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Miniotti M, Botto R, Soro G, Olivero A, Leombruni P. A Critical Overview of the Construct of Supportive Care Need in the Cancer Literature: Definitions, Measures, Interventions and Future Directions for Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:215. [PMID: 38397704 PMCID: PMC10887927 DOI: 10.3390/ijerph21020215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
The growing amount of evidence about the role of supportive care in enhancing cancer patients' outcomes has made healthcare providers more sensitive to the need for support that they experience during cancer's trajectory. However, the lack of a consensus in the definition of supportive care and lack of uniformity in the theoretical paradigm and measurement tools for unmet needs does not allow for defined guidelines for evidence-based best practices that are universally accepted. Contemporary cancer literature confirms that patients continue to report high levels of unmet supportive care needs and documents the low effectiveness of most of the interventions proposed to date. The aim of this critical review is to consolidate the conceptual understanding of the need for supportive care, providing definitions, areas of expertise and a careful overview of the measurement tools and intervention proposals developed to date. The possible reasons why the currently developed interventions do not seem to be able to meet the needs, and the issues for future research were discussed.
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Affiliation(s)
- Marco Miniotti
- ‘Rita Levi Montalcini’ Department of Neuroscience, University of Turin, 10126 Turin, Italy; (R.B.); (G.S.); (A.O.); (P.L.)
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Fang SY, Chen TC. Validation of the modified Chinese Information and Support Needs Questionnaire (ISNQ-C) for daughters of mothers with breast cancer. Palliat Support Care 2024; 22:110-118. [PMID: 36217687 DOI: 10.1017/s1478951522001407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adult daughters concerned about getting breast cancer throughout their lives and required support because their mothers had breast cancer. OBJECTIVES This article aims to examine the revised Information and Support Needs Questionnaire (ISNQ) and validate it in a Taiwanese community population comprising daughters of mothers with breast cancer. METHODS Using convenience sampling, daughters of mothers with breast cancer were recruited and were separated into 2 samples (Sample 1, n = 102, and Sample 2, n = 118). First, we translated and modified the ISNQ to ensure cultural adaptation and formed ISNQ Chinese version (ISNQ-C). Second, we conducted an exploratory factor analysis using both samples to explore the ISNQ-C factor structure. Finally, we tested the criterion validity and known-group validity of the ISNQ-C using Sample 2. RESULTS Thirty-two items addressing 5 factors were identified for the ISNQ-C. Each factor had good internal consistency. The criterion validity was supported by significant correlations between the ISNQ-C scores and scores on the impacts of an event, anxiety, and depression. Known-group comparisons revealed that the group with deceased mothers reported significantly more unmet needs related to "releasing my anxiety" compared to the group where the mother was stable and undergoing regular follow-ups. SIGNIFICANCE OF RESULTS The ISNQ-C demonstrated good reliability and validity in terms of assessing needs among daughters of mothers with breast cancer in Taiwan. Using this assessment tool before genetic counseling to target the individual needs of this population at risk for breast cancer would be helpful to provide personalized care.
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Affiliation(s)
- Su-Ying Fang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Nuring, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Ting-Chun Chen
- Department of Nursing, Chi Mei Medical Center, Tainan, Taiwan
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Chukwuemeka NA, Yinka Akintunde T, Uzoigwe FE, Okeke M, Tassang A, Oloji Isangha S. Indirect effects of health-related quality of life on suicidal ideation through psychological distress among cancer patients. J Health Psychol 2024:13591053231225306. [PMID: 38279547 DOI: 10.1177/13591053231225306] [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: 01/28/2024] Open
Abstract
The interrelationships of suicidal ideation, psychological distress, and impaired health-related quality of life (HRQoL) in cancer patients are complex and multifaceted. Limited empirical evidence exists on the indirect effects of impaired HRQoL on suicidal ideation through psychological distress among cancer patients. To fill this research gap, 250 cancer patients were recruited through a cross-sectional hospital-based research design. Structural equation model (SEM) results indicated that impaired HRQoL is a predictor of psychological distress (β = 0.153; p < 0.05), and psychological distress positively predicts suicidal ideation (β = 0.647; p < 0.000). The study found no direct effects of impaired HRQoL on suicidal ideation (β = -0.05; p = 0.223). Indirect effects of HRQoL on suicidal ideation was confirmed, showing a full-mediation effect β = 0.099 (SE = 0.048, CI = [0.030, 0.189], p < 0.05) (i.e. the pathway impaired HRQoL predict suicidal ideation is through psychological distress). Cognitive-behavioral therapy and other emotional support programs should be considered for cancer patients to mitigate psychological vulnerabilities linking impaired HRQoL to suicidal ideation.
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Affiliation(s)
| | | | | | | | - Andrew Tassang
- University of Buea, Cameroon
- Buea Regional Hospital, Annex, Cameroon
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Lin W, Yoon S, Zhao Y, Seow-En I, Chok AY, Tan EKW. Patient-reported unmet supportive care needs in long-term colorectal cancer survivors after curative treatment in an Asian population. Asian J Surg 2024; 47:256-262. [PMID: 37659941 DOI: 10.1016/j.asjsur.2023.08.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/21/2023] [Accepted: 08/21/2023] [Indexed: 09/04/2023] Open
Abstract
OBJECTIVES Despite an increase in colorectal cancer (CRC) survival, less is known about CRC-specific long-term unmet supportive needs in Asian patients. This study aimed to examine the prevalence of long-term unmet needs and identify clinical and socio-demographic factors associated with increased unmet needs in Asian CRC survivors. DESIGN AND SETTING We conducted a cross-sectional study that assessed unmet needs using the Cancer Survivors' Unmet Needs scale. CRC survivors of at least two years after undergoing curative surgery were recruited from an outpatient clinic of a large public hospital in Singapore. RESULTS In total, 400 CRC survivors with a mean age of 64 and a median survival time post-surgery of 78 months participated in the study. Approximately half of patients (52%) reported at least one unmet need. Male gender (RR 1.19, p = 0.01), age greater than 65 years (RR 0.63, p < 0.0001), longer follow up of more than 5 years (RR 0.80, p = 0.009), presence of a permanent stoma (RR 1.78, p < 0.0001), prior radiotherapy in treatment course (RR 1.99, p < 0.0001), higher educational status (RR 1.30, p = 0.0002), currently employed (RR 0.84, p = 0.014), currently married (RR 0.84, p = 0.01) were significant predictors for increased unmet needs. CONCLUSION There is a high prevalence of unmet needs in long-term Asian CRC survivors, which underscores the importance of screening patients to allow for early detection of unmet needs. Our findings on sociodemographic and clinical predictors can inform the development of targeted interventions tailored to the need domains and improvement of survivorship programmes.
