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Wojeck RK, Knisely MR, Bailey DE, Somers TJ, Kwakkenbos L, Carrier ME, Nielson WR, Bartlett SJ, Malcarne VL, Hudson M, Levis B, Benedetti A, Mouthon L, Thombs BD, Silva SG. Patterns of patient-reported symptoms and association with sociodemographic and systemic sclerosis disease characteristics: a scleroderma Patient-centered Intervention Network (SPIN) Cohort cross-sectional study. EClinicalMedicine 2023; 62:102104. [PMID: 37533421 PMCID: PMC10393558 DOI: 10.1016/j.eclinm.2023.102104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 08/04/2023] Open
Abstract
Background Systemic sclerosis is a heterogenous disease in which little is known about patterns of patient-reported symptom clusters. We aimed to identify classes of individuals with similar anxiety, depression, fatigue, sleep disturbance, and pain symptoms and to evaluate associated sociodemographic and disease-related characteristics. Methods This multi-centre cross-sectional study used baseline data from Scleroderma Patient-centered Intervention Network Cohort participants enrolled from 2014 to 2020. Eligible participants completed the PROMIS-29 v2.0 measure. Latent profile analysis was used to identify homogeneous classes of participants based on patterns of anxiety, depression, fatigue, sleep disturbance, and pain scores. Sociodemographic and disease-related characteristics were compared across classes. Findings Among 2212 participants, we identified five classes, including four classes with "Low" (565 participants, 26%), "Normal" (651 participants, 29%), "High" (569 participants, 26%), or "Very High" (193 participants, 9%) symptom levels across all symptoms. Participants in a fifth class, "High Fatigue/Sleep/Pain and Low Anxiety/Depression" (234 participants, 11%) had similar levels of fatigue, sleep disturbance, and pain as in the "High" class but low anxiety and depression symptoms. There were significant and substantive trends in sociodemographic characteristics (age, education, race or ethnicity, marital or partner status) and increasing disease severity (diffuse disease, tendon friction rubs, joint contractures, gastrointestinal symptoms) across severity-based classes. Disease severity and sociodemographic characteristics of "High Fatigue/Sleep/Pain and Low Anxiety/Depression" class participants were similar to the "High" severity class. Interpretation Most people with systemic sclerosis can be classified by levels of patient-reported symptoms, which are consistent across symptoms and highly associated with sociodemographic and disease-related variables, except for one group which reports low mental health symptoms despite high levels of other symptoms and substantial disease burden. Studies are needed to better understand resilience in systemic sclerosis and to identify and facilitate implementation of cognitive and behavioural strategies to improve coping and overall quality of life. Funding National Institute of Nursing Research (F31NR019007), Canadian Institutes of Health Research, Arthritis Society Canada, the Lady Davis Institute for Medical Research, the Jewish General Hospital Foundation, McGill University, Scleroderma Society of Ontario, Scleroderma Canada, Sclérodermie Québec, Scleroderma Manitoba, Scleroderma Atlantic, Scleroderma Association of BC, Scleroderma SASK, Scleroderma Australia, Scleroderma New South Wales, Scleroderma Victoria, and Scleroderma Queensland.
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Affiliation(s)
| | | | | | | | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen, the Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Radboudumc Center for Mindfulness, Department of Psychiatry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Susan J. Bartlett
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Vanessa L. Malcarne
- Department of Psychology, San Diego State University, California, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
| | - Susan G. Silva
- Duke University School of Nursing, Durham, North Carolina, USA
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2
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Wurz A, Ellis K, Duchek D, Bansal M, Carrier ME, Tao L, Dyas L, Kwakkenbos L, Levis B, El-Baalbaki G, Rice DB, Wu Y, Henry RS, Bustamante L, Harb S, Hebblethwaite S, Patten SB, Bartlett SJ, Varga J, Mouthon L, Markham S, Thombs BD, Culos-Reed SN. Exploring research team members' and trial participants' perceptions of acceptability and implementation within one videoconference-based supportive care program for individuals affected by systemic sclerosis during COVID-19: a qualitative interview study. Transl Behav Med 2023; 13:442-452. [PMID: 36999812 PMCID: PMC10314727 DOI: 10.1093/tbm/ibac091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
The SPIN-CHAT Program was designed to support mental health among individuals with systemic sclerosis (SSc; commonly known as scleroderma) and at least mild anxiety symptoms at the onset of COVID-19. The program was formally evaluated in the SPIN-CHAT Trial. Little is known about program and trial acceptability, and factors impacting implementation from the perspectives of research team members and trial participants. Thus, the propose of this follow-up study was to explore research team members' and trial participants' experiences with the program and trial to identify factors impacting acceptability and successful implementation. Data were collected cross-sectionally through one-on-one, videoconference-based, semi-structured interviews with 22 research team members and 30 purposefully recruited trial participants (Mage = 54.9, SD = 13.0 years). A social constructivist paradigm was adopted, and data were analyzed thematically. Data were organized into seven themes: (i) getting started: the importance of prolonged engagement and exceeding expectations; (ii) designing the program and trial: including multiple features; (iii) training: research team members are critical to positive program and trial experiences; (iv) offering the program and trial: it needs to be flexible and patient-oriented; (v) maximizing engagement: navigating and managing group dynamics; (vi) delivering a videoconference-based supportive care intervention: necessary, appreciated, and associated with some barriers; and (vii) refining the program and trial: considering modification when offered beyond the period of COVID-19 restrictions. Trial participants were satisfied with and found the SPIN-CHAT Program and Trial to be acceptable. Results offer implementation data that can guide the design, development, and refinement of other supportive care programs seeking to promote psychological health during and beyond COVID-19.
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Affiliation(s)
- Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Kelsey Ellis
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Delaney Duchek
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Mannat Bansal
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Laura Dyas
- National Scleroderma Foundation, Michigan Chapter, Southfield, MI, USA
| | - Linda Kwakkenbos
- Clinical Psychology, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Radboudumc Center for Mindfulness, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, UK
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Yin Wu
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Laura Bustamante
- Department of Applied Human Sciences, Concordia University, Montreal, QC, Canada
| | - Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute and O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, QC, Canada
- Research Institute, McGill University Health Centre, Montreal, QC, Canada
| | - John Varga
- University of Michigan, Ann Arbor, MI, USA
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares d’Ile de France, Hôpital Cochin, Assistance Publique, Hôpitaux de Paris (APHP), Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King’s College London, London, UK
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, AB, Canada
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Rodríguez-Reyna TS, Hant FN, Cutolo M, Smith V. Training the Next Generation of Rheumatologists: What Is the Best Way to Teach Fellows About Scleroderma? Rheum Dis Clin North Am 2023; 49:425-444. [PMID: 37028845 DOI: 10.1016/j.rdc.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
Rheumatology is rich in educational opportunities, learning about a variety of diseases. Rheumatology subspecialty training is a time of unparalleled learning, and within the curriculum of a training program, the connective tissue diseases (CTDs) represent a unique challenge to the fellows. The challenge therein lies in the multisystem presentations they are faced with mastering. Scleroderma, as a rare and life-threatening CTD, remains one of the most difficult conditions to manage and treat. In this article, the authors focus on an approach to training the next generation of rheumatologists to take care of patients with scleroderma.
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Affiliation(s)
- Tatiana S Rodríguez-Reyna
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Faye N Hant
- Department of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina, 96 Jonathan Lucas Street Suite 822, Charleston, SC 29425, USA
| | - Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital, Viale Benedetto XV, 6, Genova 16132, Italy
| | - Vanessa Smith
- Department of Internal Medicine, Ghent University, Corneel Heymanslaan 10, Ghent 9000, Belgium; Department of Rheumatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium; Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium.
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Kwakkenbos L, Carrier ME, Welling J, Turner KA, Cumin J, Pépin M, van den Ende C, Schouffoer AA, Hudson M, van Breda W, Sauve M, Mayes MD, Malcarne VL, Nielson WR, Nguyen C, Boutron I, Rannou F, Thombs BD, Mouthon L. Randomized feasibility trial of the Scleroderma Patient-centered Intervention Network hand exercise program (SPIN-HAND). PeerJ 2022; 10:e13471. [PMID: 35945943 PMCID: PMC9357372 DOI: 10.7717/peerj.13471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 04/29/2022] [Indexed: 01/20/2023] Open
Abstract
Purpose The Scleroderma Patient-centered Intervention Network (SPIN) online hand exercise program (SPIN-HAND), is an online self-help program of hand exercises designed to improve hand function for people with scleroderma. The objective of this feasibility trial was to evaluate aspects of feasibility for conducting a full-scale randomized controlled trial of the SPIN-HAND program. Materials and Methods The feasibility trial was embedded in the SPIN cohort and utilized the cohort multiple randomized controlled trial (cmRCT) design. In the cmRCT design, at the time of cohort enrollment, cohort participants consent to be assessed for trial eligibility and randomized prior to being informed about trials conducted using the cohort. When trials were conducted in the cohort, participants randomized to the intervention were informed and consented to access the intervention. Participants randomized to control were not informed that they have not received an intervention. All participants eligible and randomized to participate in the trial were included in analyses on an intent-to-treat basis. Cohort participants with a Cochin Hand Function Scale score ≥ 3/90 and an interest in using an online hand-exercise intervention were randomized (1:1 ratio) to be offered as usual care plus the SPIN-HAND Program or usual care for 3 months. User satisfaction was assessed with semi-structured interviews. Results Of the 40 randomized participants, 24 were allocated to SPIN-HAND and 16 to usual care. Of 24 participants randomized to be offered SPIN-HAND, 15 (63%) consented to use the program. Usage of SPIN-HAND content among the 15 participants who consented to use the program was low; only five (33%) logged in more than twice. Participants found the content relevant and easy to understand (satisfaction rating 8.5/10, N = 6). Automated eligibility and randomization procedures via the SPIN Cohort platform functioned properly. The required technical support was minimal. Conclusions Trial methodology functioned as designed, and the SPIN-HAND Program was feasibly delivered; however, the acceptance of the offer and use of program content among accepters were low. Adjustments to information provided to potential participants will be implemented in the full-scale SPIN-HAND trial to attempt to increase offer acceptance.
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Affiliation(s)
| | - Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | - Joep Welling
- NVLE Dutch patient organization for systemic autoimmune diseases, Utrecht, The Netherlands
| | | | - Julie Cumin
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | - Mia Pépin
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | | | - Anne A. Schouffoer
- Leiden University Medical Center, Leiden, The Netherlands,Haga Teaching Hospital, The Hague, The Netherlands
| | - Marie Hudson
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada,Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Ward van Breda
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maureen Sauve
- Scleroderma Society of Ontario, Hamilton, Ontario, Canada,Scleroderma Canada, Ottawa, Ontario, Canada
| | - Maureen D. Mayes
- University of Texas McGovern School of Medicine, Houston, Texas, United States of America
| | | | | | | | - Isabelle Boutron
- Centre d’Épidémiologie Clinique, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Paris, France,Centre of Research Epidemiology and Statistics (CRESS), Inserm, INRA, Université de Paris, Paris, France
| | - François Rannou
- Université de Paris, Paris, France,Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Brett D. Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada,Department of Medicine, McGill University, Montreal, Quebec, Canada,Department of Psychiatry, McGill University, Montreal, Quebec, Canada,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada,Department of Psychology, McGill University, Montreal, Quebec, Canada,Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d’Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France,APHP-CUP, Hôpital Cochin, Paris, France
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5
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Becetti K, Nguyen JT, Kwakkenbos L, Carrier ME, Tao L, Gordon JK, Mancuso CA, Welling J, Mouthon L, Bartlett SJ, Malcarne VL, Thombs BD, Spiera RF. Mental Health Care Use and Associated Factors in Systemic Sclerosis: A Scleroderma Patient-Centered Intervention Network Cohort Study. ACR Open Rheumatol 2022; 4:647-657. [PMID: 35603782 PMCID: PMC9374049 DOI: 10.1002/acr2.11439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Systemic sclerosis (SSc) has significant psychosocial implications. We aimed to evaluate the proportion of participants in a large international SSc cohort who used mental health services in a 3‐month period and to evaluate demographic, psychological, and disease‐specific factors associated with use. Methods Baseline data of participants enrolled in the Scleroderma Patient‐Centered Intervention Network Cohort were analyzed. We determined the proportion that used mental health services and the source of services in the 3 months prior to enrollment. Multivariable logistic regression was used to identify variables associated with service use. Results Of the 2319 participants included in the analysis, 417 (18%) used mental health services in the 3 months prior to enrollment. General practitioners were the most common mental health service providers (59%), followed by psychologists (25%) and psychiatrists (19%). In multivariable analysis, mental health service use was independently associated with higher education (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.03‐1.11), smoking (OR 1.06, 95% CI 1.02‐1.11), being retired (OR 0.60, 95% CI 0.38‐0.93), having limited SSc (OR 1.39, 95% CI 1.02‐1.89), and having higher anxiety symptom scores (OR 1.04, 95% CI 1.03‐1.06) and lower self‐efficacy scores (OR 0.90, 95% CI 0.83‐0.97). Variables not significantly associated included age, race, disease manifestations, depression symptom scores, and body image distress. Conclusion About 18% of participants in a large international cohort received mental health services in a 3‐month period, of whom the majority received these services from a general practitioner.
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Affiliation(s)
| | | | - Linda Kwakkenbos
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | | | | | - Joep Welling
- Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, the Netherlands, and Federation of European Scleroderma Associations, Brussels, Belgium
| | - Luc Mouthon
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, and Hôpital Cochin, Paris, France
| | - Susan J Bartlett
- McGill University and McGill University Health Center Research Institute, Montreal, Quebec, Canada
| | | | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital and McGill University, Montreal, Quebec, Canada
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Kwakkenbos L, Østbø N, Carrier ME, Nielson WR, Fedoruk C, Levis B, Henry RS, Pope J, Frech T, Gholizadeh S, Johnson SR, Piotrowski P, Jewett LR, Gordon J, Chung L, Bilsker D, Tao L, Turner KA, Cumin J, Welling J, Fortuné C, Leite C, Gottesman K, Sauvé M, Reyna TSR, Hudson M, Larche M, van Breda W, Suarez-Almazor ME, Bartlett SJ, Malcarne VL, Mayes MD, Boutron I, Mouthon L, Benedetti A, Thombs BD. Randomized feasibility trial of the Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program. Pilot Feasibility Stud 2022; 8:45. [PMID: 35219340 PMCID: PMC8881754 DOI: 10.1186/s40814-022-00994-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 01/27/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The Scleroderma Patient-centered Intervention Network (SPIN) developed an online self-management program (SPIN-SELF) designed to improve disease-management self-efficacy in people with systemic sclerosis (SSc, or scleroderma). The aim of this study was to evaluate feasibility aspects for conducting a full-scale randomized controlled trial (RCT) of the SPIN-SELF Program. METHODS This feasibility trial was embedded in the SPIN Cohort and utilized the cohort multiple RCT design. In this design, at the time of cohort enrollment, cohort participants consent to be assessed for trial eligibility and randomized prior to being informed about the trial. Participants in the intervention arm are informed and provide consent, but not the control group. Forty English-speaking SPIN Cohort participants from Canada, the USA, or the UK with low disease-management self-efficacy (Self-Efficacy for Managing Chronic Disease Scale [SEMCD] score ≤ 7) who were interested in using an online self-management program were randomized (3:2 ratio) to be offered the SPIN-SELF Program or usual care for 3 months. Program usage was examined via automated usage logs. User satisfaction was assessed with semi-structured interviews. Trial personnel time requirements and implementation challenges were logged. RESULTS Of 40 SPIN Cohort participants randomized, 26 were allocated to SPIN-SELF and 14 to usual care. Automated eligibility and randomization procedures via the SPIN Cohort platform functioned properly, except that two participants with SEMCD scores > 7 (scores of 7.2 and 7.3, respectively) were included, which was caused by a system programming error that rounded SEMCD scores. Of 26 SPIN Cohort participants offered the SPIN-SELF Program, only 9 (35%) consented to use the program. Usage logs showed that use of the SPIN-SELF Program was low: 2 of 9 users (22%) logged into the program only once (median = 3), and 4 of 9 (44%) accessed none or only 1 of the 9 program's modules (median = 2). CONCLUSIONS The results of this study will lead to substantial changes for the planned full-scale RCT of the SPIN-SELF Program that we will incorporate into a planned additional feasibility trial with progression to a full-scale trial. These changes include transitioning to a conventional RCT design with pre-randomization consent and supplementing the online self-help with peer-facilitated videoconference-based groups to enhance engagement. TRIAL REGISTRATION clinicaltrials.gov , NCT03914781 . Registered 16 April 2019.
