Contribution to an Assessment of the Validity of the SubjectiveTherapeutic Report Form (STReF) Using Second-OrderConfirmatory Factor Analysis Approach toMultitrait-Multimethod Analysis

Introduction: The purpose of the study is to contribute to the assessment of the construct validity of the STReF (Subjective Therapeutic Report Form), a questionnaire meant to be used in psycho-oncology to evaluate relationships between patients and medical staff; results from the application of this instrument may orientate intervention aimed at improving the therapeutic relationship. STReF is composed of 2 symmetric sections - one administered to patients and the other to medical staff. Both are composed of 3 subscales: Communication within the hospital, Care, and Quality of life. Methods: The STReF was administered to 230 patients hospitalized in 4 hospitals in Piedmont, and to their medical staff. A multitrait-multimethod approach via second-order confirmatory factor analysis was applied to test both the multiple-indicator factorial structure and the method effect (patient versus medical staff ratings). Results: Two factors emerged instead of 3 (Communication/Care as a single factor, and Quality of life). Responses showed a consistent method effect pertaining to the Communication/Care factor in the patients’ section and to the Quality of life factor in the medical staff section of the questionnaire. Conclusions: Some guidelines for the application of the STReF and possible further developments of research are outlined.