# Development and Validation of the Socio-Ecological Scale for Identifying Delays in Treatment for Breast Cancer Patients

## TL;DR

This study created a scale to identify factors causing delays in breast cancer treatment among patients in Pakistan.

## Contribution

The novel contribution is the development and validation of the Socio-Ecological Scale for Breast Cancer Patients (SES-BCP).

## Key findings

- The SES-BCP consists of 51 items across five factors with strong psychometric properties.
- The scale provides a multidimensional view of factors contributing to delayed treatment.
- It is a valuable tool for assessing socio-ecological factors in breast cancer care in Pakistan.

## Abstract

Background: The study was aimed at measuring the factors contributing to the delayed presentation of breast cancer patients within the socio-ecological context by developing a scale.

Methods: The study objectives were measured by developing the items on the basis of a 5-point scale named the Socio-Ecological Scale for Breast Cancer Patients (SES-BCP). The dimensionality of the measure and internal consistency were determined by collecting data from 350 breast cancer patients from five main hospitals in three main cities (Lahore, Multan, and Faisalabad) in the Punjab province of Pakistan. A multistage sampling technique was employed, and sociodemographic factors were kept in consideration. Confirmatory factor analysis was applied for the factor structure in the study by using a structural equation model.

Results: With the distinctive five factors of the SES-BCP, a total of 51 items were confirmed in the final scale with sound psychometric properties, providing a multidimensional view of the study that helps in the early detection and cure of disease.

Conclusions: It can be concluded that this scale is a valuable addition to assess the underlying factors of delayed presentation in patients with breast cancer in the context of the socio-ecological model in Pakistan.