Measuring social relational quality in colorectal cancer: the Social Relational Quality Scale (SRQS)

Determinants of preparedness in family caregivers of patients with heart failure

AIMS

Inadequate preparedness of family caregivers contributes to adverse outcomes of patients with heart failure (HF). However, evidence on caregiver preparedness is limited. This study aims to examine the determinants and potential mechanisms of preparedness in family caregivers of patients with HF.

METHODS AND RESULTS

In the cross-sectional study, 298 HF patient-caregiver dyads were recruited from 4 tertiary hospitals in China. Preparedness, uncertainty in illness, family relational quality, social support, and positive aspects of caregiving (PAC) were assessed in family caregivers using self-reported questionnaires. In the path analysis model, uncertainty in illness had an indirect negative effect on preparedness via reduced PAC [indirect effect = -0.020; 95% confidence interval (CI) -0.050 to -0.002]. Whereas, family relational quality had direct (β = 0.266; P < 0.001) and indirect positive effects on preparedness through increased PAC (indirect effect = 0.027; 95% CI, 0.003-0.067). Similarly, social support also had direct (β = 0.184; P = 0.004) and indirect positive effects on preparedness through increased PAC (indirect effect = 0.027; 95% CI, 0.004-0.065).

CONCLUSION

This study highlights that diminishing uncertainty in illness may indirectly improve caregiver preparedness through the enhancement of PAC, while raising family relational quality and social support may improve caregiver preparedness both directly and indirectly by augmenting PAC. These findings provide insightful implications for healthcare professionals in developing tailored interventions to ameliorate preparedness in family caregivers of patients with HF.

The predictive role of hope and social relational quality in disability acceptance among Iranian patients under hemodialysis

BACKGROUND

Patients undergoing hemodialysis face disabilities that its acceptance may influenced by several factors. This study aimed to determine the predictive role of hope and quality of social relationship on accepting disability amongst patients undergoing hemodialysis.

METHODS

This cross-sectional study was conducted on 120 hemodialysis patients referred to hemodialysis centers in Nemazi and Shahid Faghihi hospitals and Imam Reza Clinic in Shiraz. Snyder Hope Scale, Acceptance of Disability Scale (ADS), and Social Relational Quality Scale (SRQS) were used for data collection. The data were analyzed through the Smart PLS-3 and SPSS software using Pearson's correlation and multiple linear regression analysis tests, and confirmatory factor analysis.

RESULTS

Face, content, and construct validities and internal consistency of the Persian version of ADS and SRQS were confirmed. The patients' mean score of hope was 38.83 (SD = 4.35), which was not desirable. Their mean score of SRQS was 45.45 (SD = 3.87), which was at the moderate level. Nonetheless, the mean score of disability acceptance (66.01 (SD = 7.15)) was lower than expected. The results showed disability acceptance was associated with having good level of hope (β = 0.44, p = 0.002) and social relationship (β = 0.31, p = 0.04).

CONCLUSIONS

Hope and social relational quality predicted the acceptance of disabilities. Therefore, designing interventions to promote hope and social relationship in hemodialysis patients may increase their disability acceptance.

Assessment of socio-relational self-efficacy in breast cancer patients: Italian validation of the social relationship coping efficacy scale (SRCE-I)

BACKGROUND

Social relationship coping efficacy (SRCE) represents the ability to maintain or enhance social relationships in the context of serious illness. The purpose of the current study was to confirm the factor structure, psychometric properties, and utility of the Italian version of the SRCE scale.

METHODS

181 breast cancer patients completed the SRCE-Italian (SRCE-I), the Cancer Behavior Inventory-Brief/Italian (CBI-B/I), quality of life (QOL) measures (EORTC QLQ-C30; EORTC QLQ-BR23), and the Hospital Anxiety and Depression Scale (HADS).

RESULTS

The SRCE-I was internally consistent (Cronbach alpha = .95) and factor analysis confirmed that the SRCE-I was a unidimensional construct. In terms of validity, the SRCE-I was correlated with QOL (EORTC QLQ-30, Social Functioning, r = .33, Emotional Functioning, r = .57, and Global Health/Quality of Life; r = .54) and scales of the EORTC QLQ-BR23 (e.g., Future Perspective, r = .38; Breast Symptoms, -.31). SRCE-I was also correlated negatively with the HADS (r = -.72) and positively with the CBI-B/I (r = .79), a measure of coping efficacy (all ps < .001). Mediation analyses confirmed the utility of the SRCE-I scale as a mediating mechanism in enhancing social functioning and QOL.

