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Islam N, Atreya A, Nepal S, Uddin KJ, Kaiser MR, Menezes RG, Lasrado S, Abdullah‐Al‐Noman M. Assessment of quality of life (QOL) in cancer patients attending oncology unit of a Teaching Hospital in Bangladesh. Cancer Rep (Hoboken) 2023; 6:e1829. [PMID: 37204133 PMCID: PMC10432493 DOI: 10.1002/cnr2.1829] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND The quality of life (QoL) of a cancer patient is their perception of their physical, functional, psychological, and social well-being. QoL is one of the most important factors to consider when treating someone with cancer and during follow-up. The aim of this study was to understand the state of QoL among cancer patients in Bangladesh and to determine the factors that affect it. METHODS This cross-sectional study was conducted on 210 cancer patients who attended the oncology unit of Delta Medical College & Hospital, Dhaka during the period between 1 May 2022 and 31 August 2022. Data were collected using the Bengali version of the European Organization for Research and Treatment of Cancer (EORTC) questionnaire. RESULTS The study reported a high number of female cancer patients (67.6%), who were married, Muslims by religion, and non-residents of Dhaka. Breast cancer was more common among women (31.43%), while lung and upper respiratory tract cancer was more prevalent among men (19.05%). The majority of the patients (86.19%) were diagnosed with cancer in the past year. The overall mean score for functional scales was higher for physical functioning (54.92) whereas it was lower for social functioning (38.89). The highest score on the symptom scale was for financial problems (63.02), while the lowest was for diarrhea (33.01). The overall QoL score of cancer patients in the study was 47.98 and it was lower for males (45.71) compared to females (49.10). CONCLUSIONS The overall QoL was poor among Bangladeshi cancer patients compared to those in developed countries. A low QoL score was observed for social and emotional functions. Financial difficulty was the main reason behind the lower QoL score on the symptom scale.
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Affiliation(s)
- Nazmul Islam
- Department of OncologyDelta Medical College & HospitalDhakaBangladesh
| | - Alok Atreya
- Department of Forensic MedicineLumbini Medical CollegePalpaNepal
| | - Samata Nepal
- Department of Community MedicineLumbini Medical CollegePalpaNepal
| | - Kazi Jashim Uddin
- Department of OncologyDelta Medical College & HospitalDhakaBangladesh
| | - Md. Rashed Kaiser
- Department of OncologyDelta Medical College & HospitalDhakaBangladesh
| | - Ritesh G. Menezes
- Department of Pathology, College of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
| | - Savita Lasrado
- Department of Otorhinolaryngology and Head & Neck SurgeryFather Muller Medical CollegeMangaloreIndia
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Takura T, Koike T, Matsuo Y, Sekimoto A, Mutou M. Proxy responses regarding quality of life of patients with terminal lung cancer: preliminary results from a prospective observational study. BMJ Open 2022; 12:e048232. [PMID: 35210333 PMCID: PMC8883223 DOI: 10.1136/bmjopen-2020-048232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE This prospective study used the EQ-5D utility and Visual Analogue Scale (VAS) scores to analyse the potential usefulness of proxy responses in quality of life assessments of Japanese patients with terminal lung cancer sufficiently healthy to communicate and reply by themselves. We did not investigate the potential usefulness of using proxy responses for patients who could not respond by themselves. DESIGN A prospective observational study. SETTING Single centre. PARTICIPANTS The EQ-5D and VAS responses were gathered from 30 in-hospital patients with lung cancer for a total of three observation points. At nearly the same time, two nurses responded by providing proxy responses. PRIMARY AND SECONDARY OUTCOME MEASURES EQ-5D and VAS responses. RESULTS There were no significant differences between the patients' and nurses' responses for EQ-5D utility and VAS scores. For the five dimensions of the EQ-5D, significant differences were found between the patients' and nurses' responses for usual activities (patients' response 1.64±0.07, nurses' response 1.41±0.05, p=0.03) and anxiety/depression (patients' response: 1.40±0.05, nurses' response: 1.19±0.03, p=0.02). There was a significant weak positive correlation between patients' and nurses' responses regarding changes in responses from the first to the third observation point (Spearman's rank correlation coefficient ρ=0.228; p<0.01). CONCLUSION The results suggest that proxy responses are useful because there were no significant differences between the patients' and nurses' responses for EQ-5D utility and VAS scores at the three observation points. These findings should, however, be verified in future large-scale trials.