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Affiliation(s)
- Wenjie Lin
- Department of Colorectal Surgery, Singapore General Hospital, 169608, Singapore.
| | - Sungwon Yoon
- Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Yun Zhao
- Department of Colorectal Surgery, Singapore General Hospital, 169608, Singapore; Strategic Finance, Group Finance Analytics, SingHealth Community Hospital, 168582, Singapore
| | - Isaac Seow-En
- Department of Colorectal Surgery, Singapore General Hospital, 169608, Singapore
| | - Aik Yong Chok
- Department of Colorectal Surgery, Singapore General Hospital, 169608, Singapore
| | - Emile Kwong Wei Tan
- Department of Colorectal Surgery, Singapore General Hospital, 169608, Singapore
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Wang IY, Jane SW, Hsu HC, Lin YC, Tsai WS, Young CY, Beaton RD, Huang HP. The Longitudinal Trends of Care Needs, Psychological Distress, and Quality of Life and Related Predictors in Taiwanese Colorectal Cancer Survivors. Semin Oncol Nurs 2023; 39:151424. [PMID: 37100635 DOI: 10.1016/j.soncn.2023.151424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/26/2023] [Accepted: 03/15/2023] [Indexed: 04/28/2023]
Affiliation(s)
- I-Ya Wang
- Department of Nursing, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Sui-Whi Jane
- Department of Nursing, Chang Gung University of Science and Technology, Taiwan; Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Hung-Chih Hsu
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan
| | - Yung-Chang Lin
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Wen-Sy Tsai
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Chia-Yung Young
- Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Lin-Kou, Taiwan
| | - Randal D Beaton
- Psychosocial & Community Health and Health Services, Schools of Nursing and Public Health, University of Washington, Seattle
| | - Hsiang-Ping Huang
- Department of Nursing, Chang Gung University of Science and Technology, Taiwan.
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Miroševič Š, Selič-Zupančič P, Prins J, Homar V, Klemenc-Ketiš Z. Psychometric properties of the Slovenian version of the Cancer Survivors’ Unmet Needs (CaSUN-SL) measure in post-treatment cancer survivors. BMC Psychol 2022; 10:175. [PMID: 35843954 PMCID: PMC9288676 DOI: 10.1186/s40359-022-00878-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 06/28/2022] [Indexed: 01/06/2023] Open
Abstract
Background As the number of cancer survivors is growing, valid instruments for assessing cancer survivors' needs are required. Thus, the aim of this study was to translate and validate the Cancer Survivors Unmet Needs (CaSUN) scale. Methods Cancer survivors were recruited from 30 family medicine practices and separated into two samples (sample 1, n = 147; sample 2, n = 148). Factor structure was explored with an exploratory analysis in sample 1 and determined with a confirmatory analysis in sample 2. Psychometric properties were assessed with internal consistency, test–retest reliability and construct validity. Results A translation and cultural adaptation of the CaSUN scale resulted in 34 items being included in the final version. The factor structure confirmed the five-factors solution of the CaSUN-SL. Cronbach’s alpha was 0.94 for the CaSUN-SL and ranged from 0.71–0.88 for specific domains. Test–retest reliability showed moderate-high stability over time. The CaSUN-SL significantly and positively correlated with anxiety (r = 0.49), depression (r = 0.44), health-related quality of life (r = 0.36), and negatively with self-perceived health (r = − 0.36) and resilience (r = − 0.47), which confirms the construct validity. In addition, we found a significant correlation between unmet needs and age (r = − 0.29), gender (r = 0.14), cancer stage (r = 0.20), cancer type (r = 0.19), and time since treatment (r = − 0.20). Conclusions Results indicate that CaSUN-SL is a valid and reliable measure to assess the Slovenian cancer survivors’ unmet, met and total needs and can be used for further prospective studies. Trial Registration: No. 0120-25/2019/6.
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Miroševič Š, Prins J, Borštnar S, Besić N, Homar V, Selič-Zupančič P, Smrdel ACŠ, Klemenc-Ketiš Z. Factors associated with a high level of unmet needs and their prevalence in the breast cancer survivors 1–5 years after post local treatment and (neo)adjuvant chemotherapy during the COVID-19: A cross-sectional study. Front Psychol 2022; 13:969918. [PMID: 36262447 PMCID: PMC9574393 DOI: 10.3389/fpsyg.2022.969918] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To assess the prevalence of unmet needs in post-treatment breast cancer survivors and identify sociodemographic, clinical, and psychosocial variables associated with reported unmet needs during the COVID-19 pandemic. Materials and methods In this cross-sectional study, 430 post-treatment breast cancer survivors, ranging between 1 and 5 years after the procedure, completed the Cancer Survivors’ Unmet Needs (CaSUN) questionnaire from September 2021 and January 2022. The multivariate logistic analysis identified factors associated with at least one reported unmet need in the total CaSUN scale and specific domains. Results A total of 67% of survivors reported at least one unmet need. The most frequently reported unmet needs were the lack of accessible hospital parking (43%) and recurrence concerns (39.5%). The majority of reported unmet needs relate to comprehensive care (44%), followed by the psychological and emotional support domain (35.3%). Younger age (OR = 0.95, 95% CI = 0.92–0.99; p < 0.001), three or more comorbidities (OR = 0.27, 95% CI = 0.11–0.71, p < 0.01), a lower quality of life (OR = 0.06, 95% CI = 0.01–0.47, p < 0.01) and low resilience (OR = 0.95, 95% CI = 0.93–0.99) were associated with a high level of unmet needs in the multivariate regression model. Results are presented for factors associated with a high level of unmet needs for comprehensive cancer care and psychological and emotional support domain. Conclusion A high prevalence found in our study could be attributed to the COVID-19 pandemic, where patients may have missed adequate follow-up care, although comparing to studies done in non-pandemic time is difficult. Family physicians should be more attentive toward younger cancer survivors and those with more comorbidities as both characteristics can be easily recognized in the family practice.