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Affiliation(s)
- Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Montessorilaan 3, 6525, HR, Nijmegen, The Netherlands.
| | - Nora Østbø
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Claire Fedoruk
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Brooke Levis
- Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Richard S Henry
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Janet Pope
- Department of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Tracy Frech
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Shadi Gholizadeh
- California School of Professional Psychology/Alliant, Los Angeles, CA, USA
| | - Sindhu R Johnson
- Toronto Scleroderma Program, Mount Sinai Hospital & Toronto Western Hospital, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Lisa R Jewett
- Department of Psychology, Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Jessica Gordon
- Department of Medicine, Hospital for Special Surgery, New York City, NY, USA
| | - Lorinda Chung
- Department of Medicine, Stanford University, Palo Alto, CA, USA
- Department of Medicine Palo Alto VA Health Care System, Palo Alto, CA, USA
| | - Dan Bilsker
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lydia Tao
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Kimberly A Turner
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Julie Cumin
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Joep Welling
- NVLE Dutch patient organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | | | | | | | - Maureen Sauvé
- Scleroderma Canada, Hamilton, Ontario, Canada
- Scleroderma Society of Ontario, Hamilton, Ontario, Canada
| | | | - Marie Hudson
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Maggie Larche
- Department of Medicine, McMaster University and St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Ward van Breda
- Faculty of Behavioural and Movement Sciences, Vrije University, Amsterdam, The Netherlands
| | - Maria E Suarez-Almazor
- Department of General Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California San Diego, San Diego, CA, USA
| | - Maureen D Mayes
- Department of Internal Medicine, University of Texas McGovern School of Medicine, Houston, TX, USA
| | - Isabelle Boutron
- Université de Paris, Centre of Research Epidemiology and Statistics (CRESS), Inserm, INRA, Paris, France
- Centre d'Épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Paris, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, F-75014, Paris, France
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Brett D Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
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Nordlund J, Henry RS, Kwakkenbos L, Carrier ME, Levis B, Nielson WR, Bartlett SJ, Dyas L, Tao L, Fedoruk C, Nielsen K, Hudson M, Pope J, Frech T, Gholizadeh S, Johnson SR, Piotrowski P, Jewett LR, Gordon J, Chung L, Bilsker D, Levis AW, Turner KA, Cumin J, Welling J, Fortuné C, Leite C, Gottesman K, Sauve M, Rodríguez-Reyna TS, Larche M, van Breda W, Suarez-Almazor ME, Wurz A, Culos-Reed N, Malcarne VL, Mayes MD, Boutron I, Mouthon L, Benedetti A, Thombs BD. The Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program: protocol for a two-arm parallel partially nested randomized controlled feasibility trial with progression to full-scale trial. Trials 2021; 22:856. [PMID: 34838105 PMCID: PMC8626736 DOI: 10.1186/s13063-021-05827-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 11/13/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Systemic sclerosis (scleroderma; SSc) is a rare autoimmune connective tissue disease. We completed an initial feasibility trial of an online self-administered version of the Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program using the cohort multiple randomized controlled trial (RCT) design. Due to low intervention offer uptake, we will conduct a new feasibility trial with progression to full-scale trial, using a two-arm parallel, partially nested RCT design. The SPIN-SELF Program has also been revised to include facilitator-led videoconference group sessions in addition to online material. We will test the group-based intervention delivery format, then evaluate the effect of the SPIN-SELF Program on disease management self-efficacy (primary) and patient activation, social appearance anxiety, and functional health outcomes (secondary). METHODS This study is a feasibility trial with progression to full-scale RCT, pending meeting pre-defined criteria, of the SPIN-SELF Program. Participants will be recruited from the ongoing SPIN Cohort ( http://www.spinsclero.com/en/cohort ) and via social media and partner patient organizations. Eligible participants must have SSc and low to moderate disease management self-efficacy (Self-Efficacy for Managing Chronic Disease (SEMCD) Scale score ≤ 7.0). Participants will be randomized (1:1 allocation) to the group-based SPIN-SELF Program or usual care for 3 months. The primary outcome in the full-scale trial will be disease management self-efficacy based on SEMCD Scale scores at 3 months post-randomization. Secondary outcomes include SEMCD scores 6 months post-randomization plus patient activation, social appearance anxiety, and functional health outcomes at 3 and 6 months post-randomization. We will include 40 participants to assess feasibility. At the end of the feasibility portion, stoppage criteria will be used to determine if the trial procedures or SPIN-SELF Program need important modifications, thereby requiring a re-set for the full-scale trial. Otherwise, the full-scale RCT will proceed, and outcome data from the feasibility portion will be utilized in the full-scale trial. In the full-scale RCT, 524 participants will be recruited. DISCUSSION The SPIN-SELF Program may improve disease management self-efficacy, patient activation, social appearance anxiety, and functional health outcomes in people with SSc. SPIN works with partner patient organizations around the world to disseminate its programs free-of-charge. TRIAL REGISTRATION ClinicalTrials.gov NCT04246528 . Registered on 27 January 2020.
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Affiliation(s)
- Julia Nordlund
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Richard S. Henry
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
- Department of Psychiatry, McGill University, Montreal, Quebec Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Brooke Levis
- Centre for Prognosis Research, School of Medicine, Keele University, Keele, Staffordshire UK
| | | | - Susan J. Bartlett
- Department of Medicine, McGill University, Montreal, Quebec Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec Canada
| | - Laura Dyas
- Scleroderma Foundation, Michigan Chapter, Southfield, MI USA
| | - Lydia Tao
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Claire Fedoruk
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Karen Nielsen
- Scleroderma Society of Ontario, Hamilton, Ontario Canada
| | - Marie Hudson
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
- Department of Medicine, McGill University, Montreal, Quebec Canada
| | - Janet Pope
- Department of Medicine, University of Western Ontario, London, Ontario Canada
| | - Tracy Frech
- Department of Internal Medicine, University of Utah, Salt Lake City, UT USA
| | - Shadi Gholizadeh
- California School of Professional Psychology/Alliant, Los Angeles, CA USA
| | - Sindhu R. Johnson
- Toronto Scleroderma Program, Mount Sinai Hospital & Toronto Western Hospital, Toronto, Ontario Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario Canada
| | | | - Lisa R. Jewett
- Department of Psychology, Jewish General Hospital, Montreal, Quebec Canada
| | - Jessica Gordon
- Department of Medicine, Hospital for Special Surgery, New York City, NY USA
| | - Lorinda Chung
- Department of Medicine, Stanford University, Palo Alto, CA USA
- Department of Medicine, Palo Alto VA Health Care System, Palo Alto, CA USA
| | - Dan Bilsker
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia Canada
| | - Alexander W. Levis
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA USA
| | - Kimberly A. Turner
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Julie Cumin
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Joep Welling
- NVLE Dutch patient organization for systemic autoimmune diseases, Utrecht, The Netherlands
| | | | | | | | - Maureen Sauve
- Scleroderma Society of Ontario, Hamilton, Ontario Canada
- Scleroderma Canada, Hamilton, Ontario Canada
| | | | - Maggie Larche
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario Canada
| | - Ward van Breda
- Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands
| | - Maria E. Suarez-Almazor
- Department of General Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, British Columbia Canada
| | - Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta Canada
- Department of Oncology, Cumming School of Medicine, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta Canada
| | - Vanessa L. Malcarne
- Department of Psychology, San Diego State University, San Diego, CA USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California San Diego, San Diego, CA USA
| | - Maureen D. Mayes
- Department of Internal Medicine, University of Texas McGovern School of Medicine, Houston, TX USA
| | - Isabelle Boutron
- Université de Paris, Centre of Research Epidemiology and Statistics (CRESS), Inserm, INRA, Paris, France
- Centre d’Épidémiologie Clinique, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Paris, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d’Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, Quebec Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec Canada
| | - Brett D. Thombs
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
- Department of Psychiatry, McGill University, Montreal, Quebec Canada
- Department of Medicine, McGill University, Montreal, Quebec Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec Canada
- Department of Psychology, McGill University, Montreal, Quebec Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec Canada
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8
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Affiliation(s)
- Ilaria Galetti
- Gruppo Italiano per la Lotta alla Sclerodermia (GILS), Milan, Italy
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9
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Kocher A, Ndosi M, Denhaerynck K, Simon M, Dwyer AA, Distler O, Hoeper K, Künzler-Heule P, Redmond AC, Villiger PM, Walker UA, Nicca D. A rare disease patient-reported outcome measure: revision and validation of the German version of the Systemic Sclerosis Quality of Life Questionnaire (SScQoL) using the Rasch model. Orphanet J Rare Dis 2021; 16:356. [PMID: 34372892 PMCID: PMC8351336 DOI: 10.1186/s13023-021-01944-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background Rare disease patient-reported outcome measures (PROMs) require linguistic adaptation to overcome the challenge of geographically dispersed patient populations. Importantly, PROMs such as health-related quality of life (HRQoL) should accurately capture responses to patient-identified concerns. The Systemic Sclerosis Quality of Life Questionnaire (SScQoL) is a 29-item tool validated in six languages. Previous evaluation of the German version revealed problems with dichotomous responses. This study aimed to revise the German SScQoL, extend the response structure, and evaluate content and construct validity, reliability and unidimensionality. Methods The instrument validation study involved revising the German SScQoL response structure, cognitive debriefing with patients and validation using Rasch analysis. The revised SScQoL was completed by Swiss-German-speaking patients with SSc within the Swiss MANagement Of Systemic Sclerosis (MANOSS) study. Rasch analysis was employed to test the validity, reliability and unidimensionality of the revised instrument. Results Based on cognitive debriefing with patients (n = 6) dichotomous items were extended to a polytomous 4-point response structure. A total of 78 patients completed the revised SScQoL. Initial analysis of the 29 items suggested the scale lacked fit to the model (χ2 = 51.224, df = 29, p = 0.007). Grouping items into five domains resulted in an adequate fit to the Rasch model (χ2 = 5.343, df = 5, p = 0.376) and unidimensionality (proportion of significant independent t tests: 0.045, 95% CI 0.016–0.114). Overall, the scale was well targeted, had high internal consistency (Person Separation Index, PSI = 0.931) and worked consistently in patients with different demographic and clinical characteristics. Conclusions The revised German SScQoL has a 4-point response structure and is a valid, reliable measure. Rasch analysis is useful for validating continuous response structure of quality of life measures. Further evaluation of measurement equivalence with other German-speaking cultures is required for multinational comparisons and data pooling. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01944-9.
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Affiliation(s)
- Agnes Kocher
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland.,Department of Rheumatology, Immunology and Allergology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mwidimi Ndosi
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Kris Denhaerynck
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Michael Simon
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland.,Nursing Research Unit, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrew A Dwyer
- Boston College, Connell School of Nursing, Chestnut Hill, MA, USA
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Kirsten Hoeper
- Hannover Medical School, Department, Rheumatology and Immunology, Hannover, Germany
| | - Patrizia Künzler-Heule
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland.,Department of Gastroenterology/Hepatology and Department of Nursing, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Anthony C Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Peter M Villiger
- Department of Rheumatology, Immunology and Allergology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ulrich A Walker
- Department of Rheumatology, University Hospital Basel, Basel, Switzerland
| | - Dunja Nicca
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland. .,Department of Global and Public Health, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland.
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10
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Mattsson M, Sandqvist G, Hesselstrand R, Olsson D, Kwakkenbos L, Nordin A, Boström C. Validity and reliability of the Swedish version of the Self-Efficacy for Managing Chronic Disease scale for individuals with systemic sclerosis. Scand J Rheumatol 2021; 51:110-119. [PMID: 34251963 DOI: 10.1080/03009742.2021.1917142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ObjectiveTo investigate aspects of validity and reliability of the Swedish version of the Self-Efficacy for Managing Chronic Disease (SEMCD-Swe) scale in systemic sclerosis (SSc).Method: A forward-backward translation procedure was used. Content validity was assessed through interviews with 11 people with SSc and 10 healthcare professionals. Construct validity, internal consistency, test-retest reliability, and floor and ceiling effects were evaluated in 104 SSc patients.Results: The content validity of the SEMCD-Swe was interpreted as satisfactory, but some adjustments were made to increase the understanding. Confirmatory factor analysis supported a single-factor structure. Moderate to strong correlations between the SEMCD-Swe and Scleroderma Health Assessment Questionnaire; Multidimensional Assessment of Fatigue; Patient Health Questionnaire-8 (rs = -0.4 to -0.7), and RAND-36 subscales (rs = 0.5 to 0.7) were found. Weak correlations were found between SEMCD-Swe and modified Rodnan skin score; and disease severity of peripheral vascular and lung (rs = -0.1 to -0.2) and kidney (rs = 0.1) systems (Medsger severity scale). Cronbach's alpha was sufficient (0.85) and corrected item-to-total correlations were good (≥ 0.50). The intraclass correlation coefficient for the total score was sufficient (0.82). No floor or ceiling effects were found.Conclusion: Support for construct validity was indicated, as the SEMCD-Swe in SSc show a single-factor structure and is more strongly associated with pain, fatigue, depressive symptoms, interferences with daily activities, disability, and quality of life than with disease severity. Our results also indicate support for content validity and reliability. However, the responsiveness of the SEMCD-Swe needs to be tested.