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Affiliation(s)
- Tomoyuki Takura
- Department of Healthcare Economics and Health Policy, The University of Tokyo Graduate School of Medicine Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Tomoko Koike
- Keio University Faculty of Nursing And Medical Care Graduate School of Health Management, Fujisawa, Kanagawa, Japan
| | - Yoko Matsuo
- W. L. Gore & Associates, G.K, Minato-ku, Tokyo, Japan
| | | | - Masami Mutou
- National Cancer Center-Hospital East, Kashiwa, Chiba, Japan
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Shaku F, Tsutsumi M, Nakamura A, Takagi H, Otsuka T, Maruoka S. Factors Relating to Caregivers' Preference for Advance Care Planning of Patients in Japan: A Cross-Sectional Study. Am J Hosp Palliat Care 2020; 36:727-733. [PMID: 31256612 DOI: 10.1177/1049909119844517] [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] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The aim of this study was to examine the preferences of home caregivers on patient advance care planning (ACP), including life-sustaining treatment (LST) and the factors relating to these preferences. BACKGROUND Personalized ACP aims to respect the autonomy and choices of terminally ill patients regarding end-of-life care. However, there have been cases wherein doctors must instead discuss ACP with surrogates (including caregivers) for various reasons such as dementia, intractable neurologic diseases, and cerebrovascular accident. METHODS In this cross-sectional study, self-written questionnaires (filled by individuals themselves) were distributed to 506 in-home caregivers in 6 Japanese prefectures; the questionnaires contained items on caregiver and patient demographics, number of people living together in a caregiver's home (aside from patients), care duration, comprehension level of doctors' explanations regarding their patient's condition, patient diseases, whether caregivers have or have not told patients about their disease, level of nursing care, and caregiver LST preference (preferred or not preferred). The questionnaire package also contained the Burden Index of Caregiver-11, Patient Health Questionnaire-9, and Short Form-8 Health Survey. RESULTS Valid responses were obtained from 309 caregivers. More than half of them were not sure of their patient's LST preference. Sex, number of people living together in a care home, comprehension level of doctors' explanations, and care duration were found to be the significant factors relating to caregivers' LST preference (P < .05). CONCLUSION Health providers should be cognizant of the background factors relating to caregiver ACP preference when deciding on LST for terminal patients.
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Affiliation(s)
- Fumio Shaku
- 1 Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital, Itabashi-ku, Tokyo, Japan.,2 Department of Internal Medicine, Division of Respiratory Medicine, Nihon University School of Medicine, Tokyo, Japan
| | | | | | | | | | - Shuichiro Maruoka
- 1 Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital, Itabashi-ku, Tokyo, Japan.,2 Department of Internal Medicine, Division of Respiratory Medicine, Nihon University School of Medicine, Tokyo, Japan
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Fukui S, Fujita J, Yoshiuchi K. Associations between Japanese People's Concern about Family Caregiver Burden and Preference for End-Of-Life Care Location. J Palliat Care 2018. [DOI: 10.1177/082585971302900104] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Through a cross-sectional nationwide survey, this study identified the associations between Japanese people's choice of end-of-life care location and their sense of being a burden or a source of concern to their family members. A total of 1,042 people responded to the survey (a response rate of 55 percent). Of these, 44 percent said they would prefer to receive end-of-life care at home, 15 percent in hospital, 19 percent in a palliative care unit, 10 percent in a public nursing home, and 2 percent in a private nursing home. Multinomial logistic regression analysis revealed that those who thought it most important to relieve caregiver burden on family members tended to prefer a palliative care unit or a public nursing home to their own homes; those who were most concerned about the effect their death would have on their family members tended to prefer a hospital or a palliative care unit to their own homes. These findings may assist in the development of a more effective end-of-life care system in Japan and in other countries.
