Quick screening tool for patients with severe negative emotional reactions to chronic illness: Psychometric study of the negative emotions due to chronic illness screening test (NECIS)

Yun Hsin Huang, Chih Hsun Wu, Hsiu Jung Chen, Yih Ru Cheng, Fu Chien Hung, Kai Kuan Leung, Bee Horng Lue, Ching Yu Chen, Tai Yuan Chiu, Yin Chang Wu

Research output: Contribution to journalArticle

1 Citation (Scopus)


Background. Severe negative emotional reactions to chronic illness are maladaptive to patients and they need to be addressed in a primary care setting. Objective. The psychometric properties of a quick screening tool-the Negative Emotions due to Chronic Illness Screening Test (NECIS)-for general emotional problems among patients with chronic illness being treated in a primary care setting was investigated. Method. Three studies including 375 of patients with chronic illness were used to assess and analyze internal consistency, test-retest reliability, criterion-related validity, a cut-off point for distinguishing maladaptive emotions and clinical application validity of NECIS. Self-report questionnaires were used. Results. Internal consistency (Cronbach's a) ranged from 0.78 to 0.82, and the test-retest reliability was 0.71 (P < 0.001). Criterion-related validity was 0.51 (P < 0.001). Based on the 'severe maladaptation' and 'moderate maladaptation' groups defined by using the 'Worsening due to Chronic Illness' index as the analysis reference, the receiver-operating characteristic curve analysis revealed an area under the curve of 0.81 and 0.82 (ps < 0.001), and a cut-off point of 19/20 was the most satisfactory for distinguishing those with overly negative emotions, with a sensitivity and specificity of 83.3 and 69.0%, and 68.5 and 83.0%, respectively. The clinical application validity analysis revealed that low NECIS group showed significantly better adaptation to chronic illness on the scales of subjective health, general satisfaction with life, self-efficacy of self-care for disease, illness perception and stressors in everyday life. Conclusion. The NECIS has satisfactory psychometric properties for use in the primary care setting.

Original languageEnglish
Pages (from-to)34-40
Number of pages7
JournalFamily Practice
Issue number1
Publication statusPublished - 2018 Feb 1



  • Behavior Rating Scale
  • Chronic disease
  • Comprehensive health care
  • Emotional adaptation
  • Emotions
  • Primary health care

ASJC Scopus subject areas

  • Family Practice

Cite this