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Majdalani MP, Alazraqui M. Predominant approaches in studies on health-related quality of life of young survivors of childhood or adolescent cancer: an integrative literature review. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022278.22132021en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Survivors of childhood cancer constitute a growing population. The disease experienced, its treatment or the occurrence of late complications may affect survivors’ health-related quality of life (HRQOL). Understanding HRQOL is a challenge due to its conceptual complexity and the mode in which it is studied. Objective: To identify the predominant lines of research in the study of HRQOL in this population. Methods: An integrative literature review was carried out, involving a systematic search of primary articles indexed in the Scopus and PubMed databases. Results: In the 48 publications selected, four main lines of research were identified: HRQOL in survivors in general; HRQOL in long-term survivors; the study of determinants of HRQOL; and the study of methodological aspects of HRQOL measurement. A quantitative approach using generic measurement instruments predominates, and the conceptual model of HRQOL based on function emphasizes the importance of physical, psychological, and social functionality and the impact of the disease and treatment on these aspects. Conclusions: incorporating a qualitative, meaning-based approach to the understanding of lived experiences from a subjective and holistic perspective is indispensable.
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Majdalani MP, Alazraqui M. Predominant approaches in studies on health-related quality of life of young survivors of childhood or adolescent cancer: an integrative literature review. CIENCIA & SAUDE COLETIVA 2022; 27:3063-3077. [PMID: 35894319 DOI: 10.1590/1413-81232022278.22132021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 03/30/2022] [Indexed: 11/22/2022] Open
Abstract
Survivors of childhood cancer constitute a growing population. The disease experienced, its treatment or the occurrence of late complications may affect survivors' health-related quality of life (HRQOL). Understanding HRQOL is a challenge due to its conceptual complexity and the mode in which it is studied. OBJECTIVE To identify the predominant lines of research in the study of HRQOL in this population. METHODS An integrative literature review was carried out, involving a systematic search of primary articles indexed in the Scopus and PubMed databases. RESULTS In the 48 publications selected, four main lines of research were identified: HRQOL in survivors in general; HRQOL in long-term survivors; the study of determinants of HRQOL; and the study of methodological aspects of HRQOL measurement. A quantitative approach using generic measurement instruments predominates, and the conceptual model of HRQOL based on function emphasizes the importance of physical, psychological, and social functionality and the impact of the disease and treatment on these aspects. CONCLUSIONS incorporating a qualitative, meaning-based approach to the understanding of lived experiences from a subjective and holistic perspective is indispensable.
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Affiliation(s)
- María Pía Majdalani
- División de Medicina Interna General, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires. Buenos Aires Argentina.
| | - Marcio Alazraqui
- Instituto de Salud Colectiva, Universidad Nacional de Lanús. Buenos Aires Argentina
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Dabaghi S, Esmaielzadeh F, Rohani C. Application of Rasch Analysis for Development and Psychometric Properties of Adolescents' Quality of Life Instruments: A Systematic Review. Adolesc Health Med Ther 2020; 11:173-197. [PMID: 33204203 PMCID: PMC7666979 DOI: 10.2147/ahmt.s265413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 10/20/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Due to the importance of assessing quality of life (QoL) in healthy and ill adolescents, the evaluation of psychometric properties of these questionnaires is important. OBJECTIVE To investigate the application of Rasch analysis in psychometric assessment studies on adolescents' QoL instruments, and to evaluate the quality of reporting Rasch parameters in these studies. METHODS This systematic review was conducted by searching for papers in electronic databases PubMed, Web of Science, EMBASE, Cochrane Library and Scopus until December 2018. RESULTS After screening 122 papers, 31 remained in the study. Around 68% of the studies used the Rasch analysis for instrument testing and 32% for the development of new instruments. In 77.4% of studies, both classical and Rasch methods were used parallel to data analysis. In 32.2% of studies, healthy adolescents were the main target group. The most commonly used instrument in Rasch studies was, KIDSCREEN, administered in different countries. Six Rasch parameters were reported with a higher percentage in the studies. Major reported parameters of Rasch analysis were application of the software program (96.7%), test of item fit to the Rasch model (93.5%), unidimensionality (80.6%), type of the identified mathematical Rasch model (74.1%), threshold (58%) and differential item functioning (54.8%). Based on the psychometric evaluation of the QoL instruments, 71% of studies showed acceptable results. CONCLUSION The application of the Rasch model for psychometric assessment of adolescents' QoL questionnaires has increased in recent decades. But, there is still no strong and commonly used critical appraisal tool or guideline for the evaluation of these papers.
