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Psychological distress
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Symptom Checklist 90 (90 items)
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5 point Likert scale
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During the past 7 days about how much were you distressed or bothered by:
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T0; T1; T2; T3
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· Anxiety (10 items)
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* range 90–450
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*Feeling fearful (anx)
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· Agoraphobia (7 items)
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· Depression (16 items)
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* Feelings of worthlessness (depr)
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· Somatisation (12 items)
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* Numbness or tingling in parts of your body (som)
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· Obsessive-compulsive behaviour (9 items)
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· Interpersonal sensitivity (18 items)
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* Feeling that people are unfriendly of dislike you (int.sens)
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· Hostility (6 items)
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* Nervousness or shakiness inside (anx)
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· Sleep (3 items)
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Psychological empowerment
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Cancer Empowerment Questionnaire (40 items)
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5 point Likert scale
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T0; T1; T2; T3
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· Personal strength (19 items)
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* range 40-200
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* I know what I am good at (pers.str)
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· Social support (9 items)
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* The people around me take me for who I am (soc.sup)
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· Community (6 items)
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* In our society people with breast cancer are considered wholly (com)
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· Health care (6 items)
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* My health care professionals are there when I need them (h.care)
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Secondary outcome measures
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Anxiety and depressive states
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Hospital Anxiety and Depression Scale (14 items)
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4 point Likert scale
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During the past week:
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T0; T1; T2; T3
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· Anxiety (7 items)
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* range 0-21 (subscales)
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* I am restless and can’t keep still (anx)
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· Depression (7 items)
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* range 0-42 (total)
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* I feel miserable and sad (depr)
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Breast cancer- related quality of life
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EORTC-C30 (30 items)
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4 point Likert scale
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During the past week:
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T0; T1; T2; T3
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· Functional scales (physical, role, emotional, social, and cognitive functioning - 15 items)
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* range 15-60
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* Has your physical condition interfered with your family life? (role.func)
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· Symptom scales (fatigue, pain, nausea/vomiting - 7 items)
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* range 7-28
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* Have you had difficulties remembering things? (cog.func)
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· Single symptom items (6 items)
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* range 6-24 7-point linear analogue scale; range 2-14
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* Did pain interfere with your daily activities? (pain)
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· Global health and global quality of life (2 items)
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* How would you rate your overall quality of life during the past week?
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EORTC-BR23 (23 items)
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4 point Likert scale
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During the past week:
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T0; T1; T2; T3
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· Functional scales (body image, sexual functioning, sexual enjoyment, future perspective - 8 items)
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* range 8-32
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* Did you find it difficult to look at yourself naked? (body.im)
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· Symptom scales (arm symptoms, breast symptoms, systemic therapy side effects, upset by hair loss - 15 items)
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* range 15-60
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* Did you have a swollen arm or hand? (arm.symp) During the past 4 weeks:
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* To what extent were you interested in sex? (sex.enj)
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General distress
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Distress Thermometer (1 item)
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11 point Likert scale
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T0; T1
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* range 0-10
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* Circle the number that best describes how much distress you have been experiencing in the past week including today.