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Affiliation(s)
- M Mattsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Physiotherapy, Sunderby Hospital, Luleå, Sweden
| | - G Sandqvist
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - R Hesselstrand
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Rheumatology, Skåne University Hospital, Lund, Sweden
| | - D Olsson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - L Kwakkenbos
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - A Nordin
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Unit of Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - C Boström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
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11
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Wojeck RK, Bailey DE, Somers TJ, Knisely MR. Self-management interventions in systemic sclerosis: A systematic review. Res Nurs Health 2021; 44:376-392. [PMID: 33651396 PMCID: PMC7971253 DOI: 10.1002/nur.22118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 12/12/2020] [Accepted: 02/02/2021] [Indexed: 11/07/2022]
Abstract
Systemic sclerosis is a rare and incurable autoimmune disease in which patients are challenged with self-managing their disease. Systematic evaluation of the essential self-management intervention components and self-management outcomes is necessary to assess the state of the science of self-management for patients with systemic sclerosis. As such, the purpose of this systematic review was to identify and describe self-management interventions and their impact on self-management outcomes in adults with systemic sclerosis. Studies were included if they contained a self-management intervention, incorporated at least one self-management outcome identified as a common data element by the National Institute of Nursing Research (i.e., patient activation, self-efficacy, self-regulation, global health), and were conducted in adults with systemic sclerosis. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, PubMed, Cumulative Index of Nursing and Allied Health Literature, and Embase were searched from the inception of each database to March 2020, yielding a total of 215 studies. Of these reports, 16 met the inclusion criteria for this review. There was notable variability in the types of self-management interventions and their effects on key self-management outcomes. Self-management interventions focused on improving physical function through rehabilitation programs were the most common interventions (n = 7). The poor methodological quality of the studies included in this systematic review, however, limited the synthesis of and recommendations for self-management interventions in adults with systemic sclerosis. Future research in systemic sclerosis should include key self-management outcomes in larger, more rigorously designed studies to allow for comparisons across studies and to advance the science of self-management.
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Affiliation(s)
- Robyn K. Wojeck
- Duke University School of Nursing, Durham, North Carolina, USA
| | | | - Tamara J. Somers
- Department of Psychiatry and Behavioral, Sciences, Duke University, Durham, North Carolina, USA
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12
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Murphy SL, Kratz AL, Whibley D, Poole JL, Khanna D. Fatigue and Its Association With Social Participation, Functioning, and Quality of Life in Systemic Sclerosis. Arthritis Care Res (Hoboken) 2021; 73:415-422. [PMID: 31841268 DOI: 10.1002/acr.24122] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/13/2019] [Accepted: 12/10/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Fatigue is consistently ranked as one of the most problematic symptoms of systemic sclerosis (SSc), but the impact of fatigue on daily life is not well characterized. The purpose of this study was to examine the contribution of fatigue to deficits in social participation, functioning, and quality of life. METHODS Baseline data from a sample undertaking a clinical trial were utilized (n = 267). Fatigue, pain interference, depressive symptoms, physical function, and social participation were assessed by measures from the Patient-Reported Outcomes Measurement Information System. Hierarchical linear regressions were performed to determine the unique contribution of fatigue to social participation, physical function, and quality of life above and beyond the effects of demographic and clinical variables, pain interference, and depressive symptoms. RESULTS The sample was predominantly female (91%), with an average age of 53.7 years, average disease duration of 9 years, and a mean fatigue T score of 58.7. Of all outcomes, fatigue was most strongly associated with deficits in social participation, explaining 48% of the variance beyond demographic and clinical factors, which is similar to the amount of variance contributed by pain interference and depressive symptoms combined (49%). Fatigue also accounted for significant amounts of variance in physical function and quality of life (R2 = 0.27 and 0.33, respectively) above and beyond the effects of demographic and clinical factors. CONCLUSION Fatigue is an important clinical problem in SSc and is strongly associated with decreased participation in social roles and activities. Rehabilitation interventions that focus on fatigue management may be necessary to maximize participation.
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Affiliation(s)
- Susan L Murphy
- University of Michigan and Ann Arbor Veterans Affairs Health Care System, Ann Arbor, USA
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13
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Sommer SJ, Harel D, Kwakkenbos L, Carrier ME, Gholizadeh S, Gottesman K, Leite C, Malcarne VL, Thombs BD. Assessing differential item functioning for the Social Appearance Anxiety Scale: a Scleroderma atient-centred Intervention Network (SPIN) Cohort Study. BMJ Open 2020; 10:e037639. [PMID: 33046467 PMCID: PMC7552836 DOI: 10.1136/bmjopen-2020-037639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The Social Appearance Anxiety Scale (SAAS) is a 16-item questionnaire developed to evaluate fear of appearance-based evaluation by others. The primary objective of this research was to investigate the existence of differential item functioning (DIF) for the 16 SAAS items, comparing patients who completed the SAAS in English and French, either to confirm that scores are comparable or provide guidance on calculating comparable scores. A secondary research objective was to investigate the existence of DIF based on sex and disease status. A tertiary research objective was to assess DIF related to language, sex, and disease status on the recently developed SAAS-5. DESIGN This was a cross-sectional analysis using baseline data from patients enrolled in the Scleroderma Patient-centred Intervention Network (SPIN). SETTING SPIN patients included in the present study were enrolled at 43 centres in Canada, USA, UK, France and Australia, with questionnaires completed in April 2014 to July 2019. PARTICIPANTS 1640 SPIN patients completed the SAAS in French (n=600) or English (n=1040). PRIMARY AND SECONDARY MEASURES The SAAS was collected along with demographic and disease characteristics. RESULTS Six items were identified with statistically significant language-based DIF, four with sex-based DIF and one with disease type-based DIF. However, factor scores before and after accounting for DIF were similar (Pearson correlation >0.99), and individual score differences were small. This was true for both the full and shortened versions of the SAAS. CONCLUSION SAAS and SAAS-5 scores are comparable across language, sex, and disease-type, despite small differences in how patients respond to some items.
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Affiliation(s)
- Sophia J Sommer
- Applied Statistics, Social Science and Humanities, New York University, New York, New York, USA
- PRIISM Applied Statistics Center, New York University, New York, New York, USA
| | - Daphna Harel
- Applied Statistics, Social Science and Humanities, New York University, New York, New York, USA
- PRIISM Applied Statistics Center, New York University, New York, New York, USA
| | - Linda Kwakkenbos
- Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Shadi Gholizadeh
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
- Psychiatry, McGill University, Montreal, Quebec, Canada
| | | | - Catarina Leite
- School of Psychology, University of Minho, Braga, Portugal
| | - Vanessa L Malcarne
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
- Psychology, San Diego State University, San Diego, California, USA
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Psychiatry, McGill University, Montreal, Quebec, Canada
- Medicine, McGill University, Montreal, Quebec, Canada
- Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Psychology, McGill University, Montreal, Quebec, Canada
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Thombs BD, Kwakkenbos L, Carrier ME, Bourgeault A, Tao L, Harb S, Gagarine M, Rice D, Bustamante L, Ellis K, Duchek D, Wu Y, Bhandari PM, Neupane D, Carboni-Jiménez A, Henry RS, Krishnan A, Sun Y, Levis B, He C, Turner KA, Benedetti A, Culos-Reed N, El-Baalbaki G, Hebblethwaite S, Bartlett SJ, Dyas L, Patten S, Varga J. Protocol for a partially nested randomised controlled trial to evaluate the effectiveness of the scleroderma patient-centered intervention network COVID-19 home-isolation activities together (SPIN-CHAT) program to reduce anxiety among at-risk scleroderma patients. J Psychosom Res 2020; 135:110132. [PMID: 32521358 PMCID: PMC7224675 DOI: 10.1016/j.jpsychores.2020.110132] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/03/2020] [Accepted: 05/04/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Contagious disease outbreaks and related restrictions can lead to negative psychological outcomes, particularly in vulnerable populations at risk due to pre-existing medical conditions. No randomised controlled trials (RCTs) have tested interventions to reduce mental health consequences of contagious disease outbreaks. The primary objective of the Scleroderma Patient-centered Intervention Network COVID-19 Home-isolation Activities Together (SPIN-CHAT) Trial is to evaluate the effect of a videoconference-based program on symptoms of anxiety. Secondary objectives include evaluating effects on symptoms of depression, stress, loneliness, boredom, physical activity, and social interaction. METHODS The SPIN-CHAT Trial is a pragmatic RCT that will be conducted using the SPIN-COVID-19 Cohort, a sub-cohort of the SPIN Cohort. Eligible participants will be SPIN-COVID-19 Cohort participants without a positive COVID-19 test, with at least mild anxiety (PROMIS Anxiety 4a v1.0 T-score ≥ 55), not working from home, and not receiving current counselling or psychotherapy. We will randomly assign 162 participants to intervention groups of 7 to 10 participants each or waitlist control. We will use a partially nested RCT design to reflect dependence between individuals in training groups but not in the waitlist control. The SPIN-CHAT Program includes activity engagement, education on strategies to support mental health, and mutual participant support. Intervention participants will receive the 4-week (3 sessions per week) SPIN-CHAT Program via videoconference. The primary outcome is PROMIS Anxiety 4a score immediately post-intervention. ETHICS AND DISSEMINATION The SPIN-CHAT Trial will test whether a brief videoconference-based intervention will improve mental health outcomes among at-risk individuals during contagious disease outbreak.
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Affiliation(s)
- Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada; Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada; Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada.
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Angelica Bourgeault
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Maria Gagarine
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Danielle Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Laura Bustamante
- Department of Applied Human Sciences, Concordia University, Montreal, Quebec, Canada
| | - Kelsey Ellis
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Delaney Duchek
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Parash Mani Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Andrea Carboni-Jiménez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, UK
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Kimberly A Turner
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Nicole Culos-Reed
- Department of Applied Human Sciences, Concordia University, Montreal, Quebec, Canada; Department of Oncology, Cumming School of Medicine, Calgary, Canada; Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, Canada
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Shannon Hebblethwaite
- Department of Applied Human Sciences, Concordia University, Montreal, Quebec, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Laura Dyas
- Scleroderma Foundation Michigan Chapter, Southfield, MI, USA
| | - Scott Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - John Varga
- Northwestern Scleroderma Program, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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15
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Mattsson M, Sandqvist G, Hesselstrand R, Nordin A, Boström C. Validity and reliability of the Patient Health Questionnaire-8 in Swedish for individuals with systemic sclerosis. Rheumatol Int 2020; 40:1675-1687. [PMID: 32661929 PMCID: PMC7452881 DOI: 10.1007/s00296-020-04641-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/29/2020] [Indexed: 12/18/2022]
Abstract
Background Depressive symptoms are common in rheumatic diseases and influence patients’ quality of life. The Patient Health Questionnaire-9 (PHQ-9), which assesses symptoms of depression, is valid in English in patients with systemic sclerosis (SSc). However, the measurement properties of the PHQ-8 (short version of the PHQ-9) have not been evaluated in Swedish patients with SSc. Objective To investigate different aspects of validity and reliability of the PHQ-8 in Swedish (PHQ-8 Swe) for individuals with SSc. Methods A total of 101 patients with SSc participated. Content validity was evaluated via interviews of 11 patients and 10 health professionals. Construct validity, internal consistency test–retest reliability, and floor/ceiling effects were evaluated in 90 patients. Results Content validity was satisfactory, but some linguistic adjustments were made. Confirmatory factor analysis supported a better fit for a two-factor structure. Moderate-to-strong correlations were found between the PHQ-8 Swe and scleroderma HAQ including VAS (rs = 0.4–0.7); Multidimensional Assessment of Fatigue (rs = 0.7); RAND-36 subscales (rs = − 0.5 to − 0.8); and lung disease severity (Medsger scores) (rs = 0.4). There were weak correlations (rs = <0.4) between the PHQ-8 Swe and modified Rodnan skin score; and vascular, heart, and kidney disease severity. Cronbach’s alpha was 0.85, corrected item-to-total correlations were >0.40, and the ICC for the total score was 0.83. No floor/ceiling effects were found. Conclusion The PHQ-8 Swe has satisfactory content validity and sufficient reliability in patients with in majority limited SSc. It is more strongly associated with self-reported disability, pain, disease interferences with daily activities, fatigue, and quality of life than with disease severity, except for a moderate association with lung severity.
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Affiliation(s)
- Malin Mattsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Stockholm, Sweden. .,Department of Physiotherapy, Sunderby Hospital, Luleå, Sweden.
| | - Gunnel Sandqvist
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Rheumatology, Skåne University Hospital, Lund, Sweden
| | - Roger Hesselstrand
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Rheumatology, Skåne University Hospital, Lund, Sweden
| | - Annica Nordin
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Unit of Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Carina Boström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Stockholm, Sweden.,Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden
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16
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Condon SE, Roesch SC, Clements PJ, Furst DE, Weisman MH, Malcarne VL. Coping profiles and health outcomes among individuals with systemic sclerosis: A latent profile analysis approach. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2020; 5:231-236. [DOI: 10.1177/2397198320930138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 04/17/2020] [Indexed: 11/16/2022]
Abstract
Background: Systemic sclerosis has negative implications for quality of life, and coping is a mechanism by which individuals can adapt more successfully to illness. This study (1) identified coping profiles in patients with systemic sclerosis and (2) examined distress and disability correlates of the profiles. Methods: A sample of 93 patients with confirmed diagnoses of systemic sclerosis received clinical examinations and reported on coping, psychological distress, and health-related disability. Latent profile analysis was used to identify coping-based profile groups. The profile groups were then compared on psychological distress and health-related disability, controlling for disease severity. Results: A two-profile solution was supported: Active Copers emphasized problem-focused, social support, counting blessings, and religious approaches to coping with systemic sclerosis. Passive Copers emphasized blaming self and others, avoidance, and wishful thinking approaches to coping. Active Copers reported significantly less psychological distress than Passive Copers, but no significant differences were found for health-related disability. Discussion: The findings identify multidimensional patterns of coping that are differentially related to psychological distress in systemic sclerosis patients. These findings can inform coping-based interventions for patients with systemic sclerosis.
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Affiliation(s)
- Shelley E Condon
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Scott C Roesch
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California San Diego, San Diego, CA, USA
| | - Philip J Clements
- Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Daniel E Furst
- Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Michael H Weisman
- Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California San Diego, San Diego, CA, USA
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17
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Fox RS, Mills SD, Gholizadeh S, Merz EL, Roesch SC, Clements PJ, Kafaja S, Khanna D, Furst DE, Malcarne VL. Validity and correlates of the Brief Satisfaction With Appearance Scale for patients with limited and diffuse systemic sclerosis: Analysis from the University of California, Los Angeles Scleroderma Quality of Life Study. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2020; 5:143-151. [PMID: 35382027 DOI: 10.1177/2397198319890813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/14/2019] [Indexed: 11/16/2022]
Abstract
Objective The Brief Satisfaction With Appearance Scale measures two dimensions (Dissatisfaction with Appearance and Social Discomfort) of body image dissatisfaction in systemic sclerosis. This study examined the structural validity of the Brief Satisfaction With Appearance Scale across limited and diffuse systemic sclerosis subtypes, compared body image dissatisfaction by systemic sclerosis subtype, and identified the significant sociodemographic and medical correlates of body image dissatisfaction and whether they differed by subtype. Methods Participants were 183 adults participating in the University of California, Los Angeles Scleroderma Quality of Life Study with limited cutaneous (n = 101) or diffuse cutaneous (n = 82) systemic sclerosis who received clinical examinations and completed questionnaires. Multiple-group confirmatory factor analysis, multivariate analysis of variance, and structural equation modeling were used. Results The Brief Satisfaction With Appearance Scale's two-factor structure fit well for both subtypes. Patients with diffuse systemic sclerosis reported greater body image dissatisfaction on both factors than patients with limited disease. Greater Dissatisfaction with Appearance was associated with younger age and being unmarried for limited patients, and with younger age and increased finger/hand skin involvement for diffuse patients. Greater Social Discomfort was associated with younger age and being unmarried for both subtypes. Conclusion The Brief Satisfaction With Appearance Scale scores can be meaningfully compared across limited and diffuse systemic sclerosis. Patients with diffuse disease reported more body image dissatisfaction than those with limited disease. Findings demonstrate that both medical and sociodemographic variables are associated with body image dissatisfaction in systemic sclerosis and can be used to identify which patients may be at increased risk for body image dissatisfaction.