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Affiliation(s)
- Špela Miroševič
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- *Correspondence: Špela Miroševič,
| | - Judith Prins
- Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Simona Borštnar
- Department of Medical Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Nikola Besić
- Department of Surgical Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Vesna Homar
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Polona Selič-Zupančič
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Psychology, Faculty of Medicine, University of Maribor, Maribor, Slovenia
- Community Health Centre Ljubljana, Primary Healthcare Research and Development Institute, Ljubljana, Slovenia
| | | | - Zalika Klemenc-Ketiš
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Community Health Centre Ljubljana, Primary Healthcare Research and Development Institute, Ljubljana, Slovenia
- Department of Family Medicine, Medical Faculty, University of Maribor, Maribor, Slovenia
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Lekdamrongkul P, Pongthavornkamol K, Molassiotis A, Dechpichai P, Pinsuntorn P. Translation and psychometric testing of the Thai version of Cancer Survivors’ Unmet Needs measure among cancer survivors. Asia Pac J Oncol Nurs 2022; 9:100083. [PMID: 35814524 PMCID: PMC9263872 DOI: 10.1016/j.apjon.2022.100083] [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: 02/26/2022] [Accepted: 05/09/2022] [Indexed: 11/28/2022] Open
Abstract
Objective To evaluate the psychometric properties of the Thai version of the Cancer Survivors’ Unmet needs (CaSUN-TH) scale among Thai cancer survivors after completion of primary treatment. Methods Standardized translation procedures developed the Cancer Survivors’ Unmet Needs into a Thai version (CaSUN-TH). Face validity was evaluated by a group of experts, and a pilot test on 10 cancer patients was conducted to evaluate its readability. A total of 236 cancer survivors who were attending follow-up visits at a cancer hospital in Thailand completed the CaSUN-TH. The internal consistency of the instrument was examined using Cronbach’s α. The association of the CaSUN-TH and its subscales with physical symptoms, QoL, age, gender, and type of cancer were examined for criterion validity and known-group validity. Construct validity was evaluated using confirmatory factor analysis. Results The CaSUN-TH showed good readability and high content validity for use as an instrument to assess unmet needs among Thai cancer survivors. Cronbach’s α for the entire scale was 0.95. Confirmatory factor analysis indicated that the five-factor structure of the CaSUN-TH was good fit to the data (CFI = 0.901, SRMR = 0.074, RMSEA = 0.076 [90% confidence interval, 0.066–0.085]). In terms of construct validity, CaSUN-TH scores significantly correlated to other variables hypothesized to influence the level of need, including higher physical symptoms prevalence was related to poor quality of life, and poorer QOL and younger age were associated with a higher level of unmet needs. In addition, the scale was able to differentiate scores between groups, including gender, age, and type of primary cancer, with theoretically hypothesized differences. Conclusions The CaSUN-TH demonstrated appropriate psychometric properties for assessing unmet needs in different cancer survivor groups in Thailand. Using the CaSUN-TH can help health professionals in targeting individual survivor needs, bridging the gap between patients’ experiences and their expectations, and improving the quality of cancer survivorship care.
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Affiliation(s)
- Pichitra Lekdamrongkul
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Kanaungnit Pongthavornkamol
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
- Corresponding author.
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Porntip Dechpichai
- Department of Mathematics, King Mongkut’s University of Technology Thonburi, Bangkok, Thailand
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Li Y, Zhou Z, Ni N, Li J, Luan Z, Peng X. Quality of Life and Hope of Women in China Receiving Chemotherapy for Breast Cancer. Clin Nurs Res 2021; 31:1042-1049. [PMID: 34519566 DOI: 10.1177/10547738211046737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We explore the association of hope and quality of life in breast cancer chemotherapy women. Their quality of life is related to treatment effects and disease outcomes. This cross-sectional study was conducted in City, China, in 2017. In a convenience sampling, 450 women who underwent breast cancer chemotherapy were selected from two hospitals. Descriptive statistics, single-factor analysis, Spearman correlation, linear regression, and structural equation modeling were used to analyze data. The mean quality of life score was 65.65. In linear regression analysis, we found patients' quality of life was significantly related to age, marital status, education level, chemotherapy cycle, and hope. Structural equation results showed the "temporality and future" and "interconnectedness" subscales of the HHI explained 43% of the variance in quality of life. We found hope is an important aspect in quality of life, and further research is needed to determine if nurses can influence this aspect of care.
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Affiliation(s)
- Yuan Li
- Jilin University, Changchun, China
| | | | - Na Ni
- Inner Mongolia Medical University, Hohhot, China
| | | | - Ze Luan
- Jilin University, Changchun, China
| | - Xin Peng
- Jilin University, Changchun, China
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Zhang J, Li L, Liu D, Zhu T, Gao Q, Chen H, Ma L, Li J, Wang Z. Development and validation of the information needs questionnaire for differentiated thyroid cancer patient with radioactive iodine therapy (INQ-DTC). Nurs Open 2021; 9:1794-1804. [PMID: 34003590 PMCID: PMC8994968 DOI: 10.1002/nop2.925] [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: 11/15/2020] [Revised: 03/29/2021] [Accepted: 04/20/2021] [Indexed: 12/24/2022] Open
Abstract
AIMS This study aimed to develop and validate the psychometric properties of Information Needs Questionnaire for Differentiated Thyroid Cancer (INQ-DTC) in DTC patients with radioactive iodine (RAI) therapy. DESIGN Mixed methods. METHODS Using qualitative methods, we developed the initial questionnaire from a personal perspective of information needs of 15 patients with DTC. We used a formal Delphi consensus process to help assess the initial questionnaire and provide recommendations for its application. Totally, 230 DTC patients with RAI therapy were selected for the process of validation. RESULTS The final version of INQ-DTC contains 33 items. The total Cronbach's alpha coefficient was 0.945, the total split-half reliability was 0.822, and the test-retest value was 0.984 for the overall score. Exploratory factor analysis extracted 5 factors, which could explain 61.86% of the total variance. The Scale-level content validity index (S-CVI) was 0.928, and 0.929 for the item-level content validity index (I-CVI).