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Affiliation(s)
- Sakiko Fukui
- S Fukui (corresponding author) Department of Community Health Nursing, Graduate School of Nursing, Japanese Red Cross University, 4-1-3 Hiroo, Shibuya-ku, Tokyo 150-0012, Japan
| | - Junko Fujita
- Department of Community Health Nursing, Graduate School of Nursing, Japanese Red Cross University, Shibuya-ku, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
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de Graaf E, Zweers D, de Graeff A, Stellato RK, Teunissen SCCM. Symptom Intensity of Hospice Patients: A Longitudinal Analysis of Concordance Between Patients' and Nurses' Outcomes. J Pain Symptom Manage 2018; 55:272-281. [PMID: 28923527 DOI: 10.1016/j.jpainsymman.2017.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/04/2017] [Accepted: 09/04/2017] [Indexed: 11/23/2022]
Abstract
CONTEXT Nearing death, hospice patients are increasingly unable or unwilling to self-report their symptom intensity and rely on nurses' assessments. OBJECTIVES We hypothesized that concordance between patients' and nurses' assessments of symptom intensity improves over time. METHOD A prospective longitudinal study was conducted from January 2012 to June 2015 using dyads of patient- and nurse-reported outcome measures, collected in daily hospice practice in the first three weeks after admission. Main outcomes were symptom intensity and well-being, measured using the Utrecht Symptom Diary (USD) and USD-Professional. Absolute concordance was the proportion of dyads with no difference in scores between USD and USD-Professional per week after admission. For agreement beyond chance, the squared weighted Kappa for symptom intensity and the one-way agreement intraclass correlation coefficient for well-being were used. RESULTS The most prevalent symptoms, fatigue, dry mouth, and anorexia also had the highest intensity scores assessed by patients and nurses. Symptom intensity was underestimated more frequently than overestimated by the nurses. The absolute concordance was fair to good (35%-69%). Agreement beyond chance was low to fair (0.146-0.539) and the intraclass correlation for well-being was low (0.25-0.28). Absolute concordance and agreement beyond chance did not improve over time. CONCLUSION Concordance between patients' and nurses' assessment of symptom prevalence is good, and both patients and nurses reveal identical symptoms as most and least prevalent and intense. However, nurses tend to underestimate symptom intensity. Concordance between patients and nurses symptom intensity scores is poor and does not improve over time.
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Affiliation(s)
- Everlien de Graaf
- Department of General Practice Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Daniëlle Zweers
- Department of General Practice Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center Utrecht, Utrecht, The Netherlands
| | - Alexander de Graeff
- Department of Medical Oncology, Cancer Center University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rebecca K Stellato
- Department of Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Saskia C C M Teunissen
- Department of General Practice Center of Expertise in Palliative Care, Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center Utrecht, Utrecht, The Netherlands
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Systematic review of caregiver responses for patient health-related quality of life in adult cancer care. Qual Life Res 2017; 26:1925-1954. [PMID: 28293821 DOI: 10.1007/s11136-017-1540-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 01/22/2023]
Abstract
PURPOSE In surveys and in research, proxies such as family members may be used to assess patient health-related quality of life. The aim of this research is to help cancer researchers select a validated health-related quality of life tool if they anticipate using proxy-reported data. METHODS Systematic review and methodological appraisal of studies examining the concordance of paired adult cancer patient and proxy responses for multidimensional, validated HRQOL tools. We searched PubMed, CINAHL, PsycINFO and perused bibliographies of reviewed papers. We reviewed concordance assessment methods, results, and associated factors for each validated tool. RESULTS A total of 32 papers reporting on 29 study populations were included. Most papers were cross-sectional (N = 20) and used disease-specific tools (N = 19), primarily the FACT and EORTC. Patient and proxy mean scores were similar on average for tools and scales, with most mean differences <10 points but large standard deviations. Average ICCs for the FACT and EORTC ranged from 0.35 to 0.62, depending on the scale. Few papers (N = 15) evaluated factors associated with concordance, and results and measurement approaches were inconsistent. The EORTC was the most commonly evaluated disease-specific tool (N = 5 papers). For generic tools, both concordance and associated factor information was most commonly available for the COOP/WONCA (N = 3 papers). The MQOL was the most frequently evaluated end-of-life tool (N = 3 papers). CONCLUSIONS Proxy and patient scores are similar on average, but there is large, clinically important residual variability. The evidence base is strongest for the EORTC (disease-specific tools), COOP/WONCA (generic tools), and MQOL (end-of-life-specific tools).