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Remoralization
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Remoralization Scale (12 items)
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4 point Likert scale
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T0; T1
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* range 12-48
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* I am in control of my life
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* I take a positive attitude toward myself
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Personal control
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Mastery scale (7 items)
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5 point Likert scale
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T0; T1; T2; T3
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* range 7-35
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* What happens to me in the future mostly depends on me
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Positive adjustment to cancer
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Positive Adjustment Questionnaire (39 items)
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1-7 scale
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Since you found out about your illness:
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T0; T1; T2; T3
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· Fulfilment (9 items)
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* range 9-63
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* My life is not limited by my illness (ful)
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· Re-evaluation (9 items)
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* range 9-63
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*I see life differently (re-ev)
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· New ways of living (10 items)
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* range 10-70
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* I can take things more in my stride (new.w)
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· Valuing life (7 items)
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* range 7-49
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* I value life a lot more now (val)
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Coping with the experience of cancer
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Impact of Event Scale
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4 point Likert scale
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T0; T1
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· Intrusion (7 items)
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* range 13-52
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* I had dreams about it (intr)
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· Avoidance (8 items)
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* I tried not to think about it (avoid)
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* I tried not to talk about it (avoid)
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Brief COPE (28 items)
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4 point Likert scale
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T0; T1
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· Active coping (2 items)
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* range 0-6 (subscales)
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* I’ve been taking action to try to make the situation better (act.cop)
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· Planning (2 items)
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* I’ve been learning to live with it (acc)
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· Positive reframing (2 items)
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* I’ve been giving up to attempt to cope (behav.dis)
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· Acceptance (2 items)
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· Humor (2 items)
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· Religion (2 items)
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· Using emotional support (2 items)
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· Using instrumental support (2 items)
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· Self-distraction (2 items)
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· Denial (2 items)
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· Venting (2 items)
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· Substance use (2 items)
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· Behavioral disengagement
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* I’ve been criticizing myself (self-bl)
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· (2 items)
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· Self-blame (2 items)
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Self-efficacy
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Self Efficacy Scale (7 items)
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4 point Likert scale
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T0; T1
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* range 7-28
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* Whatever I do, I cannot change my complaints
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* I think I could positively influence my complaints
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Fear of cancer recurrence
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Cancer Worry Scale (8 items)
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4 point Likert scale
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During the past month:
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T0; T1; T2; T3
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* range 8-32
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* How often have you thought about your chance of getting cancer (again)?
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* Have these thoughts affected your mood?
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Cancer Acceptance Scale (2 items)
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4 point Likert scale
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T0; T1
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* range 2-8
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* I worry about the cancer returning
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* I am anxious about my health
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Fatigue Severity
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Checklist Individual Strength
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7-point Likert scale
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T0; T1; T2; T3
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· subscale Fatigue Severity (8 items)
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* range 8-56
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* I feel tired
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* I am rested
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* Physically I feel exhausted
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Family communication
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ODHCF (14 items)
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5 point Likert scale
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T0; T1; T2; T3
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· Nuclear family (7 items)
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* range 7-35 (subscales) (or less if not applicable; no partner/ children/ parents/ siblings)
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* My partner doesn’t (nucl.fam) / parents don’t (fam.or) want me to talk about breast cancer
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· Family of origin (7 items)
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* My children (nucl.fam) / siblings (fam.or) often don’t know what to say or do, when I’m feeling down because of breast cancer.
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Illness perceptions
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Illness Cognition Questionnaire (18 items)
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4 point Likert scale
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· Helplessness (6 items)
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* range 6-24 (subscales)
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* My illness controls my life (help)
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T0; T1; T2; T3
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· Acceptance (6 items)
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* I can accept my illness well (acc)
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· Perceived benefits (6 items)
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* I have learned a great deal from my illness (perc.ben)
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Personality
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Big Five Inventory (44 items)
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5 point Likert scale
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I see myself as someone who:
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T0; T1
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· Neuroticism (8 items)
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* range 1-5 (subscales)
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* Worries a lot (neu)
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· Extraversion (8 items)
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* Is full of energy (ext)
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· Openness to experience (10 items)
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* Tends to be disorganized (con)
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· Conscientiousness (9 items)
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* Is considerate and kind to almost everyone (agr)
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· Agreeableness (9 items)
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Health care utilization
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Trimbos/iMTA questionnaire for Costs associated with Psychiatric illness (TiC-P)
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Since completion of primary curative breast cancer treatment (T0) / In the past four months (T1; T3) / In the past two months (T2):
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T0; T1; T2; T3
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· Contacts with medical or mental health care professionals (14 items)
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Yes/no; frequency
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* Did you visit a psychologist? (con)
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· Hospitalization (1 item)
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Yes/no; reason Yes/no; dose and frequency
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* Did you use antidepressants? (med)
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· Use of breast cancer- specific, psychiatric and other medication (8 items)
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Yes/no; costs
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* Did you take part in a breast cancer rehabilitation program? (other)
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· Other costs (10 items)
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