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Affiliation(s)
- Jing Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Limei Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dongling Liu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Tingting Zhu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Qiaoqiao Gao
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Hui Chen
- The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Ling Ma
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Jiayin Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Zichen Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
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Shih IH, Lin CY, Fang SY. Prioritizing care for women with breast cancer based on survival stage: A study examining the association between physical symptoms, psychological distress and unmet needs. Eur J Oncol Nurs 2020; 48:101816. [PMID: 32937261 DOI: 10.1016/j.ejon.2020.101816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE 1) To examine the differences in physical symptoms, psychological distress and unmet needs between short-term (2-5 years) and long-term (>5 years) breast cancer survivors (BCSs). 2) To explore how physical symptoms and psychological distress impact unmet needs among women in different survival stages. METHOD Three hundred forty-nine people with breast cancer completed questionnaires. Short-term (2-5 years) and long-term (>5 years) survival stages were examined. Physical symptoms (number of physical symptoms); psychological distress, including fear of recurrence (FOR) (FOR visual analogue scale (VAS)) and depressive symptoms (Center for Epidemiological Studies-Depression Scale); and unmet needs (Chinese Cancer Survivors' Unmet Needs scale) were measured. Structural equation modelling with multi-group analysis was used to assess differences between short- and long-term survivors in the magnitude of paths. RESULTS In total, 157 women who had survived <5 years and 192 women who had survived >5 years were recruited. The path coefficients from physical and depressive symptoms to unmet needs were similar between short-term BCSs and long-term BCSs (p > .05). However, the path coefficient from FOR to unmet needs among women who had survived for >5 years was significantly greater than that among those who had survived <5 years (p < .001). CONCLUSION Based on these results, health care professionals should be aware of the FOR that women experience even 5 years after their initial diagnosis. Providing survivorship care plans with comprehensive side effect-related information soon after treatment is recommended.
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Affiliation(s)
- I-Hsuan Shih
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Su-Ying Fang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Vuksanovic D, Sanmugarajah J, Lunn D, Sawhney R, Eu K, Liang R. Unmet needs in breast cancer survivors are common, and multidisciplinary care is underutilised: the Survivorship Needs Assessment Project. Breast Cancer 2020; 28:289-297. [PMID: 32929637 DOI: 10.1007/s12282-020-01156-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 09/03/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The transition from a breast cancer patient to a survivor can be associated with significant physical, psychological, and social challenges. Development of multidisciplinary evidence-based care during the post-treatment period is a key area of cancer research. This study examined survivorship issues, unmet needs and perceptions about care among a cohort of breast cancer survivors. METHODS Participants were 130 women diagnosed with breast cancer for at least one year, and attending a hospital breast or oncology outpatient clinic. They completed a series of self-report questionnaires assessing demographic and clinical characteristics, unmet needs, severity of survivorship issues, use of multidisciplinary services, clinical benchmarks, survivorship care satisfaction, and suggestions for service improvements. RESULTS There was an average of 4.9 unmet survivorship needs, with 67% of participants reporting at least one unmet need. Fear of cancer recurrence, stress, coordination of medical care and negative iatrogenic impacts of hormonal treatments were key concerns. The cancer support team typically consisted of medical and nursing staff, and family/friends, and most were satisfied with their survivorship care. There was minimal use of other multidisciplinary clinicians and support groups. Provision of additional dietary and cancer recurrence education, and a written treatment plan were identified as key areas of service improvement. CONCLUSION Despite high satisfaction ratings, survivorship issues and unmet needs were relatively common, particularly among younger participants. Use of multidisciplinary care was inconsistent and overall underutilised. IMPLICATIONS FOR CANCER SURVIVORS Ongoing specific evaluation and optimisation of existing models of multidisciplinary survivorship care are essential in meeting the complex needs of breast cancer survivors.
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Affiliation(s)
- Dean Vuksanovic
- Gold Coast Hospital and Health Service, 1 Hospital Blvd, Parklands Drive, Southport, QLD, 4215, Australia
| | - Jasotha Sanmugarajah
- Gold Coast Hospital and Health Service, 1 Hospital Blvd, Parklands Drive, Southport, QLD, 4215, Australia
| | - Dominic Lunn
- ICON Cancer Centre, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD, 4215, Australia
| | - Raja Sawhney
- Gold Coast Hospital and Health Service, 1 Hospital Blvd, Parklands Drive, Southport, QLD, 4215, Australia
| | - Kelly Eu
- Bond University, 14 University Dr, Robina, QLD, 4226, Australia
| | - Rhea Liang
- Gold Coast Hospital and Health Service, 1 Hospital Blvd, Parklands Drive, Southport, QLD, 4215, Australia. .,Bond University, 14 University Dr, Robina, QLD, 4226, Australia.
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Ohlsson-Nevo E, Ahlgren J, Karlsson J. Impact of health-related stigma on psychosocial functioning in cancer patients: Construct validity of the stigma-related social problems scale. Eur J Cancer Care (Engl) 2020; 29:e13312. [PMID: 32865867 PMCID: PMC7757179 DOI: 10.1111/ecc.13312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 07/06/2020] [Accepted: 08/07/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the validity of Stigma-related Social Problems scale (SSP) in a cancer population. MATERIALS AND METHODS The SSP was sent to 1,179 cancer patients. Mean age was 67.9 year and 43% were women. Tests of internal consistency reliability, construct validity, item-scale convergent validity, ceiling and floor effects and known-group validity were conducted. RESULTS The response rate was 62%, and the final sample comprised 728 patients. Reliability coefficients were high for both subscales (Cronbach's alpha = 0.94). Exploratory factor analyses confirmed the unidimensionality and homogeneity of the scales. Item-scale correlations for both scales indicated satisfactory item-scale convergent validity. The proportion of subjects scoring at the lowest possible score level was 26% for the Distress scale and 28% for the Avoidance scale, while ceiling effects were marginal (<1%). The proportion of missing items was low, ranging from 1.4% to 1.5%. Known-group validity tests confirmed that the scales could capture expected differences between subgroups. CONCLUSIONS The SSP scale is a feasible instrument with sound psychometric properties that is validated in a study on 728 cancer patients. The instrument can be used to identify cancer patients at risk for psychosocial disturbances and thus in need of support.