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Dawber R, Armour K, Ferry P, Mukherjee B, Carter C, Meystre C. Comparison of informal caregiver and named nurse assessment of symptoms in elderly patients dying in hospital using the palliative outcome scale. BMJ Support Palliat Care 2016; 9:175-182. [PMID: 26758469 PMCID: PMC6582819 DOI: 10.1136/bmjspcare-2015-000850] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 10/26/2015] [Accepted: 12/16/2015] [Indexed: 11/08/2022]
Abstract
Objectives A prospective study of symptom assessments made by a healthcare professional (HCP; named nurse) and an informal caregiver (ICG) compared with that of the patient with a terminal diagnosis. To look at the validity of HCP and ICG as proxies, which symptoms they can reliably assess, and to determine who is the better proxy between HCP and ICG. Methods A total of 50 triads of patient (>65 years) in the terminal phase, ICG and named nurse on medical wards of an acute general hospital. Assessments were made using the patient and caregiver versions of the palliative outcome scale (POS), all taken within a 24 h period. Agreement between patient-rated, ICG-rated and HCP-rated POS and POS for symptoms (POS-S) was measured using weighted-κ statistics. Demographic and clinical data on each group of participants were collected. Results ICG assessments have higher agreement with those of the patient than HCP. Better agreement in both groups was found for physical symptoms, and best agreement was for pain. The worst agreements were for psychological symptoms, such as anxiety and depression, and for satisfaction with information given. Psychological symptoms are overestimated by both ICG and HCP. Conclusions ICGs are more reliable proxies than HCPs. A trend for overestimation of symptoms was found in both groups which may lead to undervaluation of the quality of life by proxy and overtreatment of symptoms. This highlights the need to always use the patient report when possible, and to be aware of the potential flaws in proxy assessment. Reasons for overestimation by proxies deserve further research.
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Affiliation(s)
- Rebecca Dawber
- Department of Palliative Care, Southend University Hospital NHS Trust, Southend-on-Sea, UK
| | | | - Peter Ferry
- Department of Geriatric Medicine, Karin Grech Hospital, Pieta, Malta
| | - Bhaskar Mukherjee
- Department of Care of the Elderly/Stroke, Burton Hospitals NHS Trust, Burton upon Trent, UK
| | - Christopher Carter
- Department of Clinical Chemistry, Heart of England NHS Trust, Heartlands Hospital, Birmingham, UK
| | - Chantal Meystre
- Marie Curie Hospice West Midlands and Heart of England NHS Trust, Solihull, UK
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Abstract
Background: An important aim of palliative care is to ensure the highest possible quality of life (QoL) for the family members of patients. Aim: We aimed to determine the QoL of family members of hospitalized patients with end-stage disease, as well as differences in QoL based on socio-demographic characteristics and the patient's functional status, psychological distress, and QoL. Methods: Study participants were 292 family members of terminally ill patients at University Hospital, Ostrava, Czech Republic. To evaluate family members' QoL, we used the Quality of Life in Life-Threatening Illness — Family Carer Version (QOLLTI-F). We used the Hospital Anxiety and Depression Scale (HADS) and the Karnofsky Performance Status (KPS) Scale to assess patients' functional status and psychological distress. Results: A statistically significant difference was found in QoL evaluation based on family members' socio-demographic characteristics in education, employment, and age. A significantly lower QoL score was observed for patients' life partners in six domains. A correlation was found between patients' poorer functional status and family members' lower QoL. We found lower global QoL in family members of patients with depression. Conclusion: Family support is a cornerstone of palliative care. Palliative care professionals should focus on at-risk family members — the life partners of patients, the unemployed, younger people, and those whose ill loved one has a poor functional status.