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Affiliation(s)
- Rina S Fox
- San Diego State University / University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sarah D Mills
- San Diego State University / University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Durham, NC, USA
| | - Shadi Gholizadeh
- San Diego State University / University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA.,Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Erin L Merz
- Department of Psychology, California State University, Dominguez Hills, Carson, CA, USA
| | - Scott C Roesch
- San Diego State University / University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA.,Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Philip J Clements
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Suzanne Kafaja
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Dinesh Khanna
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Daniel E Furst
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Vanessa L Malcarne
- San Diego State University / University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA.,Department of Psychology, San Diego State University, San Diego, CA, USA
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18
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Creadore A, Watchmaker J, Maymone MBC, Pappas L, Lam C, Vashi NA. Cosmetic treatment in patients with autoimmune connective tissue diseases: Best practices for patients with morphea/systemic sclerosis. J Am Acad Dermatol 2020; 83:315-341. [PMID: 32360721 DOI: 10.1016/j.jaad.2019.12.081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/24/2019] [Accepted: 12/28/2019] [Indexed: 02/06/2023]
Abstract
Morphea and systemic sclerosis are inflammatory, sclerosing disorders. Morphea primarily affects the dermis and subcutaneous fat, while systemic sclerosis typically involves the skin and internal organs. Functional impairment and cosmetic disfigurement are common in both diseases. Treatment options to mitigate disease progression remain limited. Both functional impairment and cosmetic deficits negatively impact quality of life and psychological well-being in this patient population. While the number of cosmetic procedures performed in the United States continues to rise each year, limited data exist regarding best practices for correcting aesthetic deficits caused by autoimmune conditions. There is scarce information to guide safety decisions regarding laser parameters, soft tissue augmentation, treatment intervals, and the concurrent use of immune-modifying or immune-suppressing medications. Given the fears of disease reactivation and exacerbation from postprocedural inflammation along with limited data, it is difficult for clinicians to provide evidence-based cosmetic treatment with realistic expectations with regard to short- and long-term outcomes. In the first article in this continuing medical education series, we attempt to address this practice gap.
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Affiliation(s)
| | - Jacqueline Watchmaker
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Mayra B C Maymone
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Leontios Pappas
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Christina Lam
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Neelam A Vashi
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
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19
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Carrier ME, Kwakkenbos L, Nielson WR, Fedoruk C, Nielsen K, Milette K, Pope J, Frech T, Gholizadeh S, Hummers L, Johnson SR, Piotrowski P, Jewett L, Gordon J, Chung L, Bilsker D, Turner KA, Cumin J, Welling J, Fortune C, Leite C, Gottesman K, Sauve M, Rodríguez-Reyna TS, Hudson M, Larche M, van Breda W, Suarez-Almazor ME, Bartlett SJ, Malcarne VL, Mayes MD, Boutron I, Mouthon L, Wigley F, Thombs BD. The Scleroderma Patient-Centered Intervention Network Self-Management Program: Protocol for a Randomized Feasibility Trial. JMIR Res Protoc 2020; 9:e16799. [PMID: 32329747 PMCID: PMC7210498 DOI: 10.2196/16799] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/18/2020] [Accepted: 01/24/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Systemic sclerosis (SSc), or scleroderma, is a rare disease that often results in significant disruptions to activities of daily living and can negatively affect physical and psychological well-being. Because there is no known cure, SSc treatment focuses on reducing symptoms and disability and improving health-related quality of life (HRQoL). Self-management programs are known to increase self-efficacy for disease management in many chronic diseases. The Scleroderma Patient-centered Intervention Network (SPIN) developed a Web-based self-management program (SPIN self-management; SPIN-SELF) to increase self-efficacy for disease management and to improve HRQoL for patients with SSc. OBJECTIVE The proposed study aims to assess the feasibility of conducting a full-scale randomized controlled trial (RCT) of the SPIN-SELF program by evaluating the trial implementation processes, required resources and management, scientific aspects, and participant acceptability and usage of the SPIN-SELF program. METHODS The SPIN-SELF feasibility trial will be conducted via the SPIN Cohort. The SPIN Cohort was developed as a framework for embedded pragmatic trials using the cohort multiple RCT design. In total, 40 English-speaking SPIN Cohort participants with low disease management self-efficacy (Self-Efficacy for Managing Chronic Disease Scale score ≤7), who have indicated interest in using a Web-based self-management program, will be randomized with a 3:2 ratio into the SPIN-SELF program or usual care for 3 months. Feasibility outcomes include trial implementation processes, required resources and management, scientific aspects, and patient acceptability and usage of the SPIN-SELF program. RESULTS Enrollment of the 40 participants occurred between July 5, 2019, and July 27, 2019. By November 25, 2019, data collection of trial outcomes was completed. Data analysis is underway, and results are expected to be published in 2020. CONCLUSIONS The SPIN-SELF program is a self-help tool that may improve disease-management self-efficacy and improve HRQoL in patients with SSc. The SPIN-SELF feasibility trial will ensure that trial methodology is robust, feasible, and consistent with trial participant expectations. The results will guide adjustments that need to be implemented before undertaking a full-scale RCT of the SPIN-SELF program. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/16799.
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Affiliation(s)
- Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, Netherlands
| | | | - Claire Fedoruk
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Karen Nielsen
- Scleroderma Society of Ontario, Hamilton, ON, Canada
| | - Katherine Milette
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Janet Pope
- University of Western Ontario, London, ON, Canada
| | - Tracy Frech
- University of Utah, Salt Lake City, UT, United States
| | - Shadi Gholizadeh
- California School of Professional Psychology/Alliant, Los Angeles, CA, United States
| | - Laura Hummers
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Sindhu R Johnson
- Toronto Scleroderma Program, Mount Sinai Hospital & Toronto Western Hospital, Toronto, ON, Canada.,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | | | - Lisa Jewett
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Jessica Gordon
- Hospital for Special Surgery, New York, NY, United States
| | - Lorinda Chung
- Departments of Pediatrics, Biomedical Data Science, Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Dan Bilsker
- Simon Fraser University, Burnaby, BC, Canada.,University of British Columbia, Vancouver, BC, Canada
| | - Kimberly A Turner
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Julie Cumin
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Joep Welling
- NVLE Dutch patient organization for systemic autoimmune diseases, Utrecht, Netherlands
| | | | | | | | - Maureen Sauve
- Scleroderma Society of Ontario, Hamilton, ON, Canada.,Scleroderma Canada, Hamilton, ON, Canada
| | | | - Marie Hudson
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
| | | | - Ward van Breda
- Faculty of Behavioural and Movement Sciences, Vrije University, Amsterdam, Netherlands
| | | | | | | | - Maureen D Mayes
- University of Texas McGovern School of Medicine, Houston, TX, United States
| | - Isabelle Boutron
- Université Paris Descartes, Paris, France.,Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Luc Mouthon
- Université Paris Descartes, Paris, France.,Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Fredrick Wigley
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Brett D Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Psychology, McGill University, Montreal, QC, Canada.,Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
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20
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Harb S, Cumin J, Rice DB, Peláez S, Hudson M, Bartlett SJ, Roren A, Furst DE, Frech TM, Nguyen C, Nielson WR, Thombs BD, Shrier I. Identifying barriers and facilitators to physical activity for people with scleroderma: a nominal group technique study. Disabil Rehabil 2020; 43:3339-3346. [DOI: 10.1080/09638288.2020.1742391] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Julie Cumin
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Danielle B. Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
| | - Sandra Peláez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Research Centre, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Medicine, McGill University, Montreal, Canada
| | | | - Alexandra Roren
- AP-HP Cochin Hospital, Université Paris Descartes Sorbonne Paris Cité, INSERM U1153, Paris, France
| | - Daniel E. Furst
- Division of Rheumatology, Geffen School of Medicine, University of California, Los Angeles, USA
| | - Tracy M. Frech
- Department of Internal Medicine, University of Utah, Salt Lake City, USA
| | - Christelle Nguyen
- Faculté de Santé, Université de Paris, UFR Médecine Paris Descartes, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Paris, France
| | - Warren R. Nielson
- St. Joseph’s Health Care and the Lawson Health Research Institute, London, Canada
| | - Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
- Department of Medicine, McGill University, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
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21
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Thombs BD, Aguila K, Dyas L, Carrier ME, Fedoruk C, Horwood L, Cañedo-Ayala M, Sauvé M, Kwakkenbos L, Malcarne VL, El-Baalbaki G, Peláez S, Connolly K, Hudson M, Platt RW. Protocol for a partially nested randomized controlled trial to evaluate the effectiveness of the Scleroderma Patient-centered Intervention Network Support Group Leader EDucation (SPIN-SSLED) Program. Trials 2019; 20:717. [PMID: 31831073 PMCID: PMC6909446 DOI: 10.1186/s13063-019-3747-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/23/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Some people with rare diseases rely on peer-led support groups for disease-specific education and emotional and practical support. Systemic sclerosis (SSc), or scleroderma, is a rare autoimmune connective tissue disease. Many people with SSc cannot access support groups, and, when support groups exist, they may not be sustained due to challenges that could be addressed via leader training. The Scleroderma Patient-centered Intervention Network (SPIN), along with SSc patient organization partners, developed a training program for SSc patient support group leaders, the Scleroderma Support group Leader EDucation (SPIN-SSLED) Program. We recently completed a feasibility trial in which we successfully delivered the program to two groups of support group leaders who reported a high level of satisfaction with the program and its delivery. The primary objective of the full-scale SPIN-SSLED trial is to evaluate the effect of the program on support group leaders' self-efficacy for carrying out their leadership role. Secondary objectives include evaluating effects on leader burnout, leader satisfaction (participation efficacy), and emotional distress. METHODS/DESIGN The SPIN-SSLED trial is a pragmatic randomized controlled trial (RCT) in which 180 support group leaders will be randomly allocated to training groups of 6 participants each or to a waitlist control. We will use a partially nested RCT design to reflect dependence between individuals in training groups, but not in the waitlist control. Participants allocated to the training program will receive the 13-module SPIN-SSLED Program, delivered via webinar over the course of 3 months in weekly 60-90-min sessions. The primary outcome is leader self-efficacy, measured by the Scleroderma Support Group Leader Self-efficacy Scale post-intervention. Secondary outcomes are leader self-efficacy at 3 months post-intervention, and leader burnout, volunteer job satisfaction (participation efficacy), and emotional distress post-intervention and at 3 months post-intervention. DISCUSSION The SPIN-SSLED trial will test whether a training program for SSc patient support group leaders increases the self-efficacy of group leaders to carry out leadership tasks. The program has the potential to significantly improve the effectiveness and sustainability of existing SSc support groups, to increase the number of available support groups, and to be adapted for other chronic diseases. TRIAL REGISTRATION ClinicalTrials.gov, NCT03965780. Registered on 29 May 2019.
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Affiliation(s)
- Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
- Department of Psychiatry, McGill University, Montreal, QC Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC Canada
- Department of Medicine, McGill University, Montreal, QC Canada
- Department of Psychology, McGill University, Montreal, QC Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC Canada
- Biomedical Ethics Unit, McGill University, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4 Canada
| | - Kylene Aguila
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
| | - Laura Dyas
- Scleroderma Foundation Michigan Chapter, Southfield, MI USA
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
| | - Claire Fedoruk
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
| | - Linda Horwood
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
- Department of Psychiatry, McGill University, Montreal, QC Canada
| | - Mara Cañedo-Ayala
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
| | - Maureen Sauvé
- Scleroderma Society of Ontario and Scleroderma Canada, Hamilton, ON Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Vanessa L. Malcarne
- Department of Psychology, San Diego State University, California, USA
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, California, USA
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montreal, QC Canada
| | - Sandra Peláez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC Canada
| | | | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
- Department of Medicine, McGill University, Montreal, QC Canada
| | - Robert W. Platt
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC Canada
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Kwakkenbos L, Cumin J, Carrier ME, Bartlett SJ, Malcarne VL, Mouthon L, Nielson WR, Rannou F, Welling J, Thombs BD. Factors associated with patient-reported likelihood of using online self-care interventions: a Scleroderma Patient-centered Intervention Network (SPIN) cohort study. BMJ Open 2019; 9:e029542. [PMID: 31615796 PMCID: PMC6797412 DOI: 10.1136/bmjopen-2019-029542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 08/26/2019] [Accepted: 08/29/2019] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES The Scleroderma Patient-centered Intervention Network (SPIN) Cohort uses the cohort multiple randomised controlled trial design to embed trials of online self-care interventions for people living with systemic sclerosis (SSc; scleroderma). To offer interventions to patients interested in using them, participants complete signalling items that query about the likelihood that patients would agree to participate in nine different hypothetical online programmes addressing common SSc-related problems. It is not known what factors influence patient-reported interest in participating in a particular online intervention and if intervention-specific signalling questions provide unique information or replicate broader characteristics, such as overall willingness to participate or self-efficacy. This study assessed factors that explain responses to intervention-specific signalling items. DESIGN Cross-sectional survey. SETTING SPIN Cohort participants enrolled at 42 centres from Canada, the USA, the UK, France, Spain and Mexico who completed study questionnaires from March 2014 to January 2018 were included. MEASURES Demographic and disease characteristics, self-efficacy and symptoms related to each specific intervention were completed in addition to signalling items. General likelihood of using interventions was calculating by taking the mean score of the remaining signalling questions. PARTICIPANTS 1060 participants with complete baseline data were included in the analyses. RESULTS For all individual signalling questions, controlling for other variables, the mean of the remaining signalling questions was the strongest predictor (standardised regression coefficient β from 0.61 (sleep) to 0.80 (self-management)). Smaller, but statistically significant, associations were found with the symptom associated with the respective signalling question and with general self-efficacy for 7 of 9 signalling questions. CONCLUSIONS The main factor associated with patients' interest in participating in a disease-specific online self-care intervention is their general interest in participating in online interventions. Factors that may influence this general interest should be explored and taken into consideration when inviting patients to try online interventions.