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Affiliation(s)
- Emma Ohlsson-Nevo
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Johan Ahlgren
- Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Regional Oncological Centre Uppsala-Örebro, Uppsala, Sweden
| | - Jan Karlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
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Chang YH, Lai YH, Tsai MK, Shun SC. Care Needs for Organ Transplant Recipients Scale: Development and psychometric testing. J Ren Care 2020; 47:123-132. [PMID: 32799380 DOI: 10.1111/jorc.12345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/03/2020] [Accepted: 05/05/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Needs assessment can determine how large the gap is between needs and available services; however, no tools are available to assess the unmet needs of renal transplant recipients. OBJECTIVES The aim of this study was to develop the Care Needs for Organ Transplant Recipients Scale (CNOTRS) and examine its psychometric properties. DESIGN A cross-sectional design for instrument development and psychometric testing. PARTICIPANTS In total, 217 renal transplant recipients were recruited through convenience sampling. METHODS An initial 36-item CNOTRS was developed after a comprehensive literature review. After the CNOTRS was tested through content validity and face validity, the factor structure was explored using exploratory factor analysis (EFA). Convergent validity was examined using Pearson's correlation between the CNOTRS and Hospital Anxiety and Depression Scale (HADS). Known-group validity was tested by comparing CNOTRS scores of patients grouped based on whether they had experienced complications or rejection. RESULTS Twenty-eight items with three factors (namely daily care and social interaction needs, psychological needs, and health system and service needs) were identified in EFA by parallel analysis and Velicer's MAP test. The psychological needs domain had a stronger positive correlation with the HADS than the other two domains. The known-group validity was supported as a significant association between complications or rejection occurrence and unmet needs. The Cronbach's α of the CNOTRS was 0.94. CONCLUSIONS The CNOTRS demonstrated satisfactory reliability and validity to assess the care needs for renal transplant recipients and can assist health care professionals to tailor more personalised care for their individual needs.
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Affiliation(s)
- Yu Hsuan Chang
- Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan.,School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yeur Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Meng Kun Tsai
- Department of Surgery, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shiow Ching Shun
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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15
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Lebel S, Mutsaers B, Tomei C, Leclair CS, Jones G, Petricone-Westwood D, Rutkowski N, Ta V, Trudel G, Laflamme SZ, Lavigne AA, Dinkel A. Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates. PLoS One 2020; 15:e0234124. [PMID: 32716932 PMCID: PMC7384626 DOI: 10.1371/journal.pone.0234124] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with chronic diseases commonly report fears of illness or symptoms recurring or worsening. These fears have been addressed from an illness-specific perspective (e.g., fear of cancer recurrence), a generic illness perspective (e.g., fear of progression), and a psychiatric perspective (DSM-5 illness anxiety disorder and somatic symptom disorder). The broader concept of health anxiety (HA) can also be applied to patients with a chronic disease. This review was conducted to investigate the conceptual, theoretical, measurement-overlap, and differences between these distinct perspectives. We also aimed to summarize prevalence, course, and correlates of these fears in different chronic illnesses. METHODS We used PsycINFO, PubMED, CINAHL, Web of Science, SCOPUS, and PSYNDEX to conduct a systematic review of studies pertaining to these fears in chronic illness published from January 1996 to October 2017. A total of 401 articles were retained. RESULTS There were commonalities across different conceptualizations and diseases: a high prevalence of clinical levels of fears (>20%), a stable course over time, and a deleterious impact on quality of life. Reviewed studies used definitions, models, and measures that were illness-specific, with only a minority employing a psychiatric perspective, limiting cross-disease generalizability. There appears to be some applicability of DSM-5 disorders to the experience of fear of illness/symptoms in patients with a chronic illness. While conceptualizing HA on a continuum ranging from mild and transient to severe may be appropriate, there is a lack of agreement about when the level of fear becomes 'excessive.' The definitions, models, and measures of HA across chronic illnesses involve affective, cognitive, behavioral, and perceptual features. CONCLUSIONS The concept of HA may offer a unifying conceptual perspective on the fears of illness/symptoms worsening or returning commonly experienced by those with chronic disease.
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Affiliation(s)
- Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Christina Tomei
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Georden Jones
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Nicole Rutkowski
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Viviane Ta
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Geneviève Trudel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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16
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Komatsu H, Yagasaki K, Sato Y, Arao H, Yamamoto S, Hayashida T. Evaluation of the Japanese Version of the Cancer Survivors' Unmet Needs Scale. Asia Pac J Oncol Nurs 2020; 7:167-173. [PMID: 32478134 PMCID: PMC7233570 DOI: 10.4103/apjon.apjon_49_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/22/2019] [Indexed: 12/24/2022] Open
Abstract
Objective This study aimed to evaluate the psychometric properties of the Japanese version of the Cancer Survivors' Unmet Needs (CaSUN-J) scale among cancer survivors in Japan. Methods The CaSUN-J was developed using standardized translation methodology. Content validity was evaluated by a group of experts, and a pilot test was conducted with a convenience sample of 10 cancer patients. A total of 183 Japanese cancer survivors completed the CaSUN-J. The internal consistency of the scale was examined with Cronbach's α. Construct validity was analyzed using correlations with the physical effects, quality of life (QoL), and age. To assess the factorial validity of the CaSUN-J, confirmatory factor analysis (CFA) was performed. Results The CaSUN-J indicated good readability and high content validity for use as an assessment tool among Japanese cancer survivors. All Cronbach's α coefficients were above the minimum acceptable criterion of ≥0.70. For construct validity, higher physical effect scores, as well as poorer QoL scores and younger patients, were significantly positively associated with higher levels of needs. CFA indicated that the five-factor structure of the CaSUN-J was a good fit to the data. Conclusions The CaSUN-J can serve as a valid and reliable tool to evaluate unmet needs among Japanese cancer survivors.