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Jacobs DI, Kumthekar P, Stell BV, Grimm SA, Rademaker AW, Rice L, Chandler JP, Muro K, Marymont M, Helenowski IB, Wagner LI, Raizer JJ. Concordance of patient and caregiver reports in evaluating quality of life in patients with malignant gliomas and an assessment of caregiver burden. Neurooncol Pract 2014; 1:47-54. [PMID: 26034616 DOI: 10.1093/nop/npu004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Accepted: 02/05/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Given the neurocognitive impairment experienced by many patients with malignant gliomas, caregiver reports can be critical in assessing the quality of life (QOL) of these patients. In this study, we explored whether assessment of patient QOL by the primary caregiver shows concordance with the patient's self-reported QOL, and we quantified the burden faced by caregivers. METHODS QOL of 45 patients was evaluated by both the patient and primary caregiver on 3 or more separate occasions using the Functional Assessment of Cancer Therapy-Brain (FACT-Br) instrument, and concordance between the 2 reports was evaluated. Caregiver burden was measured using the Caregiver Quality of Life Index-Cancer (CQOL-C) instrument. RESULTS Overall, good concordance was observed between the patient and caregiver FACT-Br reports (intraclass correlation coefficient = 0.74). Patient-reported FACT-Br scores were 4.75 (95% CI, 1.44-8.05) points higher than paired caregiver reports on the 200-point scale (P = .008); however, this difference did not achieve clinical significance. Caregiver burden, as measured by the CQOL-C, was significantly greater among caregivers in this study than those previously reported for caregivers of patients with lung, breast, or prostate cancer (P < .001). CONCLUSIONS Despite minor discrepancies in caregiver assessments of patient QOL relative to patient self-reports, our results suggest that the caregiver assessments can serve as adequate proxies for patient reports. Our results also illustrate the particularly heavy burden faced by caregivers of patients with malignant glioma. Further research into both of these areas is warranted.
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Affiliation(s)
- Daniel I Jacobs
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
| | - Priya Kumthekar
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
| | - Becky V Stell
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
| | - Sean A Grimm
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
| | - Alfred W Rademaker
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
| | - Laurie Rice
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
| | - James P Chandler
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
| | - Kenji Muro
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
| | - MaryAnne Marymont
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
| | - Irene B Helenowski
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
| | - Lynne I Wagner
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
| | - Jeffrey J Raizer
- Department of Neurology, Northwestern University , Chicago, Illinois (D.I.J., P.K., B.V.S., S.A.G., L.R., J.J.R.); Department of Preventive Medicine Northwestern University , Chicago, Illinois (A.W.R., I.B.H.); Department of Neurosurgery Northwestern University , Chicago, Illinois (J.P.C., K.M.); Department of Radiation Oncology , Northwestern University , Chicago, Illinois (M.M.); Medical Social Sciences , Northwestern University , Chicago, Illinois (L.I.W.)