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Affiliation(s)
- Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, The Netherlands
| | - Julie Cumin
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Monteal, Québec, Canada
- McGill University Health Center, Montréal, Québec, Canada
- Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, California, USA
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
| | - Luc Mouthon
- Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Descartes, Paris, France
- Service de Médecine Interne, Hôpital Cochin, Paris, France
| | - Warren R Nielson
- Beryl & Richard Ivey Rheumatology Day Programs, St. Joseph's Health Care, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - François Rannou
- Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Descartes, Paris, France
| | - Joep Welling
- NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Medicine, McGill University, Monteal, Québec, Canada
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
- Department of Psychology, McGill University, Montréal, Québec, Canada
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Harel D, Mills SD, Kwakkenbos L, Carrier ME, Nielsen K, Portales A, Bartlett SJ, Malcarne VL, Thombs BD. Shortening patient-reported outcome measures through optimal test assembly: application to the Social Appearance Anxiety Scale in the Scleroderma Patient-centered Intervention Network Cohort. BMJ Open 2019; 9:e024010. [PMID: 30798308 PMCID: PMC6398718 DOI: 10.1136/bmjopen-2018-024010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The Social Appearance Anxiety Scale (SAAS) is a 16-item measure that assesses social anxiety in situations where appearance is evaluated. The objective was to use optimal test assembly (OTA) methods to develop and validate a short-form SAAS based on objective and reproducible criteria. DESIGN This study was a cross-sectional analysis of baseline data from adults enrolled in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort. SETTING Adults in the SPIN Cohort in the present study were enrolled at 28 centres in Canada, the USA and the UK. PARTICIPANTS The SAAS was administered to 926 adults with scleroderma. PRIMARY AND SECONDARY MEASURES The SAAS, Brief Fear of Negative Evaluation II (BFNE II), Brief Satisfaction with Appearance Scale (Brief-SWAP), Patient Health Questionnaire-8 (PHQ8) and Social Interaction Anxiety Scale-6 (SIAS-6) were collected, as well as demographic characteristics. RESULTS OTA methods identified a maximally informative shortened version for each possible form length between 1 and 15 items. The final shortened version was selected based on prespecified criteria for reliability, concurrent validity and statistically equivalent convergent validity with the BFNE II scale. A five-item short version was selected (SAAS-5). The SAAS-5 had a Cronbach's α of 0.95 and had high concurrent validity with the full-length form (r=0.97). The correlation of the SAAS-5 with the BFNE II was 0.66, which was statistically equivalent to that of the full-length form. Furthermore, the correlation of the SAAS-5 with the two subscales of the Brief-SWAP, and the SIAS-6, were statistically equivalent to that of the full-length form. CONCLUSIONS OTA was an efficient method for shortening the full-length SAAS to create the SAAS-5.
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Affiliation(s)
- Daphna Harel
- Applied Statistics, Social Science, Humanities, New York University, New York City, New York, USA
- PRIISM Applied Statistics Center, New York University, New York City, New York, USA
| | - Sarah D Mills
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, UK
| | - Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Karen Nielsen
- Scleroderma Society of Ontario, Hamilton, Ontario, Canada
| | | | - Susan J Bartlett
- Department of Medicine, McGill University, Monteal, Quebec, Canada
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, California, USA
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
| | - Brett D Thombs
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Abstract
PURPOSE OF REVIEW This review presents evidence on support group effectiveness in common diseases, research on support groups in systemic sclerosis (SSc), and work underway by the Scleroderma Patient-centered Intervention Network in collaboration with patient organizations to train SSc support group leaders in order to improve support group access and the experiences of support groups for members and leaders. RECENT FINDINGS Giving and receiving emotional and practical support from others with SSc is an important reason that individuals with SSc attend support groups, but many patients cannot access support groups. SSc support group leaders report confidence in their ability to facilitate groups, but are less confident in tasks such as managing group dynamics and sustaining the group. The Scleroderma Support group Leader EDucation (SPIN-SSLED) Program was developed to provide training to support group leaders and was recently tested through a feasibility trial. A full-scale trial will commence in 2019.
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Unmet Needs in Systemic Sclerosis Understanding and Treatment: the Knowledge Gaps from a Scientist's, Clinician's, and Patient's Perspective. Clin Rev Allergy Immunol 2019; 55:312-331. [PMID: 28866756 PMCID: PMC6244948 DOI: 10.1007/s12016-017-8636-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Systemic sclerosis (SSc) is a highly heterogeneous disease caused by a complex molecular circuitry. For decades, clinical and molecular research focused on understanding the primary process of fibrosis. More recently, the inflammatory, immunological and vascular components that precede the actual onset of fibrosis, have become a matter of increasing scientific scrutiny. As a consequence, the field has started to realize that the early identification of this syndrome is crucial for optimal clinical care as well as for understanding its pathology. The cause of SSc cannot be appointed to a single molecular pathway but to a multitude of molecular aberrances in a spatial and temporal matter and on the backbone of the patient's genetic predisposition. These alterations underlie the plethora of signs and symptoms which patients experience and clinicians look for, ultimately culminating in fibrotic features. To solve this complexity, a close interaction among the patient throughout its "journey," the clinician through its clinical assessments and the researcher with its experimental design, seems to be required. In this review, we aimed to highlight the features of SSc through the eyes of these three professionals, all with their own expertise and opinions. With this unique setup, we underscore the importance of investigating the role of environmental factors in the onset and perpetuation of SSc, of focusing on the earliest signs and symptoms preceding fibrosis and on the application of holistic research approaches that include a multitude of potential molecular alterations in time in an unbiased fashion, in the search for a patient-tailored cure.
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Gholizadeh S, Meier A, Malcarne VL. Measuring and managing appearance anxiety in patients with systemic sclerosis. Expert Rev Clin Immunol 2019; 15:341-346. [PMID: 30681381 DOI: 10.1080/1744666x.2019.1573673] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Systemic sclerosis (SSc, scleroderma) is a progressive, autoimmune, connective tissue disease of unknown etiology that can cause changes in appearance in socially important areas of the body (e.g. face and hands). Social concerns related to changes in appearance can contribute to anxiety specific to situations where one's appearance will be evaluated, or appearance anxiety. Appearance anxiety is a relevant but underexplored construct in SSc. Areas covered: We review the current knowledge on appearance anxiety in SSc, including assessment of the construct and interventions. Relevant references in the field were obtained through a literature search in MEDLINE/PubMed and PsycINFO for articles published through September 2018. Expert commentary: There is a dearth of research in the SSc literature examining the construct of appearance anxiety. A growing interest in appearance anxiety in SSc has led to several relevant measures being validated in this population, including the Social Appearance Anxiety Scale. Important areas for future research are the development of interventions to address appearance anxiety and the use of randomized controlled trials to evaluate these interventions.
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Affiliation(s)
- Shadi Gholizadeh
- a Department of Psychiatry , McGill University , Montréal , Canada.,b Department of Psychology , San Diego State University , San Diego , CA , USA
| | - Annie Meier
- b Department of Psychology , San Diego State University , San Diego , CA , USA
| | - Vanessa L Malcarne
- b Department of Psychology , San Diego State University , San Diego , CA , USA.,c Departments of Psychology and Psychiatry , SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology , San Diego , CA , USA
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Bourne AM, Johnston RV, Cyril S, Briggs AM, Clavisi O, Duque G, Harris IA, Hill C, Hiller C, Kamper SJ, Latimer J, Lawson A, Lin CWC, Maher C, Perriman D, Richards BL, Smitham P, Taylor WJ, Whittle S, Buchbinder R. Scoping review of priority setting of research topics for musculoskeletal conditions. BMJ Open 2018; 8:e023962. [PMID: 30559158 PMCID: PMC6303563 DOI: 10.1136/bmjopen-2018-023962] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Describe research methods used in priority-setting exercises for musculoskeletal conditions and synthesise the priorities identified. DESIGN Scoping review. SETTING AND POPULATION Studies that elicited the research priorities of patients/consumers, clinicians, researchers, policy-makers and/or funders for any musculoskeletal condition were included. METHODS AND ANALYSIS We searched MEDLINE and EMBASE from inception to November 2017 and the James Lind Alliance top 10 priorities, Cochrane Priority Setting Methods Group, and Cochrane Musculoskeletal and Back Groups review priority lists. The reported methods and research topics/questions identified were extracted, and a descriptive synthesis conducted. RESULTS Forty-nine articles fulfilled our inclusion criteria. Methodologies and stakeholders varied widely (26 included a mix of clinicians, consumers and others, 16 included only clinicians, 6 included only consumers or patients and in 1 participants were unclear). Only two (4%) reported any explicit inclusion criteria for priorities. We identified 294 broad research priorities from 37 articles and 246 specific research questions from 17 articles, although only four (24%) of the latter listed questions in an actionable format. Research priorities for osteoarthritis were identified most often (n=7), followed by rheumatoid arthritis (n=4), osteoporosis (n=4) and back pain (n=4). Nearly half of both broad and specific research priorities were focused on treatment interventions (n=116 and 111, respectively), while few were economic (n=8, 2.7% broad and n=1, 0.4% specific), implementation (n=6, 2% broad and n=4, 1.6% specific) or health services and systems research (n=15, 5.1% broad and n=9, 3.7% specific) priorities. CONCLUSIONS While many research priority-setting studies in the musculoskeletal field have been performed, methodological limitations and lack of actionable research questions limit their usefulness. Future studies should ensure they conform to good priority-setting practice to ensure that the generated priorities are of maximum value. PROSPERO REGISTRATION NUMBER CRD42017059250.
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Affiliation(s)
- Allison M Bourne
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Renea V Johnston
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sheila Cyril
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Andrew M Briggs
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | | | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Victoria, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ian A Harris
- South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Catherine Hill
- Division of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Rheumatology Unit, Queen Elizabeth Hospital, Woodville, South Australia, Australia
- Department of Rheumatology Unit, Royal Adelaide Hospital, North Terrace, Adelaide, Australia
| | - Claire Hiller
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Steven J Kamper
- Centre for Pain, Health and Lifestyle, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jane Latimer
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew Lawson
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | | | - Christopher Maher
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Diana Perriman
- Trauma and Orthopaedic Research Unit, Canberra Hospital, Woden, Australian Capital Territory, Australia
- Medical School, College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Bethan L Richards
- Rheumatology Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Peter Smitham
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | - Sam Whittle
- Department of Rheumatology Unit, Queen Elizabeth Hospital, Woodville, South Australia, Australia
| | - Rachelle Buchbinder
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Fox RS, Kwakkenbos L, Carrier M, Mills SD, Gholizadeh S, Jewett LR, Roesch SC, Merz EL, Assassi S, Furst DE, Gottesman K, Mayes MD, Thombs BD, Malcarne VL, Baron M, Bartlett SJ, Ells C, Hudson M, Jang Y, Körner A, Kafaja S, Hoogen F, Mouthon L, Nielson WR, Riggs R, Nielsen K, Wigley F, Boutron I, Maia AC, Leite C, El‐Baalbaki G, Ende C, Fligelstone K, Frech T, Godard D, Harel D, Impens A, Johnson SR, Kennedy AT, Khalidi N, Marra C, Pope J, Portales A, Luna D, Schouffoer AA, Levis B, Suarez‐Almazor ME, Welling J, Wong‐Rieger D, Agard C, Ikic A, Smets P, Roux S, Terrier B, Hij A, Berthier S, Rodriguez E, Chung L, Gill A, Domsic R, Wilcox P, Fortin PR, Spiera R, Granel‐Rey B, Grange C, Sobanski V, Herrick AL, Varga J, Jones N, Manning J, Martin T, Maurier F, Rivière S, Robinson D, Smith D, Steen V, Sutton E, Thorne C, Turner K. Reliability and Validity of Three Versions of the Brief Fear of Negative Evaluation Scale in Patients With Systemic Sclerosis: A Scleroderma Patient‐Centered Intervention Network Cohort Study. Arthritis Care Res (Hoboken) 2018; 70:1646-1652. [DOI: 10.1002/acr.23532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/30/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Rina S. Fox
- Northwestern University Feinberg School of Medicine, Chicago, Illinois and San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology San Diego
| | - Linda Kwakkenbos
- Lady Davis Institute for Medical Research, Jewish General Hospital, and McGill University, Montreal, Quebec, Canada and Radboud University Nijmegen The Netherlands
| | - Marie‐Eve Carrier
- Lady Davis Institute for Medical Research Jewish General Hospital Montreal Quebec Canada
| | - Sarah D. Mills
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology San Diego
| | - Shadi Gholizadeh
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology San Diego
| | - Lisa R. Jewett
- Lady Davis Institute for Medical Research, Jewish General Hospital and McGill University Montreal Quebec Canada
| | - Scott C. Roesch
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology and San Diego State University San Diego
| | - Erin L. Merz
- California State University Dominguez Hills Carson
| | | | - Daniel E. Furst
- Geffen School of Medicine at the University of California Los Angeles
| | | | | | - Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital and McGill UniversityMontreal Quebec Canada
| | - Vanessa L. Malcarne
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology and San Diego State University San Diego
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Cañedo-Ayala M, Rice DB, Levis B, Carrier ME, Cumin J, Malcarne VL, Hagedoorn M, Thombs BD. Factors associated with symptoms of depression among informal caregivers of people with systemic sclerosis: a cross-sectional study. Disabil Rehabil 2018; 42:394-399. [DOI: 10.1080/09638288.2018.1500647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Mara Cañedo-Ayala
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | - Danielle B. Rice
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
| | - Brooke Levis
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | - Julie Cumin
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | - Vanessa L. Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Mariët Hagedoorn
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Brett D. Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
- Department of Medicine, McGill University, Montreal, Canada
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Merz EL, Kwakkenbos L, Carrier ME, Gholizadeh S, Mills SD, Fox RS, Jewett LR, Williamson H, Harcourt D, Assassi S, Furst DE, Gottesman K, Mayes MD, Moss TP, Thombs BD, Malcarne VL. Factor structure and convergent validity of the Derriford Appearance Scale-24 using standard scoring versus treating 'not applicable' responses as missing data: a Scleroderma Patient-centered Intervention Network (SPIN) cohort study. BMJ Open 2018; 8:e018641. [PMID: 29511009 PMCID: PMC5855329 DOI: 10.1136/bmjopen-2017-018641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Valid measures of appearance concern are needed in systemic sclerosis (SSc), a rare, disfiguring autoimmune disease. The Derriford Appearance Scale-24 (DAS-24) assesses appearance-related distress related to visible differences. There is uncertainty regarding its factor structure, possibly due to its scoring method. DESIGN Cross-sectional survey. SETTING Participants with SSc were recruited from 27 centres in Canada, the USA and the UK. Participants who self-identified as having visible differences were recruited from community and clinical settings in the UK. PARTICIPANTS Two samples were analysed (n=950 participants with SSc; n=1265 participants with visible differences). PRIMARY AND SECONDARY OUTCOME MEASURES The DAS-24 factor structure was evaluated using two scoring methods. Convergent validity was evaluated with measures of social interaction anxiety, depression, fear of negative evaluation, social discomfort and dissatisfaction with appearance. RESULTS When items marked by respondents as 'not applicable' were scored as 0, per standard DAS-24 scoring, a one-factor model fit poorly; when treated as missing data, the one-factor model fit well. Convergent validity analyses revealed strong correlations that were similar across scoring methods. CONCLUSIONS Treating 'not applicable' responses as missing improved the measurement model, but did not substantively influence practical inferences that can be drawn from DAS-24 scores. Indications of item redundancy and poorly performing items suggest that the DAS-24 could be improved and potentially shortened.