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Affiliation(s)
- Hiroko Komatsu
- Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan
| | - Kaori Yagasaki
- Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan
| | - Yasunori Sato
- Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Harue Arao
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Sena Yamamoto
- Department of Nursing, Hakuaikai Sagara Hospital, Kagoshima, Japan
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17
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Li Q, Xu Y, Lin Y, Li J, Huang W, Chen Y. Psychometric properties of the Chinese version of the cancer survivors' unmet needs measure. Eur J Oncol Nurs 2020; 46:101772. [PMID: 32512527 DOI: 10.1016/j.ejon.2020.101772] [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: 12/28/2019] [Revised: 04/25/2020] [Accepted: 05/08/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Recognition has been growing that when developing effective and affordable survivorship care programmes, it is crucial to assess cancer survivors' unmet needs. The purpose of this study was to evaluate the psychometric properties, including construct validity, internal consistency, test-retest reliability, and concurrent validity, of the Chinese version of the Cancer Survivors' Unmet Needs measure (C-CaSUN) using a sample of Chinese adult cancer survivors. METHOD A test battery, consisting of a self-developed information sheet and four Chinese version measurement scales [CaSUN, the Benefit Finding Scale, Hospital Anxiety and Depression Scale, and the Medical Outcomes Study 12-item Short Form (SF-12)], was applied to collect data from Chinese adult cancer survivors. Statistics methods used included exploratory factor analysis, confirmatory factor analysis, Cronbach's coefficient α, Pearson's correlation, and Kappa coefficient. RESULTS There were 610 cancer survivors. Factor analysis confirmed the five-factor model of C-CaSUN, including information and medical care, life perspective, relationship, comprehensive support, and quality of life. Cronbach's α for all of the C-CaSUN scales was greater than 0.845. The test-retest correlations at the scale level, including the total and the five factors between the two time points, ranged from good to excellent (r = 0.713-0.833). The average Kappa coefficient at the item level was 44%. Evidence of significant negative correlations with SF-12 MCS, and positive correlations with anxiety and depression, established the concurrent validity of the C-CaSUN. CONCLUSIONS Evidence indicates that the C-CaSUN is a reliable and valid measure of unmet needs in Chinese cancer survivors. Findings support the five-factor construct of C-CaSUN.
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Affiliation(s)
- Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Yinghua Xu
- Wuxi People's Hospital, Wuxi, Jiangsu Province, China
| | - Yi Lin
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Jinping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Wei Huang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Ying Chen
- Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China.
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18
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Fang SY, Wang YL, Lu WH, Lee KT, Kuo YL, Fetzer SJ. Long-term effectiveness of an E-based survivorship care plan for breast cancer survivors: A quasi-experimental study. PATIENT EDUCATION AND COUNSELING 2020; 103:549-555. [PMID: 31558323 DOI: 10.1016/j.pec.2019.09.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the effect of a web-based survivorship care plan (SCP) computerized application (APP): (SCP-A) on women's unmet needs, fear of recurrence, symptom distress, anxiety, depression, and quality of life (QoL). METHODS Women diagnosed with breast cancer, who had completed their primary treatment but less than 5 years without a sign of recurrence (N = 165) were randomized to a SCP-A or a control group. Self-reported questionnaires were completed by the both groups at baseline (T0), 5 weeks (T1), 3 months (T2), 6 months (T3), and 12 months (T4). RESULTS Controlling for relevant covariates, mixed effect model analyses revealed a significant decrease in women in the SCP-A group compared to the control group for total unmet needs since T3 (p < .004) and fear of recurrence since T4 (p = .02). Women in the SCP-A group also reported significant improvements in QoL at T4 (p < .001) relative to those in the control group. CONCLUSION Providing SCP using an information website application for women with breast cancer can decrease unmet needs, fear of recurrence, and improve quality of life during short-term and long-term use. PRACTICE IMPLICATIONS Web-based information that provides survivorship care plans for breast cancer survivors are beneficial.
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Affiliation(s)
- Su-Ying Fang
- Department of Nursing, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan City, 701, Taiwan.
| | - Yu-Ling Wang
- National Taiwan University Hospital Hsin-Chu Branch, Taiwan
| | - Wen-Hsiang Lu
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Kuo-Ting Lee
- Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan & Department of Surgery, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yao-Lung Kuo
- Department of Surgery, National Cheng Kung University Hospital, Tainan and Dou-Liou Branch, Taiwan; Department of Surgery, College of Medicine, National Cheng Kung University, Tainan and Dou-Liou Branch, Taiwan
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Zhou K, Li M, Wang W, An J, Huo L, He X, Li J, Zhuang G, Li X. Reliability, validity, and sensitivity of the Chinese Short-Form 36 Health Survey version 2 (SF-36v2) in women with breast cancer. J Eval Clin Pract 2019; 25:864-872. [PMID: 30548365 DOI: 10.1111/jep.13088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/22/2018] [Accepted: 11/23/2018] [Indexed: 11/26/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES The psychometrics of the Short-Form 36 Health Survey version 2 (SF-36v2) in female breast cancer patients remains unknown. This study aimed to test the reliability, validity, and sensitivity of the Chinese SF-36v2 in women with breast cancer. METHODS The sample included 326 eligible participants. The reliability and the item convergent and discriminant validity were estimated using Cronbach α (≥0.70) and the multi-trait multi-item matrix analysis, respectively. The structural validity was tested using confirmatory factor analysis. Sensitivity was determined via an analysis of variance and the relative efficiency for initially diagnosed cases (yes vs no) as well as the time since diagnosis (years) before and after stratifying by initially diagnosed cases. RESULTS The overall Cronbach α was 0.91 (eight scales range: 0.72-0.92). All hypothesized item-scale correlations were greater than the alternatives (r ≥ 0.40). With acceptable model fit indices, the physical functioning, role-physical, bodily pain, and general health subscales had stronger contributions to the physical component summary (goodness-of-fit index [GFI]: 0.92, parsimony goodness-of-fit index [PGFI]: 0.60, comparative fit index [CFI]: 0.91, Tucker-Lewis index [TLI]: 0.93, adjusted goodness-of-fit index [AGFI]: 0.91, root mean square error of approximation [RMSEA]: 0.06, normed chi-squared [NC]: 2.65), while the vitality, social functioning, role-emotional, and mental health subscales contributed more to the mental component summary (GFI: 0.91, PGFI: 0.62, CFI: 0.91, TLI: 0.92, AGFI: 0.91, RMSEA: 0.07, NC: 2.76). The relative efficiencies with significant F-statistics were found for mental health (relative efficiency: 34.28; initially diagnosed cases), physical functioning (12.88; time since diagnosis), and physical functioning (5.80), role-physical (5.15), bodily pain (7.70), social functioning (4.62), role-emotional (4.72), mental health (4.75), and physical component summary (6.96; initially diagnosed cases with time since diagnosis; P < 0.05 for all variables). CONCLUSIONS Chinese SF-36v2 has acceptable psychometric properties and is suitable for women with breast cancer.
