Objectives/Purpose: The Benefit Finding Scale (BFS) is widely used to assess positive psychological changes in individuals living with and beyond cancer. However, questions remain about its dimensionality and conceptual overlap with related constructs, particularly post-traumatic growth. This study evaluated the psychometric properties of the BFS using both classical test theory and multidimensional item response theory (MIRT) to clarify its structure, reliability, and validity in a diverse cancer population.
Sample and Setting: A cross-sectional online survey design was used. Adults previously diagnosed with any cancer and treated with curative intent participated (n=482). Participants were primarily from the UK, USA, and South Africa, with a broad range of cancer types represented.
Procedures: Participants completed the BFS alongside validated measures of happiness, subjective well-being, optimism, and post-traumatic growth to assess validity. Factor analysis and MIRT were used to evaluate dimensionality and item-level functioning. Differential item functioning analyses explored whether individuals of different genders or cancer types varied in the positive changes they reported after cancer.
Results: Confirmatory factor analysis showed that the original unidimensional 17-item model did not fit the data adequately. Exploratory analyses identified a two-factor, 14-item model with strong psychometric properties and excellent internal consistency. While the BFS demonstrated reliability, a strong correlation with post-traumatic growth suggests considerable conceptual overlap. Although certain items were endorsed differently by gender and cancer types, these differences did not substantially affect total scores.
Conclusion and Clinical Implications: This study provides a strong psychometric foundation for the continued use and refinement of the BFS in psycho-oncology. The revised 14-item model improves precision in the assessment of positive psychological change after cancer. However, the conceptual overlap with post-traumatic growth highlights the need for future research to distinguish these constructs. Findings have important implications for the development, evaluation, and interpretation of psychosocial interventions and patient-reported outcomes in psycho-oncology.