CONCLUSIONS

The SRCE-I is a structurally sound, reliable, and valid measure that assesses the ability to maintain or enhance social support and mitigate the loss of social support. The SRCE-I can be used as a screening measure to assess low efficacy for maintaining social support or as a measure to detect the change in efficacy for enhancing social support in interventions to improve the QOL of patients.

Regional Social Relationships Evaluation Using the AHP and Entropy Weight Method: A Case Study of the Qinghai–Tibet Plateau, China

The quality of social relationships is recognized as an important aspect of human well-being. Improving social relationships can help to promote other aspects of human well-being, such as health and income. The development of individual social relationships relies on regional social relationships. However, few studies have focused on social relationships evaluation at the regional level. Therefore, the study aims to construct a comprehensive evaluation index system and to evaluate regional social relationships by calculating the regional social relationships index (RSRI). The weights of the indicators were calculated by using the analytic hierarchy process (AHP) and entropy weight method. The social relationships of prefecture-level cities in the Qinghai–Tibet Plateau were evaluated based on statistical data. The results showed that (1) the top three indicators of comprehensive weight were number of community service agencies, number of vehicles operated on highway, and telephone penetration; (2) the regional social relationships on the Qinghai–Tibet Plateau showed an upward trend from 2010 to 2019; (3) the average RSRI scores of prefecture-level cities in Qinghai and Gansu were higher than other provinces; and (4) the number of community service agencies was the main obstacle factor for the development of regional social relationships in the Qinghai–Tibet Plateau. The finding of this study can provide further insights about social relationships research from a regional analysis perspective and cover the gap in the literature on regional social relationships.

Type C Behavior and Associated Factors in Patients with Breast Cancer During Postoperative Chemotherapy: A Cross-Sectional Study

Background

Type C behavior is a cancer-prone behavior that can affect the occurrence and development of cancer. This study aimed to investigate the prevalence of type C behavior in patients with breast cancer during postoperative chemotherapy and determine its associated factors.

Methods

This study enrolled 161 patients with breast cancer who received postoperative chemotherapy. Type C personality behavior pattern questionnaire was used to assess type C behavior patterns. The following instruments were employed: medical coping modes questionnaire, social support scale, social relational quality scale, Herth hope index. logistic regression was used to identify the factors affecting type C behavior.

Results

The incidence of type C behavior was 28%. Participants aged 45-59 years (OR = 3.62, 95% CI = 1.04-12.56, P = 0.043), and who adopted a resignation coping style (OR = 1.25, 95% CI = 1.03-1.50, P = 0.021), were more likely to develop type C behavior. Type C behavior was less common in patients with employment (OR = 0.38, 95% CI = 0.15-0.97, P = 0.043), with a high level of social support (OR = 0.89, 95% CI= 0.80-0.98, P = 0.023), and more hope (OR = 0.83, 95% CI = 0.71-0.98, P = 0.079).

Conclusion

In this study, 28% patients with breast cancer during postoperative chemotherapy exhibited type C behavior. Associated factors with type C behavior were identified, which could guide health care professionals to reduce the prevalence of type C behavior through guiding patients to adopt positive coping styles and improving their level of social support and hope, especially in those aged 45 to 59 years or in those without employment.

Combined and Relative Effect Levels of Perceived Risk, Knowledge, Optimism, Pessimism, and Social Trust on Anxiety among Inhabitants Concerning Living on Heavy Metal Contaminated Soil

This research aims at combined and relative effect levels on anxiety of: (1) perceived risk, knowledge, optimism, pessimism, and social trust; and (2) four sub-variables of social trust among inhabitants concerning living on heavy metal contaminated soil. On the basis of survey data from 499 Chinese respondents, results suggest that perceived risk, pessimism, optimism, and social trust have individual, significant, and direct effects on anxiety, while knowledge does not. Knowledge has significant, combined, and interactive effects on anxiety together with social trust and pessimism, respectively, but does not with perceived risk and optimism. Social trust, perceived risk, pessimism, knowledge, and optimism have significantly combined effects on anxiety; the five variables as a whole have stronger predictive values than each one individually. Anxiety is influenced firstly by social trust and secondly by perceived risk, pessimism, knowledge, and optimism. Each of four sub-variables of social trust has an individual, significant, and negative effect on anxiety. When introducing four sub-variables into one model, trust in social organizations and in the government have significantly combined effects on anxiety, while trust in experts and in friends and relatives do not; anxiety is influenced firstly by trust in social organization, and secondly by trust in the government.