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Affiliation(s)
- Kaina Zhou
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Minjie Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Wen Wang
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Jinghua An
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Lanting Huo
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Xiaole He
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Jin Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Guihua Zhuang
- School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Xiaomei Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
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20
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Nejati B, Lin CC, Aaronson NK, Cheng ASK, Browall M, Lin CY, Broström A, Pakpour AH. Determinants of satisfactory patient communication and shared decision making in patients with multiple myeloma. Psychooncology 2019; 28:1490-1497. [PMID: 31087365 DOI: 10.1002/pon.5105] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 04/16/2019] [Accepted: 05/07/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To identify determinants of shared decision making in patients with multiple myeloma (MM) to facilitate the design of a program to maximize the effects of shared decision making. METHODS This prospective longitudinal study recruited 276 adult patients (52% male, mean age 62.86 y, SD 15.45). Each patient completed the eHealth Literacy Scale (eHEALS), Multidimensional Trust in Health Care Systems Scale (MTHCSS), Patient Communication Pattern Scale (PCPS), and 9-Item Shared Decision-Making Questionnaire (SDM-Q-9) at baseline and the SDM-Q-9 again 6 months later. One family member of the patient completed the Family Decision-Making Self-Efficacy (FDMSE) at baseline. Structural equation modeling (SEM) was used to investigate the associations between eHealth literacy (eHEALS), trust in the health care system (MTHCSS), self-efficacy in family decision making (FDMSE), patient communication pattern (PCPS), and shared decision making (SDM-Q-9). RESULTS SEM showed satisfactory fit (comparative fit index = 0.988) and significant correlations between the following: eHealth literacy and trust in the health care system (β = 0.723, P < 0.001); eHealth literacy and patient communication pattern (β = 0.242, P < 0.001); trust in the health care system and patient communication pattern (β = 0.397, P < 0.001); self-efficacy in family decision making and patient communication pattern (β = 0.264, P < 0.001); eHealth literacy and shared decision making (β = 0.267, P < 0.001); and patient communication pattern and shared decision making (β = 0.349, P < 0.001). CONCLUSIONS Patient communication and eHealth literacy were found to be important determinants of shared decision making. These factors should be taken into consideration when developing strategies to enhance the level of shared decision making.
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Affiliation(s)
- Babak Nejati
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Chien-Chin Lin
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Division of Hematology and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Maria Browall
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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21
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Ou H, Chung W, Su P, Lin T, Lin J, Wen Y, Fang W. Health‐related quality of life associated with different cancer treatments in Chinese breast cancer survivors in Taiwan. Eur J Cancer Care (Engl) 2019; 28:e13069. [DOI: 10.1111/ecc.13069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/26/2019] [Accepted: 03/25/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Huang‐Tz Ou
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine National Cheng Kung University Tainan Taiwan
- Department of Pharmacy, College of Medicine National Cheng Kung University Tainan Taiwan
- Department of Pharmacy National Cheng Kung University Hospital Tainan Taiwan
| | - Wei‐Pang Chung
- Division of Hemato‐Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine National Cheng Kung University Tainan Taiwan
| | - Pei‐Fang Su
- Department of Statistics National Cheng Kung University Tainan Taiwan
| | - Tzu‐Hsuan Lin
- Department of Statistics National Cheng Kung University Tainan Taiwan
| | - Ji‐Ying Lin
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine National Cheng Kung University Tainan Taiwan
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22
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Xing W, So WKW, Choi KC, Wong CL, Tong M, Choy YP, Molassiotis A, Yates P, Chan RJ. Translation and psychometric testing of Cancer Survivors’ Unmet Needs, Chinese version. Asia Pac J Clin Oncol 2019; 15:e142-e146. [PMID: 30761749 DOI: 10.1111/ajco.13137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 01/21/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Weijie Xing
- School of NursingFudan University Shanghai China
- The Nethersole School of NursingFaculty of MedicineThe Chinese University of Hong Kong Hong Kong China
| | - Winnie Kwok Wei So
- The Nethersole School of NursingFaculty of MedicineThe Chinese University of Hong Kong Hong Kong China
| | - Kai Chow Choi
- The Nethersole School of NursingFaculty of MedicineThe Chinese University of Hong Kong Hong Kong China
| | - Cho Lee Wong
- The Nethersole School of NursingFaculty of MedicineThe Chinese University of Hong Kong Hong Kong China
| | - Man Tong
- Department of Clinical OncologyTuen Mun Hospital Hong Kong China
| | - Yin Ping Choy
- Department of OncologyPrincess Margaret Hospital Hong Kong China
| | - Alex Molassiotis
- School of NursingHong Kong Polytechnic University Hong Kong China
| | - Patsy Yates
- School of NursingQueensland University of Technology Brisbane Queensland Australia
| | - Raymond Javan Chan
- School of NursingQueensland University of Technology Brisbane Queensland Australia
- Princess Alexandra HospitalMetro South Hospital and health Service Brisbane Queensland Australia
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23
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Tian L, Cao X, Feng X. Evaluation of psychometric properties of needs assessment tools in cancer patients: A systematic literature review. PLoS One 2019; 14:e0210242. [PMID: 30620770 PMCID: PMC6324833 DOI: 10.1371/journal.pone.0210242] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 12/19/2018] [Indexed: 02/05/2023] Open
Abstract
Background Although a wide range of needs assessment tools for cancer patients have been developed, no standardized and commonly accepted instruments were recommended to use in clinical care. This systematic review was conducted to assess the quality of psychometric properties of needs assessment tools among cancer patients in order to help oncology healthcare professionals select the most appropriate needs assessment tools in routine clinical practice. Methods Searches were conducted in the electronic databases of PUBMED from 1966, CINAHL from 1960, EMBASE from 1980 and PsychINFO from 1967 as well as additional sources. The quality of psychometric properties of the recruited needs assessment tools was evaluated using the agreed quality criteria for measurement properties of health status questionnaires. Results Thirty-seven studies which evaluated the psychometric properties of 20 needs assessment tools were identified. Internal consistency was tested in 32 studies with 9 studies indicating negative rating and 4 studies intermediate rating. Less than half of the studies (13 studies) assessed test-retest reliability, and only 4 studies reported positive rating. Content validity was the most tested psychometric property appraised in 33 studies and indicated positive rating in all the evaluated studies. Structural validity was adequately evaluated in 28 studies with 23 studies reporting intermediate rating. More than half of the studies (29 studies) tested hypothesis testing and 13 studies were rated positive. Cross-cultural validity results were obtained in 13 studies with 7 studies showing negative rating. No data was available on measurement error and criterion validity. Only one study appraised responsiveness and showed intermediate rating. The Supportive Care Needs Survey-Short Form (SCNS-SF) is the most widely used instrument for needs assessment in cancer patients. It had strong evidence for internal consistency, content validity, structural validity and hypothesis testing, and moderate evidence for reliability and cross-cultural validity. Cancer Survivors’ Unmet Needs Measure (CaSUN) reported strong or moderate evidence for internal consistency, reliability, content and structural validity, and hypothesis testing. Furthermore, Supportive Cancer Care Needs Assessment Tool for Indigenous People (SCNAT-IP) had strong evidence for content validity, and moderate evidence for internal consistency, structural validity and hypothesis testing. Conclusions Despite several needs assessment tools exist to assess care needs in cancer patients, further improvement of already existing and promising instruments is recommended.