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Affiliation(s)
- Erin L Merz
- Department of Psychology, California State University, Dominguez Hills, Carson, California, USA
| | - Linda Kwakkenbos
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Behavioral Science Institute, Clinical Psychology, Radboud University, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Shadi Gholizadeh
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Sarah D Mills
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Rina S Fox
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lisa R Jewett
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Educational and Counseling Psychology, McGill University, Montreal, Quebec, Canada
| | - Heidi Williamson
- Centre for Appearance Research, Faculty of Health and Life Science, University of the West of England, Bristol, UK
| | - Diana Harcourt
- Centre for Appearance Research, Faculty of Health and Life Science, University of the West of England, Bristol, UK
| | - Shervin Assassi
- Department of Internal Medicine, Division of Rheumatology, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Daniel E Furst
- Division of Rheumatology, Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | | | - Maureen D Mayes
- Department of Internal Medicine, Division of Rheumatology, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Tim P Moss
- Centre for Appearance Research, Faculty of Health and Life Science, University of the West of England, Bristol, UK
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Department of Educational and Counseling Psychology, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Vanessa L Malcarne
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
- Department of Psychology, San Diego State University, San Diego, California, USA
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Validation of the Social Interaction Anxiety Scale in scleroderma: a Scleroderma Patient-centered Intervention Network Cohort study. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2017; 3:98-105. [DOI: 10.5301/jsrd.5000264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/24/2017] [Indexed: 11/20/2022]
Abstract
Introduction: Individuals with visible differences due to medical conditions, such as systemic sclerosis (SSc; scleroderma), have reported difficulty navigating social situations because of issues such as staring, invasive questions, and rude comments. Fears or anxiety linked to situations in which a person interacts with others is known as social interaction anxiety. However, there exists no validated measurement tool to examine social interaction anxiety in rheumatologic conditions. Methods: The present study examines the reliability (internal consistency) and validity (structural and convergent) of the Social Interaction Anxiety Scale-6 (SIAS-6) in a sample of 802 individuals with SSc, and compares these psychometric properties across limited and diffuse subtypes of the disease. Multi-group confirmatory factor analysis was used to examine the factor structure of the SIAS-6 in patients with both limited and diffuse SSc. Results: A one-factor structure was found to fit well for individuals with SSc with both limited and diffuse disease. The measure demonstrated strong internal consistency reliability and convergent validity with relevant measures in expected magnitudes and directions. Conclusions: The SIAS-6 is a psychometrically robust measure that can confidently be used in SSc populations to examine social interaction anxiety. Moreover, scores can meaningfully be compared between patients with limited and diffuse disease.
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Randomized feasibility trial of the Scleroderma Patient-centered Intervention Network hand exercise program (SPIN-HAND): Study protocol. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2017; 3:91-97. [DOI: 10.5301/jsrd.5000263] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 10/16/2017] [Indexed: 11/20/2022]
Abstract
Background: Significant functional impairment of the hands is nearly universal in systemic sclerosis (SSc, scleroderma). Hand exercises may improve hand function, but developing, testing and disseminating rehabilitation interventions in SSc is challenging. The Scleroderma Patient-centered Intervention Network (SPIN) was established to address this issue and has developed an online hand exercise program to improve hand function for SSc patients (SPIN-HAND). The aim of the proposed feasibility trial is to evaluate the feasibility of conducting a full-scale randomized controlled trial (RCT) of the SPIN-HAND intervention. Design and methods: The SPIN-HAND feasibility trial will be conducted via the SPIN Cohort. The SPIN Cohort was developed as a framework for embedded pragmatic trials using the cohort multiple RCT design. In total, 40 English-speaking SPIN Cohort participants with at least mild hand function limitations (Cochin Hand Function Scale ≥3) and an indicated interest in using an online hand-exercise intervention will be randomized with a 1:1 ratio to be offered to use the SPIN-HAND program or usual care for 3 months. The primary aim is to evaluate the trial implementation processes, required resources and management, scientific aspects, and participant acceptability and usage of the SPIN-HAND program. Discussion: The SPIN-HAND exercise program is a self-help tool that may improve hand function in patients with SSc. The SPIN-HAND feasibility trial will ensure that trial methodology is robust, feasible, and consistent with trial participant expectations. The results will guide adjustments that need to be implemented before undertaking a full-scale RCT of the SPIN-HAND program. Trial registration: ClinicalTrials.gov Identifier: NCT03092024.
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Sumpton D, Thakkar V, O'Neill S, Singh-Grewal D, Craig JC, Tong A. “It's Not Me, It's Not Really Me.” Insights From Patients on Living With Systemic Sclerosis: An Interview Study. Arthritis Care Res (Hoboken) 2017; 69:1733-1742. [DOI: 10.1002/acr.23207] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/24/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Daniel Sumpton
- University of Sydney; Sydney, The Children's Hospital at Westmead, Westmead, Liverpool Hospital and Ingham Institute for Applied Medical Research; Liverpool New South Wales Australia
| | - Vivek Thakkar
- Liverpool Hospital and Ingham Institute for Applied Medical Research; Liverpool, and Western Sydney University; Campbelltown New South Wales Australia
| | - Sean O'Neill
- Liverpool Hospital; University of New South Wales, and the Ingham Institute for Applied Medical Research; Liverpool New South Wales Australia
| | - Davinder Singh-Grewal
- The Children's Hospital at Westmead; Westmead, and Liverpool Hospital and Ingham Institute for Applied Medical Research; Liverpool New South Wales Australia
| | - Jonathan C. Craig
- University of Sydney; Sydney, and The Children's Hospital at Westmead; Westmead New South Wales Australia
| | - Allison Tong
- University of Sydney; Sydney, and The Children's Hospital at Westmead; Westmead New South Wales Australia
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Gumuchian ST, Peláez S, Delisle VC, Carrier ME, Jewett LR, El-Baalbaki G, Fortune C, Hudson M, Körner A, Kwakkenbos L, Bartlett SJ, Thombs BD. Understanding coping strategies among people living with scleroderma: a focus group study. Disabil Rehabil 2017; 40:3012-3021. [DOI: 10.1080/09638288.2017.1365954] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Stephanie T. Gumuchian
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Canada
| | - Sandra Peláez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Canada
| | - Vanessa C. Delisle
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada
| | - Lisa R. Jewett
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Canada
| | | | | | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada
- Department of Medicine, McGill University, Montréal, Canada
| | - Annett Körner
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Canada
| | - Linda Kwakkenbos
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, the Netherlands
| | - Susan J. Bartlett
- Department of Medicine, McGill University, Montréal, Canada
- Department of Medicine, McGill University Health Center, McGill University, Montréal, Canada
| | - Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Canada
- Department of Medicine, McGill University, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Canada
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Kwakkenbos L, Thombs BD, Khanna D, Carrier ME, Baron M, Furst DE, Gottesman K, van den Hoogen F, Malcarne VL, Mayes MD, Mouthon L, Nielson WR, Poiraudeau S, Riggs R, Sauvé M, Wigley F, Hudson M, Bartlett SJ. Performance of the Patient-Reported Outcomes Measurement Information System-29 in scleroderma: a Scleroderma Patient-centered Intervention Network Cohort Study. Rheumatology (Oxford) 2017; 56:1302-1311. [PMID: 28431140 PMCID: PMC5850469 DOI: 10.1093/rheumatology/kex055] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 02/15/2017] [Indexed: 11/15/2022] Open
Abstract
Objective The Patient-Reported Outcomes Measurement Information System (PROMIS)-29 assesses seven health-related quality of life domains plus pain intensity. The objective was to examine PROMIS-29v2 validity and explore clinical associations in patients with SSc. Methods English-speaking SSc patients in the Scleroderma Patient-centered Intervention Network Cohort from 26 sites in Canada, the USA and the UK completed the PROMIS-29v2 between July 2014 and November 2015. Enrolling physicians provided medical data. To examine convergent validity, hypotheses on the direction and magnitude of correlations with legacy measures were tested. For clinical associations, t -tests were conducted for dichotomous variables and PROMIS-29v2 domain scores. Effect sizes (ESs) were labelled as small (<0.25), small to moderate (0.25-0.45), moderate (0.46-0.55), moderate to large (0.56-0.75) and large (>0.75). Results There were 696 patients (87% female), mean ( s . d .) disease duration 11.6 (8.7) years, 57% with limited cutaneous subtype. Validity indices were consistent with seven of nine hypotheses (| r | =0.51-0.87, P < 0.001), with minor divergence for two hypotheses. Gastrointestinal involvement was associated with significantly worse outcomes for all eight PROMIS-29v2 domains (moderate or moderate to large ES in six of eight). Presence of joint contractures was associated with significant decrements in seven domains (small or small to moderate ESs). Skin thickening, diffuse cutaneous subtype and presence of overlap syndromes were significantly associated (small or small to moderate ESs) with five or six domains. Conclusion This study further establishes the validity of the PROMIS-29v2 in SSc and underlines the importance of gastrointestinal symptoms and joint contractures in reduced health-related quality of life.
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Affiliation(s)
- Linda Kwakkenbos
- Lady Davis Institute for Medical Research, Jewish General Hospital
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Department of Medicine, McGill UniversityMontréal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational HealthMcGill University, Montréal, Québec, Canada
- Department of Educational and Counselling PsychologyMcGill University, Montréal, Québec, Canada
- Department of PsychologyMcGill University, Montréal, Québec, Canada
- School of Nursing, McGill University, Montréal, Québec, Canada
| | - Dinesh Khanna
- University of Michigan Scleroderma Program, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Murray Baron
- Lady Davis Institute for Medical Research, Jewish General Hospital
- Department of Medicine, McGill UniversityMontréal, Québec, Canada
| | - Daniel E Furst
- Division of Rheumatology, Geffen School of Medicine, University of California, Los Angeles
| | | | - Frank van den Hoogen
- Department of Rheumatology, Radboud University Medical Center
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University and the University of California, San Diego, CA
| | - Maureen D Mayes
- Department of Internal Medicine, Division of Rheumatology, McGovern Medical School, University of Texas, Houston, TX, USA
| | - Luc Mouthon
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris
- Service de Médecine Interne, Hôpital Cochin, Paris, France
| | - Warren R Nielson
- Beryl & Richard Ivey Rheumatology Day Programs, St Joseph’s Health Care
- Lawson Health Research Institute, London, Ontario, Canada
| | - Serge Poiraudeau
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris
- Service de Médecine Physique et Réadaptation, Hôpital Cochin
- IFR Handicap, INSERM, Paris, France
| | | | - Maureen Sauvé
- Scleroderma Society of Ontario, Hamilton
- Scleroderma Society of Canada, Ottawa, ON, Canada
| | - Fredrick Wigley
- Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital
- Department of Medicine, McGill UniversityMontréal, Québec, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill UniversityMontréal, Québec, Canada
- Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- McGill University Health Center, Montréal, Québec, Canada
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Gholizadeh S, Mills SD, Fox RS, Merz EL, Roesch SC, Clements PJ, Kafaja S, Furst DE, Khanna D, Malcarne VL. Structural Validity of the Rheumatology Attitudes Index in Systemic Sclerosis: Analysis from the UCLA Scleroderma Quality of Life Study. J Rheumatol 2017; 44:795-798. [PMID: 28412704 DOI: 10.3899/jrheum.161080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the structural validity of the Rheumatology Attitudes Index (RAI), a widely used measure of rheumatic disease-related helplessness in patients with systemic sclerosis (SSc). METHODS Patients with physician-confirmed SSc from the University of California, Los Angeles (UCLA) Scleroderma Quality of Life Study (n = 208) received clinical examinations and completed self-report questionnaires. The structural validity of the RAI was examined through confirmatory and exploratory factor analysis (CFA/EFA). RESULTS A tenable factor structure was not identified through CFA or EFA. CONCLUSION The present structural analysis did not support the use of the RAI with SSc patients.