Psycho-oncology assessment in Chinese populations: a systematic review of quality of life and psychosocial measures

This systematic review describes psychosocial and quality of life (QOL) measures used in psycho-oncology research with cancer patients and caregivers in China. Medline and PsycINFO databases were searched (1980-2014). Studies reviewed met the following criteria: English language; peer-reviewed; sampled Chinese cancer patients/caregivers; developed, validated or assessed psychometric properties of psychosocial or QOL outcome measures; and reported validation data. The review examined characteristics of measures and participants, translation and cultural adaptation processes and psychometric properties of the measures. Ninety five studies met review criteria. Common characteristics of studies reviewed were they: assessed primarily QOL measures, sampled patients with breast, colorectal, or head and neck cancer, and validated existing measures (>80%) originating in North America or Europe. Few studies reported difficulties translating measures. Regarding psychometric properties of the measures >50% of studies reported subscale reliabilities <α = 0.70, <50% reported test-retest reliability, and <30% reported divergent validity. Few reported sensitivity, specificity or responsiveness. Improved accuracy and transparency of reporting for translation, cultural adaptation and psychometric testing of psychosocial measures is needed. Developing support structures for translating and validating psychosocial measures would enable this and ensure Chinese psycho-oncology clinical practice and research keeps pace with international focus on patient reported outcome measures and data management.

Systematic review recommends the European Organization for Research and Treatment of Cancer colorectal cancer-specific module for measuring quality of life in colorectal cancer patients

OBJECTIVES

To critically appraise the measurement properties of standardized health-related quality of life (HRQOL) instruments for colorectal cancer (CRC) patients and to provide recommendations on the choice of HRQOL instruments.

STUDY DESIGN AND SETTING

Systematic review of English language literature published between January 1985 and May 2014 identified through a database search of PubMed, Web of Science, Embase, and Ovid MEDLINE. HRQOL instruments were rated on methodological quality and overall levels of evidence using a Consensus-based Standards for the selection of health Measurement Instrument checklist.

RESULTS

Internal consistency and hypothesis testing were evaluated most frequently in 63 studies identified. The Functional Assessment of Cancer Therapy-Colorectal (FACT-C) was the most extensively evaluated. The highest number of positive ratings in the overall level of evidence was found in the CRC-specific quality of life questionnaire module (QLQ-CR38) in European Organization for Research and Treatment of Cancer (EORTC) module, followed by the Memorial Sloan Kettering Cancer Center Bowel instrument, FACT-C, and Quick-FLIC. The EORTC QLQ-CR38 had the most positive ratings on measurement property and was recommended.

CONCLUSION

The EORTC QLQ-CR38 was recommended to assess HRQOL in patients with CRC, regardless of disease stage and primary tumor site.

Perceived control mediates the prospective impact of relationship quality in the year after colorectal cancer diagnosis

BACKGROUND

Negative cancer-related intrusive thoughts reduce the benefit of relationship quality on the psychological adjustment of cancer patients. Little is known about the role of perceived control over cancer-related problems in the association between relationship quality and adjustment.

PURPOSE

This study examined whether perceived personal control (i.e., on one's own) and collective control (i.e., collaboration with family/friends) mediate the associations between relationship quality and psychological outcomes.

METHODS

Chinese colorectal cancer patients (n = 234) were assessed at diagnosis (T1) and at 3- (T2) and 12-month (T3) follow-ups.

RESULTS

T2 collective control mediated the association between T1 family relationship quality and T3 satisfaction with life. The negative association between T1 family relationship quality and T3 depression was independent of T2 personal/collective control.

CONCLUSIONS

Collective control mediates the relationship between family relationship quality and satisfaction with life, suggesting the need for interventions to enhance relationship quality and perceived control among newly diagnosed cancer patients.

Assessing the social impact of cancer: a review of available tools

OBJECTIVES

Taking care of oncological patients holistically--from a biological, social, and psychological point of view--also involves evaluating the social aspects of the disease. In the present study, we provide further insights on how investigations regarding the social impact of an oncological disease are conducted with specifically designed tools on patients who have personally been affected. The objective is then to understand how the social dimension is theorized and, therefore, which practical aspects of subjective experience are employed to assess the social impact.