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Affiliation(s)
- Lang Tian
- Department of hepatobiliary surgery, Sichuan Cancer Hospital, Chengdu, Sichuan province, People’s Republic of China
- * E-mail: (LT); (XC)
| | - Xiaoyi Cao
- Hemodialysis Center, Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan province, People’s Republic of China
- * E-mail: (LT); (XC)
| | - Xielin Feng
- Department of hepatobiliary surgery, Sichuan Cancer Hospital, Chengdu, Sichuan province, People’s Republic of China
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Setyowibowo H, Purba FD, Hunfeld JAM, Iskandarsyah A, Sadarjoen SS, Passchier J, Sijbrandij M. Quality of life and health status of Indonesian women with breast cancer symptoms before the definitive diagnosis: A comparison with Indonesian women in general. PLoS One 2018; 13:e0200966. [PMID: 30024978 PMCID: PMC6053201 DOI: 10.1371/journal.pone.0200966] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/05/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Breast cancer (BC) is prevalent in low and middle-income countries (LMICs) where the majority of cases are diagnosed in late stages. The aims of this study were: (1) to assess quality of life (QOL) and health status of Indonesian women with BC symptoms before definitive diagnosis; (2) to compare QOL and health status between women with BC symptoms before definitive diagnosis and Indonesian women in general; (3) to evaluate the association between demographic variables (age, residence, social economic status and education level) and QOL within the Indonesian women with BC symptoms before definitive diagnosis. METHODS We used WHOQOL-BREF to measure QOL and EQ-5D-5L for health status. Multivariate analysis of covariance (MANCOVA) was used to compare QOL and health status between women with BC symptoms and women from the general Indonesian population in order to control for confounders. Regression analyses were used for testing the association between the demographic variables, QOL, and health status. RESULTS In comparison with the data from the women from the general population (n = 471), the women with BC symptoms (n = 132) reported lower QOL, especially in physical and psychological domains. They also reported more problems in all dimensions of health status. Higher education and monthly income were positively associated with QOL and health status among the women with BC symptoms. CONCLUSION Before receiving a definitive diagnosis, women who visit hospitals with symptoms of BC, report a lower QOL and health status than women in general. Our results suggest that healthcare providers should provide targeted strategies for women with BC symptoms to improve their QOL.
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Affiliation(s)
- Hari Setyowibowo
- Department of Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, The Netherlands
- Department of Educational Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
- * E-mail: ,
| | - Fredrick Dermawan Purba
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Joke A. M. Hunfeld
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Aulia Iskandarsyah
- Department of Clinical Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Sawitri S. Sadarjoen
- Department of Clinical Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Jan Passchier
- Department of Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, The Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, The Netherlands
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Lo WT, Yates P, Chan RJ. Unmet supportive care needs and symptom burden in Taiwanese cancer survivors who have completed primary treatment. Eur J Oncol Nurs 2018; 35:79-84. [PMID: 30057088 DOI: 10.1016/j.ejon.2018.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/18/2018] [Accepted: 05/29/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE The number of cancer survivors is increasing due to scientific advances. Previous research on unmet care needs of Taiwanese cancer survivors focused on patients with newly or recently diagnosed cancer. Little is known about the needs and symptom experiences of cancer survivors who have completed treatment. METHODS This is a cross-sectional survey study. Patients who were over 20 years old; had completed their first-line treatment for their cancer were recruited into the study. The questionnaire included demographic characteristics, a global item of quality of life, the physical effects subscale of the Cancer Survivors' Survey of Needs (CSSN), and Cancer Survivors' Unmet Needs measure (CaSUN). RESULTS One hundred and twenty cancer survivors participated in this study. Body changes, loss of strength, weight change, memory and concentration and fatigue were the top five symptom concerns. Nearly half of the Taiwanese survivors reported needs for up-to-date information, understandable information, and an ongoing case manager were not met. On average, survivors reported 7.68 unmet care needs. Male gender, being under 50 years of age, and having a solid tumor were associated with higher levels of unmet needs. CONCLUSIONS This study provides preliminary information about the type and levels of physical symptom concerns and supportive care needs in long-term cancer survivors in Taiwan. Specific groups of cancer survivors whose needs were unmet were identified. The current healthcare system is not sufficiently meeting the needs of cancer survivors and more efforts are required to advance survivorship care and research in Taiwan.
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Affiliation(s)
- Wan-Tzu Lo
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia
| | - Patsy Yates
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia; Metro North Hospital and Health Service, Herston, Queensland 4029, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia
| | - Raymond Javan Chan
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia; Princess Alexandra Hospital, Metro South Hospital and Health Service, Woolloongabba, Queensland 4102, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia.
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