7%)

“Can you lift that trash bag out of that trash can and take it to the dumpster or take it to the big trashcan outside, the garbage can.”

 Concept was experienced by patient

8/14 (57.1%)

Item 10: Does your health now limit you in doing moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf?

 Item was understood by patient

15/15 (100.0%)

“I don’t bowl or play golf. I couldn’t get in the heat or that kind of weather or anything. I don’t do any moderate activities. Moving a table, no, I would never attempt that.… Um, so there’s only one in there I would do.… With some difficulty, the vacuum.… Yeah. I couldn’t pick up a bowling ball and golf I wouldn’t get out in the heat or the sun.… And, um, picking up a table, I’m not going to pick up a table either. I don’t have the strength for that.”

 Concept was experienced by patient

10/12 (83.3%)

Response options

 Response option “Without any difficulty” understood by patient

15/15 (100.0%)

 Response option “With some difficulty” understood by patient

13/13 (100.0%)

 Response option “With much difficulty” understood by patient

15/15 (100.0%)

 Response option “Unable to do” understood by patient

15/15 (100.0%)

 Response option “Not at all” understood by patient

7/14 (50.0%)

 Response option “Very little” understood by patient

3/12 (25.0%)

 Response option “Somewhat” understood by patient

8/10 (80.0%)

 Response option “Quite a lot” understood by patient

6/10 (60.0%)

 Response option “Cannot do” understood by patient

13/13 (100.0%)

Overall

 Patient reported PROMIS is easy to complete

15/15 (100.0%)

 Patient reported that there are no missing concepts

11/13 (84.6%)

  1. aNote: The total counts vary based on the number of patients who provided sufficient data that could be used in analysis