METHOD

We performed a systematic review of the literature identified by MedLine and PsycINFO databases.

RESULTS

Of the 469 articles obtained from the search, 27 deal with 14 different measurement instruments of the social impact of the oncological experience. Of the identified tools, 71% were specifically designed for the oncological setting and were heterogeneous both in the investigated domains as well as social referrals; 64% of these had a multidimensional structure. Internal consistency was reported for all instruments, while temporal stability only for 36% of the tools. Construct validity and concurrent validity were reported for 79% of the instruments, criterion and predictive validity for one instrument only, external validity for 18% of the tools, and cross-cultural validity for one instrument only. The content was directly available for most instruments.

CONCLUSIONS

The great interest in this subject as borne out by the amount of studies published in international psycho-oncological literature confirms the importance of having a valid and reliable instrument specifically dedicated to measuring the social impact of the oncological experience. At the same time, further investigation is required to investigate the psychometric properties of the existing tools.

Cancer-related pain and disability: a longitudinal study

CONTEXT

Although the cross-sectional association between cancer-related pain and disability is well established, their longitudinal relationship has been less studied.

OBJECTIVES

Data from the Indiana Cancer Pain and Depression (INCPAD) trial were analyzed to determine whether baseline cancer-related pain and changes in pain over time predict disability over 12 months.

METHODS

A total of 274 cancer survivors with cancer-related pain were accrued in the INCPAD trial. Data were collected at baseline, one, three, six, and 12 months by interviewers blinded to treatment arm. Disability outcomes included a continuous measure (Sheehan Disability Scale [SDS] score) and a categorical measure (≥14 days in the past four weeks with a ≥50% reduction in usual activities). Predictor variables, operationalized by the Brief Pain Inventory, included baseline pain severity and changes in pain severity scores between each time point. Multivariable analyses were conducted adjusting for treatment group, baseline disability, and selected covariates including depression.

RESULTS

Baseline pain severity did not predict disability outcomes at 12 months. However, improvement in pain severity predicted less disability over 12 months both in terms of SDS scores (b=-0.17, t=-5.33, P<0.001) and ≥14 disability days in the past month (odds ratio=0.85; 95% confidence interval, 0.79-0.93; P<0.001).

CONCLUSION

Disability over 12 months in patients with cancer-related pain is predicted by changes in pain severity over time. Results suggest that effective pain management may reduce subsequent disability among cancer survivors.

Intrapersonal and interpersonal dimensions of cancer perception: a confirmatory factor analysis of the cancer experience and efficacy scale (CEES)

PURPOSE

Sociocultural factors influence psychological adjustment to cancer in Asian patients in two major ways: prioritization of relationships over individual orientations and belief in the efficacy of interpersonal cooperation. We derived and validated among Chinese colorectal cancer (CRC) patients an instrument assessing cancer perceptions to enable the study of the sociocultural processes.

PATIENTS AND METHODS

Qualitative interviews (n = 16) derived 15 items addressing interpersonal experience in Chinese CRC patients' adjustment. These 15 items and 18 corresponding self-referent items were administered to 166 Chinese CRC survivors and subjected to exploratory factor analysis (EFA) to establish the initial scale structure and reliability. The final 29 items, together with other psychometric measures, were administered to a second cohort of 215 CRC patients and subjected to confirmatory factor analysis (CFA).

RESULTS

EFA (63.35% of the total variance) extracted six factors: personal strain, socioeconomic strain, emotional strain, personal efficacy, collective efficacy, and proxy efficacy. CFA confirmed the psychometric structure [chi (2)(df) = 702.91(368); Comparative Fit Index = 0.95; Nonnormed Fit Index = 0.94; Incremental Fit Index = 0.95; standardized root mean square residual = 0.08] of the six factors by using a model with two latent factors: experience and efficacy. All subscales were reliable (alpha = 0.76-0.92). Appropriate correlations with adjustment outcomes (symptom distress, psychological morbidity, and subjective well-being), optimistic personalities, and social relational quality indicated its convergent and divergent validity. Known group comparisons (i.e., age, active treatment, and colostomy) showed its clinical utility.

CONCLUSION

The cancer experience and efficacy scale is a valid multidimensional instrument for assessing intrapersonal and interpersonal dimensions of cancer experience in Asian patients, potentiating existing patient-reported outcome measures.