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Affiliation(s)
- Shadi Gholizadeh
- From the San Diego State University (SDSU)/University of California (UC) San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego; Department of Psychology, California State University, Dominguez Hills; SDSU, Department of Psychology, San Diego; David Geffen School of Medicine, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, California; University of Michigan Health System, Ann Arbor, Michigan, USA.,S. Gholizadeh, Doctoral Student, MS, MSc, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; S.D. Mills, Doctoral Student, MS, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; R.S. Fox, Postdoctoral Fellow, PhD, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; E.L. Merz, Assistant Professor, PhD, MPH, California State University, Dominguez Hills, Department of Psychology; S.C. Roesch, Professor, PhD, SDSU, Department of Psychology; P.J. Clements, MD, Professor Emeritus, David Geffen School of Medicine, UCLA; S. Kafaja, MD, Clinical Instructor, David Geffen School of Medicine, UCLA; D.E. Furst, MD, Professor, David Geffen School of Medicine, UCLA; D. Khanna, MD, Professor, University of Michigan Health System; V.L. Malcarne, PhD, Professor, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU
| | - Sarah D Mills
- From the San Diego State University (SDSU)/University of California (UC) San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego; Department of Psychology, California State University, Dominguez Hills; SDSU, Department of Psychology, San Diego; David Geffen School of Medicine, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, California; University of Michigan Health System, Ann Arbor, Michigan, USA.,S. Gholizadeh, Doctoral Student, MS, MSc, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; S.D. Mills, Doctoral Student, MS, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; R.S. Fox, Postdoctoral Fellow, PhD, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; E.L. Merz, Assistant Professor, PhD, MPH, California State University, Dominguez Hills, Department of Psychology; S.C. Roesch, Professor, PhD, SDSU, Department of Psychology; P.J. Clements, MD, Professor Emeritus, David Geffen School of Medicine, UCLA; S. Kafaja, MD, Clinical Instructor, David Geffen School of Medicine, UCLA; D.E. Furst, MD, Professor, David Geffen School of Medicine, UCLA; D. Khanna, MD, Professor, University of Michigan Health System; V.L. Malcarne, PhD, Professor, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU
| | - Rina S Fox
- From the San Diego State University (SDSU)/University of California (UC) San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego; Department of Psychology, California State University, Dominguez Hills; SDSU, Department of Psychology, San Diego; David Geffen School of Medicine, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, California; University of Michigan Health System, Ann Arbor, Michigan, USA.,S. Gholizadeh, Doctoral Student, MS, MSc, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; S.D. Mills, Doctoral Student, MS, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; R.S. Fox, Postdoctoral Fellow, PhD, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; E.L. Merz, Assistant Professor, PhD, MPH, California State University, Dominguez Hills, Department of Psychology; S.C. Roesch, Professor, PhD, SDSU, Department of Psychology; P.J. Clements, MD, Professor Emeritus, David Geffen School of Medicine, UCLA; S. Kafaja, MD, Clinical Instructor, David Geffen School of Medicine, UCLA; D.E. Furst, MD, Professor, David Geffen School of Medicine, UCLA; D. Khanna, MD, Professor, University of Michigan Health System; V.L. Malcarne, PhD, Professor, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU
| | - Erin L Merz
- From the San Diego State University (SDSU)/University of California (UC) San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego; Department of Psychology, California State University, Dominguez Hills; SDSU, Department of Psychology, San Diego; David Geffen School of Medicine, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, California; University of Michigan Health System, Ann Arbor, Michigan, USA.,S. Gholizadeh, Doctoral Student, MS, MSc, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; S.D. Mills, Doctoral Student, MS, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; R.S. Fox, Postdoctoral Fellow, PhD, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; E.L. Merz, Assistant Professor, PhD, MPH, California State University, Dominguez Hills, Department of Psychology; S.C. Roesch, Professor, PhD, SDSU, Department of Psychology; P.J. Clements, MD, Professor Emeritus, David Geffen School of Medicine, UCLA; S. Kafaja, MD, Clinical Instructor, David Geffen School of Medicine, UCLA; D.E. Furst, MD, Professor, David Geffen School of Medicine, UCLA; D. Khanna, MD, Professor, University of Michigan Health System; V.L. Malcarne, PhD, Professor, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU
| | - Scott C Roesch
- From the San Diego State University (SDSU)/University of California (UC) San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego; Department of Psychology, California State University, Dominguez Hills; SDSU, Department of Psychology, San Diego; David Geffen School of Medicine, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, California; University of Michigan Health System, Ann Arbor, Michigan, USA.,S. Gholizadeh, Doctoral Student, MS, MSc, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; S.D. Mills, Doctoral Student, MS, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; R.S. Fox, Postdoctoral Fellow, PhD, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; E.L. Merz, Assistant Professor, PhD, MPH, California State University, Dominguez Hills, Department of Psychology; S.C. Roesch, Professor, PhD, SDSU, Department of Psychology; P.J. Clements, MD, Professor Emeritus, David Geffen School of Medicine, UCLA; S. Kafaja, MD, Clinical Instructor, David Geffen School of Medicine, UCLA; D.E. Furst, MD, Professor, David Geffen School of Medicine, UCLA; D. Khanna, MD, Professor, University of Michigan Health System; V.L. Malcarne, PhD, Professor, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU
| | - Philip J Clements
- From the San Diego State University (SDSU)/University of California (UC) San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego; Department of Psychology, California State University, Dominguez Hills; SDSU, Department of Psychology, San Diego; David Geffen School of Medicine, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, California; University of Michigan Health System, Ann Arbor, Michigan, USA.,S. Gholizadeh, Doctoral Student, MS, MSc, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; S.D. Mills, Doctoral Student, MS, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; R.S. Fox, Postdoctoral Fellow, PhD, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; E.L. Merz, Assistant Professor, PhD, MPH, California State University, Dominguez Hills, Department of Psychology; S.C. Roesch, Professor, PhD, SDSU, Department of Psychology; P.J. Clements, MD, Professor Emeritus, David Geffen School of Medicine, UCLA; S. Kafaja, MD, Clinical Instructor, David Geffen School of Medicine, UCLA; D.E. Furst, MD, Professor, David Geffen School of Medicine, UCLA; D. Khanna, MD, Professor, University of Michigan Health System; V.L. Malcarne, PhD, Professor, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU
| | - Suzanne Kafaja
- From the San Diego State University (SDSU)/University of California (UC) San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego; Department of Psychology, California State University, Dominguez Hills; SDSU, Department of Psychology, San Diego; David Geffen School of Medicine, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, California; University of Michigan Health System, Ann Arbor, Michigan, USA.,S. Gholizadeh, Doctoral Student, MS, MSc, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; S.D. Mills, Doctoral Student, MS, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; R.S. Fox, Postdoctoral Fellow, PhD, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; E.L. Merz, Assistant Professor, PhD, MPH, California State University, Dominguez Hills, Department of Psychology; S.C. Roesch, Professor, PhD, SDSU, Department of Psychology; P.J. Clements, MD, Professor Emeritus, David Geffen School of Medicine, UCLA; S. Kafaja, MD, Clinical Instructor, David Geffen School of Medicine, UCLA; D.E. Furst, MD, Professor, David Geffen School of Medicine, UCLA; D. Khanna, MD, Professor, University of Michigan Health System; V.L. Malcarne, PhD, Professor, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU
| | - Daniel E Furst
- From the San Diego State University (SDSU)/University of California (UC) San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego; Department of Psychology, California State University, Dominguez Hills; SDSU, Department of Psychology, San Diego; David Geffen School of Medicine, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, California; University of Michigan Health System, Ann Arbor, Michigan, USA.,S. Gholizadeh, Doctoral Student, MS, MSc, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; S.D. Mills, Doctoral Student, MS, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; R.S. Fox, Postdoctoral Fellow, PhD, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; E.L. Merz, Assistant Professor, PhD, MPH, California State University, Dominguez Hills, Department of Psychology; S.C. Roesch, Professor, PhD, SDSU, Department of Psychology; P.J. Clements, MD, Professor Emeritus, David Geffen School of Medicine, UCLA; S. Kafaja, MD, Clinical Instructor, David Geffen School of Medicine, UCLA; D.E. Furst, MD, Professor, David Geffen School of Medicine, UCLA; D. Khanna, MD, Professor, University of Michigan Health System; V.L. Malcarne, PhD, Professor, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU
| | - Dinesh Khanna
- From the San Diego State University (SDSU)/University of California (UC) San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego; Department of Psychology, California State University, Dominguez Hills; SDSU, Department of Psychology, San Diego; David Geffen School of Medicine, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, California; University of Michigan Health System, Ann Arbor, Michigan, USA.,S. Gholizadeh, Doctoral Student, MS, MSc, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; S.D. Mills, Doctoral Student, MS, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; R.S. Fox, Postdoctoral Fellow, PhD, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; E.L. Merz, Assistant Professor, PhD, MPH, California State University, Dominguez Hills, Department of Psychology; S.C. Roesch, Professor, PhD, SDSU, Department of Psychology; P.J. Clements, MD, Professor Emeritus, David Geffen School of Medicine, UCLA; S. Kafaja, MD, Clinical Instructor, David Geffen School of Medicine, UCLA; D.E. Furst, MD, Professor, David Geffen School of Medicine, UCLA; D. Khanna, MD, Professor, University of Michigan Health System; V.L. Malcarne, PhD, Professor, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU
| | - Vanessa L Malcarne
- From the San Diego State University (SDSU)/University of California (UC) San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology, San Diego; Department of Psychology, California State University, Dominguez Hills; SDSU, Department of Psychology, San Diego; David Geffen School of Medicine, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, California; University of Michigan Health System, Ann Arbor, Michigan, USA. .,S. Gholizadeh, Doctoral Student, MS, MSc, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; S.D. Mills, Doctoral Student, MS, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; R.S. Fox, Postdoctoral Fellow, PhD, MPH, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, Department of Psychology; E.L. Merz, Assistant Professor, PhD, MPH, California State University, Dominguez Hills, Department of Psychology; S.C. Roesch, Professor, PhD, SDSU, Department of Psychology; P.J. Clements, MD, Professor Emeritus, David Geffen School of Medicine, UCLA; S. Kafaja, MD, Clinical Instructor, David Geffen School of Medicine, UCLA; D.E. Furst, MD, Professor, David Geffen School of Medicine, UCLA; D. Khanna, MD, Professor, University of Michigan Health System; V.L. Malcarne, PhD, Professor, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU.
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The association of sociodemographic and objectively-assessed disease variables with fatigue in systemic sclerosis: an analysis of 785 Canadian Scleroderma Research Group Registry patients. Clin Rheumatol 2016; 36:373-379. [DOI: 10.1007/s10067-016-3501-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 10/20/2022]
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Comparison of Self-Efficacy for Managing Chronic Disease between patients with systemic sclerosis and other chronic conditions: a systematic review. Rheumatol Int 2016; 37:281-292. [DOI: 10.1007/s00296-016-3602-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 11/04/2016] [Indexed: 11/26/2022]
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Racine M, Hudson M, Baron M, Nielson WR. The Impact of Pain and Itch on Functioning and Health-Related Quality of Life in Systemic Sclerosis: An Exploratory Study. J Pain Symptom Manage 2016; 52:43-53. [PMID: 26876159 DOI: 10.1016/j.jpainsymman.2015.12.314] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 12/30/2015] [Accepted: 01/07/2016] [Indexed: 10/22/2022]
Abstract
CONTEXT Pain and itch are common symptoms reported by patients with systemic sclerosis (SSc; scleroderma), which can markedly diminish function and health-related quality of life (HRQL). OBJECTIVES The aim of this exploratory study was to examine the impact that pain, itch, and the interaction of both have on function (depressive symptoms, overall disability, fatigue, sleep disturbance) and HRQL in patients with SSc. METHODS A total of 964 patients from the Canadian Scleroderma Reserch Group Registry completed questionnaires measuring itch and pain severity, function, and HRQL. Multiple regression analyses were performed to examine the impact that pain, itch, and pain × itch interaction have on each outcome variable while controlling for demographic measures. A P-value of ≤0.01 was required for a difference to be deemed statistically significant. RESULTS Our results revealed that patients with SSc who reported higher pain and itch severity were also more likely to have greater depressive symptoms, overall disability, sleep and fatigue problems, even when demographic measures were controlled for (P-values ≤0.001). Similar results were obtained for HRQL, regardless of the domains (P-values ≤0.001). A significant association between pain × itch interaction and sleep (P = 0.002), physical functioning (P = 0.003), and general health (P ≤ 0.001) variables also was found. Further investigation of the nature of the pain × itch interaction showed that the effect of pain severity on outcome variables diminishes as itch severity increases. CONCLUSION Both pain and itch appear to have a detrimental impact on functioning and HRQL in patients with SSc, suggesting that more targeted approaches to symptom management are warranted.
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Affiliation(s)
- Mélanie Racine
- Lawson Health Research Institute, London, Ontario, Canada; Department of Clinical and Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Marie Hudson
- Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| | - Murray Baron
- Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| | - Warren R Nielson
- Lawson Health Research Institute, London, Ontario, Canada; Department of Psychology, Western University, London, Ontario, Canada.
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Gumuchian ST, Peláez S, Delisle VC, Carrier ME, Jewett LR, El-Baalbaki G, Fortune C, Hudson M, Impens A, Körner A, Persmann J, Kwakkenbos L, Bartlett SJ, Thombs BD. Exploring Sources of Emotional Distress among People Living with Scleroderma: A Focus Group Study. PLoS One 2016; 11:e0152419. [PMID: 27008209 PMCID: PMC4805283 DOI: 10.1371/journal.pone.0152419] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 03/14/2016] [Indexed: 11/25/2022] Open
Abstract
Background Systemic sclerosis, or scleroderma, is a chronic and rare connective tissue disease with negative physical and psychological implications. Sources of emotional distress and the impact they have on the lives of people with scleroderma are not well understood. Objectives To gain an in-depth understanding of the emotional experiences and sources of emotional distress for women and men living with scleroderma through focus group discussions. Methods Three semi-structured focus group discussions were conducted (two in English, one in French) with a total of 22 people with scleroderma recruited through the Scleroderma Society of Ontario in Hamilton, Ontario and a scleroderma clinic in Montreal, Canada. Interviews were recorded, transcribed, and then coded for emerging themes using thematic inductive analysis. Results Core themes representing sources of emotional distress were identified, including: (a) facing a new reality; (b) the daily struggle of living with scleroderma; (c) handling work, employment and general financial burden; (d) changing family roles; (e) social interactions; and (f) navigating the health care system. Collectively, these themes refer to the stressful journey of living with scleroderma including the obstacles faced and the emotional experiences beginning prior to receiving a diagnosis and continuing throughout the participants’ lives. Conclusion Scleroderma was portrayed as being an unpredictable and overwhelming disease, resulting in many individuals experiencing multiple sources of emotional distress. Interventions and supportive resources need to be developed to help individuals with scleroderma and people close to them manage and cope with the emotional aspects of the disease.
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Affiliation(s)
- Stephanie T. Gumuchian
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Sandra Peláez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire Sainte-Justine, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
| | - Vanessa C. Delisle
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
| | - Lisa R. Jewett
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | | | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Ann Impens
- Institute for Health Innovation, Midwestern University, Downers Grove, Illinois, United States of America
| | - Annett Körner
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
| | - Jennifer Persmann
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Linda Kwakkenbos
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, the Netherlands
| | - Susan J. Bartlett
- Department of Medicine, McGill University, Montréal, Québec, Canada
- McGill University Health Center, McGill University, Montréal, Québec, Canada
- * E-mail: (BDT); (SJB)
| | - Brett D. Thombs
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Psychology, McGill University, Montréal, Québec, Canada
- School of Nursing, McGill University, Montréal, Québec, Canada
- * E-mail: (BDT); (SJB)
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Deer TR, Caraway DL, Wallace MS. A definition of refractory pain to help determine suitability for device implantation. Neuromodulation 2015; 17:711-5. [PMID: 25521165 DOI: 10.1111/ner.12263] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mills SD, Fox RS, Merz EL, Clements PJ, Kafaja S, Malcarne VL, Furst DE, Khanna D. Evaluation of the Satisfaction with Appearance Scale and Its Short Form in Systemic Sclerosis: Analysis from the UCLA Scleroderma Quality of Life Study. J Rheumatol 2015; 42:1624-30. [PMID: 26034157 DOI: 10.3899/jrheum.141482] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Changes in appearance are common in patients with systemic sclerosis (SSc) and can significantly affect well-being. The Satisfaction with Appearance Scale (SWAP) measures body image dissatisfaction in persons with visible disfigurement; the Brief-Satisfaction with Appearance Scale (Brief-SWAP) is its short form. The present study evaluated the reliability and validity of SWAP and Brief-SWAP scores in SSc. METHODS A sample of 207 patients with SSc participating in the University of California, Los Angeles Scleroderma Quality of Life Study completed the SWAP. Brief-SWAP scores were derived from the SWAP. The structural validity of both measures was investigated using confirmatory factor analysis. Internal consistency reliability of total and subscale scores was assessed with Cronbach's alpha coefficients. Convergent and divergent validity was evaluated using the Center for Epidemiological Studies Depression Scale, the Health Assessment Questionnaire-Disability Index, and the Medical Outcomes Study Short Form-36 questionnaire. RESULTS SWAP and Brief-SWAP total scores were highly correlated (r = 0.97). The 4-factor structure of the SWAP fit well descriptively; the 2-factor structure of the Brief-SWAP fit well descriptively and statistically. Internal consistencies for total and subscale scores were good, and results supported convergent and divergent validity. CONCLUSION Both versions are suitable for use in patients with SSc. The Brief-SWAP is most efficient; the full SWAP yields additional subscales that may be informative in understanding body image issues in patients with SSc.