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Evans CJ, Benalia H, Preston NJ, Grande G, Gysels M, Short V, Daveson BA, Bausewein C, Todd C, Higginson IJ. The selection and use of outcome measures in palliative and end-of-life care research: the MORECare International Consensus Workshop. J Pain Symptom Manage 2013; 46:925-37. [PMID: 23628515 PMCID: PMC3858887 DOI: 10.1016/j.jpainsymman.2013.01.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 01/16/2013] [Accepted: 01/28/2013] [Indexed: 11/21/2022]
Abstract
CONTEXT A major barrier to widening and sustaining palliative care service provision is the requirement for better selection and use of outcome measures. Service commissioning is increasingly based on patient, carer, and service outcomes as opposed to service activity. OBJECTIVES To generate recommendations and consensus for research in palliative and end-of-life care on the properties of the best outcome measures, enhancing the validity of proxy-reported data and optimal data collection time points. METHODS An international expert "workshop" was convened and an online consensus survey was undertaken using the MORECare Transparent Expert Consultation to generate recommendations and level of agreement. We focused on three areas: 1) measurement properties, 2) use of proxies, and 3) measurement timing. Data analysis comprised descriptive analysis of aggregate scores and collation of narrative comments. RESULTS There were 31 workshop attendees; 29 recommendations were included in the online survey, completed by 28 experts. The top three recommendations by area were the following: 1) the properties of the best outcome measures are responsive to change over time and capture clinically important data, 2) to enhance the validity of proxy data requires clear and specific guidelines to aid lay individuals' and/or professionals' completion of proxy measures, and 3) data collection time points need clear identification to establish a baseline. CONCLUSION Outcome measurement in palliative and end-of-life care requires the use of psychometrically robust measures that are clinically responsive, with defined data collection time points to establish a baseline and clear administration guidelines to complete proxy measures. To further the field requires clinical imperatives to more closely inform recommendations on outcome measurement.
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Affiliation(s)
- Catherine J Evans
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom.
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Popovic M, Lao N, Bedard G, Zeng L, Zhang L, Cella D, Beaumont JL, Chiu N, Chiu L, Lam H, Poon M, Chow R, Chow E. Quality of Life in Patients with Advanced Cancer Using the Functional Assessment of Cancer Therapy-General Assessment Tool: A Literature Review. World J Oncol 2013; 4:8-17. [PMID: 29147325 PMCID: PMC5649914 DOI: 10.4021/wjon594w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2013] [Indexed: 01/22/2023] Open
Abstract
Quality of life (QOL) has become an increasingly meaningful endpoint in advanced cancer research. Clinicians assess QOL to help them select appropriate treatment options and regimens. The present review aims to compare QOL scores of the Functional Assessment of Cancer Therapy-General Assessment Tool (FACT-G) in relation to clinical and socio-demographic features in patients with advanced cancer. A literature search in MEDLINE and EMBASE was conducted; a total of 33 studies encompassing 39 study arms were identified that reported FACT-G scores. Four statistically significant parameters were identified with respect to FACT-G scores: education, national per capita healthcare expenditures, admittance status and previous radiation therapy. A greater percentage of patients completing higher education programs were correlated to significantly better emotional well-being and global QOL. Cohorts from countries with higher national per capita healthcare expenditures had better physical well-being, social/family well-being and improved relationships with their doctors. Patient samples comprised of purely outpatients had better levels of emotional well-being and global QOL when compared to samples with a mix of outpatients and inpatients. A greater percentage of patients previously receiving radiation therapy were correlated to a better relationship with doctor score. Although limitations of the present review exist, differences in QOL scores based on socio-demographic and clinical factors are observed; certain correlations described in the present work have been described previously in the literature while others have not. Future work aimed at either determining confounding parameters or cause and effect relationships is recommended.
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Affiliation(s)
- Marko Popovic
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Nicholas Lao
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Gillian Bedard
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Liang Zeng
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Liying Zhang
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Jennifer L Beaumont
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Nicholas Chiu
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Leonard Chiu
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Henry Lam
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Michael Poon
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Ronald Chow
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Edward Chow
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Hladschik-Kermer B, Kierner KA, Heck U, Miksovsky A, Reiter B, Zoidl H, Medicus E, Masel EK, Watzke HH. Patients and staff perceptions of cancer patients' quality of life. Eur J Oncol Nurs 2013; 17:70-4. [DOI: 10.1016/j.ejon.2012.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Revised: 12/29/2011] [Accepted: 01/24/2012] [Indexed: 11/29/2022]
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