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Affiliation(s)
- Sarah D Mills
- From the San Diego State University (SDSU)/University of California, San Diego (UC San Diego) Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU, San Diego; Department of Psychology, California State University, Dominguez Hills, Carson; Department of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.S.D. Mills, MS, MPH, Doctoral Student; R.S. Fox, MS, MPH, Doctoral Student, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology; E.L. Merz, PhD, MPH, Assistant Professor, Department of Psychology, California State University, Dominguez Hills; P.J. Clements, MD, MPH, Professor Emeritus; S. Kafaja, MD, Clinical Instructor, Department of Medicine, University of California, Los Angeles; V.L. Malcarne, PhD, Professor, Department of Psychology, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU; D.E. Furst, MD, Professor, Department of Medicine, University of California, Los Angeles; D. Khanna, MD, MSc, Associate Professor, Department of Medicine, University of Michigan
| | - Rina S Fox
- From the San Diego State University (SDSU)/University of California, San Diego (UC San Diego) Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU, San Diego; Department of Psychology, California State University, Dominguez Hills, Carson; Department of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.S.D. Mills, MS, MPH, Doctoral Student; R.S. Fox, MS, MPH, Doctoral Student, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology; E.L. Merz, PhD, MPH, Assistant Professor, Department of Psychology, California State University, Dominguez Hills; P.J. Clements, MD, MPH, Professor Emeritus; S. Kafaja, MD, Clinical Instructor, Department of Medicine, University of California, Los Angeles; V.L. Malcarne, PhD, Professor, Department of Psychology, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU; D.E. Furst, MD, Professor, Department of Medicine, University of California, Los Angeles; D. Khanna, MD, MSc, Associate Professor, Department of Medicine, University of Michigan
| | - Erin L Merz
- From the San Diego State University (SDSU)/University of California, San Diego (UC San Diego) Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU, San Diego; Department of Psychology, California State University, Dominguez Hills, Carson; Department of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.S.D. Mills, MS, MPH, Doctoral Student; R.S. Fox, MS, MPH, Doctoral Student, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology; E.L. Merz, PhD, MPH, Assistant Professor, Department of Psychology, California State University, Dominguez Hills; P.J. Clements, MD, MPH, Professor Emeritus; S. Kafaja, MD, Clinical Instructor, Department of Medicine, University of California, Los Angeles; V.L. Malcarne, PhD, Professor, Department of Psychology, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU; D.E. Furst, MD, Professor, Department of Medicine, University of California, Los Angeles; D. Khanna, MD, MSc, Associate Professor, Department of Medicine, University of Michigan
| | - Philip J Clements
- From the San Diego State University (SDSU)/University of California, San Diego (UC San Diego) Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU, San Diego; Department of Psychology, California State University, Dominguez Hills, Carson; Department of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.S.D. Mills, MS, MPH, Doctoral Student; R.S. Fox, MS, MPH, Doctoral Student, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology; E.L. Merz, PhD, MPH, Assistant Professor, Department of Psychology, California State University, Dominguez Hills; P.J. Clements, MD, MPH, Professor Emeritus; S. Kafaja, MD, Clinical Instructor, Department of Medicine, University of California, Los Angeles; V.L. Malcarne, PhD, Professor, Department of Psychology, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU; D.E. Furst, MD, Professor, Department of Medicine, University of California, Los Angeles; D. Khanna, MD, MSc, Associate Professor, Department of Medicine, University of Michigan
| | - Suzanne Kafaja
- From the San Diego State University (SDSU)/University of California, San Diego (UC San Diego) Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU, San Diego; Department of Psychology, California State University, Dominguez Hills, Carson; Department of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.S.D. Mills, MS, MPH, Doctoral Student; R.S. Fox, MS, MPH, Doctoral Student, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology; E.L. Merz, PhD, MPH, Assistant Professor, Department of Psychology, California State University, Dominguez Hills; P.J. Clements, MD, MPH, Professor Emeritus; S. Kafaja, MD, Clinical Instructor, Department of Medicine, University of California, Los Angeles; V.L. Malcarne, PhD, Professor, Department of Psychology, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU; D.E. Furst, MD, Professor, Department of Medicine, University of California, Los Angeles; D. Khanna, MD, MSc, Associate Professor, Department of Medicine, University of Michigan
| | - Vanessa L Malcarne
- From the San Diego State University (SDSU)/University of California, San Diego (UC San Diego) Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU, San Diego; Department of Psychology, California State University, Dominguez Hills, Carson; Department of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.S.D. Mills, MS, MPH, Doctoral Student; R.S. Fox, MS, MPH, Doctoral Student, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology; E.L. Merz, PhD, MPH, Assistant Professor, Department of Psychology, California State University, Dominguez Hills; P.J. Clements, MD, MPH, Professor Emeritus; S. Kafaja, MD, Clinical Instructor, Department of Medicine, University of California, Los Angeles; V.L. Malcarne, PhD, Professor, Department of Psychology, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU; D.E. Furst, MD, Professor, Department of Medicine, University of California, Los Angeles; D. Khanna, MD, MSc, Associate Professor, Department of Medicine, University of Michigan.
| | - Daniel E Furst
- From the San Diego State University (SDSU)/University of California, San Diego (UC San Diego) Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU, San Diego; Department of Psychology, California State University, Dominguez Hills, Carson; Department of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.S.D. Mills, MS, MPH, Doctoral Student; R.S. Fox, MS, MPH, Doctoral Student, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology; E.L. Merz, PhD, MPH, Assistant Professor, Department of Psychology, California State University, Dominguez Hills; P.J. Clements, MD, MPH, Professor Emeritus; S. Kafaja, MD, Clinical Instructor, Department of Medicine, University of California, Los Angeles; V.L. Malcarne, PhD, Professor, Department of Psychology, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU; D.E. Furst, MD, Professor, Department of Medicine, University of California, Los Angeles; D. Khanna, MD, MSc, Associate Professor, Department of Medicine, University of Michigan
| | - Dinesh Khanna
- From the San Diego State University (SDSU)/University of California, San Diego (UC San Diego) Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU, San Diego; Department of Psychology, California State University, Dominguez Hills, Carson; Department of Medicine, University of California, Los Angeles, Los Angeles, California; Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.S.D. Mills, MS, MPH, Doctoral Student; R.S. Fox, MS, MPH, Doctoral Student, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology; E.L. Merz, PhD, MPH, Assistant Professor, Department of Psychology, California State University, Dominguez Hills; P.J. Clements, MD, MPH, Professor Emeritus; S. Kafaja, MD, Clinical Instructor, Department of Medicine, University of California, Los Angeles; V.L. Malcarne, PhD, Professor, Department of Psychology, SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, and Department of Psychology, SDSU; D.E. Furst, MD, Professor, Department of Medicine, University of California, Los Angeles; D. Khanna, MD, MSc, Associate Professor, Department of Medicine, University of Michigan
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Abstract
Patients with systemic sclerosis (SSc; also called scleroderma) have to cope with not only the physical impacts of the disease but also the emotional and social consequences of living with the condition. Because there is no cure for SSc, improving quality of life is a primary focus of treatment and an important clinical challenge. This article summarizes significant problems faced by patients with SSc, including depression, anxiety, fatigue, sleep disruption, pain, pruritus, body image dissatisfaction, and sexual dysfunction, and describes options to help patients cope with the consequences of the disease.
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Abstract
Systemic sclerosis is a complex autoimmune disease characterized by a chronic and frequently progressive course and by extensive patient-to-patient variability. Like other autoimmune diseases, systemic sclerosis occurs more frequently in women, with a peak of onset in the fifth decade of life. The exact cause of systemic sclerosis remains elusive but is likely to involve environmental factors in a genetically primed individual. Pathogenesis is dominated by vascular changes; evidence of autoimmunity with distinct autoantibodies and activation of both innate and adaptive immunity; and fibrosis of the skin and visceral organs that results in irreversible scarring and organ failure. Intractable progression of vascular and fibrotic organ damage accounts for the chronic morbidity and high mortality. Early and accurate diagnosis and classification might improve patient outcomes. Screening strategies facilitate timely recognition of life-threatening complications and initiation of targeted therapies to halt their progression. Effective treatments of organ-based complications are now within reach. Discovery of biomarkers - including autoantibodies that identify patient subsets at high risk for particular disease complications or rapid progression - is a research priority. Understanding the key pathogenetic pathways, cell types and mediators underlying disease manifestations opens the door for the development of targeted therapies with true disease-modifying potential. For an illustrated summary of this Primer, visit: http://go.nature.com/lchkcA.
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Weisner TS, Hay MC. Practice to research: integrating evidence-based practices with culture and context. Transcult Psychiatry 2015; 52:222-43. [PMID: 25416746 DOI: 10.1177/1363461514557066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There are ways to integrate culturally competent services (CCS) and evidence-based practices (EBP) which can improve the experiences of patients and their families and communities when faced with health problems, as well as the effectiveness and positive experiences of practitioners. CCS and EBP evidence should be jointly deployed for helping patients and clinicians. Partnership research models are useful for achieving the integration of CCS and EBP, since they involve close observation of and participation by clinicians and practitioners in the research process, and often use integrated qualitative and quantitative mixed methods. We illustrate this with 3 examples of work that can help integrate CCS and EBP: ongoing collection of information from patients, clinicians and staff, or "evidence farming"; close study and continuous improvement of activities and accommodations; and use of evidence of tacit, implicit cultural scripts and norms, such as being "productive," as well as explicit scripts. From a research practice point of view, collaborative partnerships will likely produce research with culture and context bracketed in, and will contribute stronger research models, methods, and units of analysis.
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Cognitive-Behavioural Therapy Targeting Fear of Progression in an Interdisciplinary Care Program: A Case Study in Systemic Sclerosis. J Clin Psychol Med Settings 2014; 21:297-312. [DOI: 10.1007/s10880-014-9414-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Kwakkenbos L, Jewett LR, Baron M, Bartlett SJ, Furst D, Gottesman K, Khanna D, Malcarne VL, Mayes MD, Mouthon L, Poiraudeau S, Sauve M, Nielson WR, Poole JL, Assassi S, Boutron I, Ells C, van den Ende CHM, Hudson M, Impens A, Körner A, Leite C, Costa Maia A, Mendelson C, Pope J, Steele RJ, Suarez-Almazor ME, Ahmed S, Coronado-Montoya S, Delisle VC, Gholizadeh S, Jang Y, Levis B, Milette K, Mills SD, Razykov I, Fox RS, Thombs BD. The Scleroderma Patient-centered Intervention Network (SPIN) Cohort: protocol for a cohort multiple randomised controlled trial (cmRCT) design to support trials of psychosocial and rehabilitation interventions in a rare disease context. BMJ Open 2013; 3:bmjopen-2013-003563. [PMID: 23929922 PMCID: PMC3740254 DOI: 10.1136/bmjopen-2013-003563] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Psychosocial and rehabilitation interventions are increasingly used to attenuate disability and improve health-related quality of life (HRQL) in chronic diseases, but are typically not available for patients with rare diseases. Conducting rigorous, adequately powered trials of these interventions for patients with rare diseases is difficult. The Scleroderma Patient-centered Intervention Network (SPIN) is an international collaboration of patient organisations, clinicians and researchers. The aim of SPIN is to develop a research infrastructure to test accessible, low-cost self-guided online interventions to reduce disability and improve HRQL for people living with the rare disease systemic sclerosis (SSc or scleroderma). Once tested, effective interventions will be made accessible through patient organisations partnering with SPIN. METHODS AND ANALYSIS SPIN will employ the cohort multiple randomised controlled trial (cmRCT) design, in which patients consent to participate in a cohort for ongoing data collection. The aim is to recruit 1500-2000 patients from centres across the world within a period of 5 years (2013-2018). Eligible participants are persons ≥18 years of age with a diagnosis of SSc. In addition to baseline medical data, participants will complete patient-reported outcome measures every 3 months. Upon enrolment in the cohort, patients will consent to be contacted in the future to participate in intervention research and to allow their data to be used for comparison purposes for interventions tested with other cohort participants. Once interventions are developed, patients from the cohort will be randomly selected and offered interventions as part of pragmatic RCTs. Outcomes from patients offered interventions will be compared with outcomes from trial-eligible patients who are not offered the interventions. ETHICS AND DISSEMINATION The use of the cmRCT design, the development of self-guided online interventions and partnerships with patient organisations will allow SPIN to develop, rigourously test and effectively disseminate psychosocial and rehabilitation interventions for people with SSc.
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Affiliation(s)
- Linda Kwakkenbos
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Psychiatry, Montréal, Québec, Canada
| | - Lisa R Jewett
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, Montréal, Québec, Canada
| | - Murray Baron
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Dan Furst
- Division of Rheumatology, Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | - Karen Gottesman
- Southern California Chapter, Scleroderma Foundation, Los Angeles, California, USA
| | - Dinesh Khanna
- University of Michigan Scleroderma Program, Ann Arbor, Michigan, USA
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, California, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Maureen D Mayes
- University of Texas Health Science Center Houston, Houston, Texas, USA
| | - Luc Mouthon
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Pôle de Médecine Interne, Hôpital Cochin, Paris, France
| | - Serge Poiraudeau
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Pôle Ostéo-articulaire, Hôpital Cochin, Paris, France
- IFR Handicap INSERM, Paris, France
| | - Maureen Sauve
- Scleroderma Societies of Canada and Ontario, Hamilton, Ontario, Canada
| | - Warren R Nielson
- Beryl & Richard Ivey Rheumatology Day Programs, St Joseph's Health Care, London, Ontario, Canada
| | - Janet L Poole
- Occupational Therapy Graduate Program, University of New Mexico, Albuquerque, New Mexico, USA
| | - Shervin Assassi
- University of Texas Health Science Center Houston, Houston, Texas, USA
| | | | - Carolyn Ells
- Biomedical Ethics Unit, McGill University, Montréal, Québec, Canada
| | | | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Ann Impens
- Internal Medicine, Midwestern University, Downers Grove, Illinois, USA
| | - Annett Körner
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, Montréal, Québec, Canada
- Department of Oncology, McGill University, Montréal, Québec, Canada
| | - Catarina Leite
- School of Psychology, University of Minho, Braga, Portugal
- Federation of European Scleroderma Associations, Froyennes, Belgium
| | | | - Cindy Mendelson
- College of Nursing, University of New Mexico, Albuquerque, New Mexico, USA
| | - Janet Pope
- Medicine, Division of Rheumatology, University of Western Ontario, St Joseph's Health Care, London, Ontario, Canada
| | - Russell J Steele
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Mathematics and Statistics, McGill University, Montréal, Québec, Canada
| | | | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, Montréal, Québec, Canada
- McGill University Health Center, Clinical Epidemiology Montréal, Montréal, Québec, Canada
| | | | - Vanessa C Delisle
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, Montréal, Québec, Canada
| | - Shadi Gholizadeh
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Yeona Jang
- Desautels Faculty of Management, McGill University, Montréal, Québec, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Katherine Milette
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, Montréal, Québec, Canada
| | - Sarah D Mills
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Ilya Razykov
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
- Department of Psychiatry, Montréal, Québec, Canada
| | - Rina S Fox
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
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