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Affiliation(s)
- Sahar Dabaghi
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Esmaielzadeh
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Camelia Rohani
- Community Health Nursing Department, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Ersta Sköndal Bräcke University College, Campus Ersta, StockholmSE-100 61, Sweden
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Wong AWK, Chang TT, Christopher K, Lau SCL, Beaupin LK, Love B, Lipsey KL, Feuerstein M. Patterns of unmet needs in adolescent and young adult (AYA) cancer survivors: in their own words. J Cancer Surviv 2017; 11:751-764. [DOI: 10.1007/s11764-017-0613-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 03/09/2017] [Indexed: 12/13/2022]
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Huang IC, Brinkman TM, Armstrong GT, Leisenring W, Robison LL, Krull KR. Emotional distress impacts quality of life evaluation: a report from the Childhood Cancer Survivor Study. J Cancer Surviv 2017; 11:309-319. [PMID: 28070769 DOI: 10.1007/s11764-016-0589-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 12/16/2016] [Indexed: 11/12/2022]
Abstract
PURPOSE We compared health-related quality of life (HRQOL) between adult survivors of childhood cancer and siblings by investigating the mediating role of emotional distress on HRQOL assessment, and examining the extent to which emotional distress affected the item responses of HRQOL measures given the same underlying HRQOL (i.e., measurement non-invariance). METHODS Cancer survivors (7103) and siblings (390) enrolled in Childhood Cancer Survivor Study who completed the SF-36 measuring HRQOL and the Brief Symptom Inventory-18 measuring anxiety, depression, and somatization were analyzed. Multiple Indicators & Multiple Causes modeling was performed to identify measurement non-invariance related to emotional distress on the responses to HRQOL items. Mediation analysis was performed to test the effects of cancer experience on HRQOL accounting for the mediating role of emotional distress. RESULTS Twenty-nine percent, 40%, and 34% of the SF-36 items were identified with measurement non-invariance related to anxiety, depression, and somatization, respectively. Survivors reported poorer HRQOL than siblings in all domains (ps < 0.05), except for pain. Other than physical functioning and general health perceptions, poorer HRQOL was explained by the mediating role of emotional distress (ps < 0.05). CONCLUSIONS Differences in HRQOL between survivors and siblings appear due, in part, to the mediating effect of emotional distress through which cancer experience influences the responses to HRQOL measures. IMPLICATIONS OF CANCER SURVIVORS Interventions to treat emotional distress may improve cancer survivors' HRQOL.
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Affiliation(s)
- I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop #735, Memphis, TN, 38105-3678, USA.
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop #735, Memphis, TN, 38105-3678, USA.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop #735, Memphis, TN, 38105-3678, USA
| | - Wendy Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop #735, Memphis, TN, 38105-3678, USA
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop #735, Memphis, TN, 38105-3678, USA.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
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Kenzik KM, Huang IC, Brinkman TM, Baughman B, Ness KK, Shenkman EA, Hudson MM, Robison LL, Krull KR. The Childhood Cancer Survivor Study-Neurocognitive Questionnaire (CCSS-NCQ) revised: item response analysis and concurrent validity. Neuropsychology 2015; 29:31-44. [PMID: 24933482 PMCID: PMC4268097 DOI: 10.1037/neu0000095] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Childhood cancer survivors are at risk for neurocognitive impairment related to cancer diagnosis or treatment. This study refined and further validated the Childhood Cancer Survivor Study-Neurocognitive Questionnaire (CCSS-NCQ; Krull et al., 2008), a scale developed to screen for impairment in long-term survivors of childhood cancer. METHOD Items related to task efficiency, memory, organization, and emotional-regulation domains were examined using item response theory (IRT). Data were collected from 833 adult survivors of childhood cancer who completed self-report and direct neurocognitive testing for the St. Jude Lifetime Cohort Study. The revision process included: (a) content-validity mapping of items to domains, (b) constructing a revised CCSS-NCQ, (c) selecting items within specific domains using IRT, and (d) evaluating concordance between the revised CCSS-NCQ and direct neurocognitive assessment. RESULTS Using content and measurement properties, 32 items were retained (8 items in 4 domains). Items captured low to middle levels of neurocognitive concerns. The latent domain scores demonstrated poor convergent/divergent validity with the direct assessments. Adjusted ESs (ES; Cohen's d) for agreement between self-reported memory and direct memory assessment were moderate for total recall (ES = 0.66), long-term memory (ES = 0.63), and short-term memory (STM; ES = 0.55). ESs between self-rated task efficiency and direct assessment of attention were moderate for focused attention (ES = 0.70) and attention span (ES = 0.50), but small for sustained attention (ES = 0.36). Cranial radiation therapy and female gender were associated with lower self-reported neurocognitive function. CONCLUSION The revised CCSS-NCQ demonstrates adequate measurement properties for assessing day-to-day neurocognitive concerns in childhood cancer survivors, and adds useful information to direct assessment.
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Affiliation(s)
- Kelly M. Kenzik
- Department of Health Outcomes and Policy, College of Medicine, University of Florida
| | - I-Chan Huang
- Department of Health Outcomes and Policy, College of Medicine, University of Florida
- Institute for Child Health Policy, College of Medicine, University of Florida
| | - Tara M. Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital
- Department of Psychology, St. Jude Children's Research Hospital
| | - Brandon Baughman
- Department of Neuropsychology, Semmes Murphey Neurologic & Spine Institute
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital
| | - Elizabeth A. Shenkman
- Department of Health Outcomes and Policy, College of Medicine, University of Florida
- Institute for Child Health Policy, College of Medicine, University of Florida
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital
- Department of Oncology, St. Jude Children's Research Hospital
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital
| | - Kevin R. Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital
- Department of Psychology, St. Jude Children's Research Hospital
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Quinn GP, Huang IC, Murphy D, Zidonik-Eddelton K, Krull KR. Missing content from health-related quality of life instruments: interviews with young adult survivors of childhood cancer. Qual Life Res 2013; 22:111-8. [PMID: 22286223 PMCID: PMC4291119 DOI: 10.1007/s11136-012-0120-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2012] [Indexed: 10/14/2022]
Abstract
PURPOSE Young adult survivors of childhood cancer (YASCC) are an ever-growing cohort of survivors due to increasing advances in technology. Today, there is a shift of focus to not just ensuring survivorship but also the quality of survivorship, which can be assessed with standardized instruments. The majority of standardized health related quality of life (HRQoL) instruments, however, are non-specific to this age group and the unique late effects within YASCC populations. The purpose of this study was to investigate the relevance and accuracy of standardized HRQoL instruments used with YASCC. METHODS In a previous study, HRQoL items from several instruments (SF-36, QLACS, QLS-CS) were examined for relevance with a population of YASCC. Participants (n = 30) from this study were recruited for a follow-up qualitative interview to expand on their perceptions of missing content from existing instruments. RESULTS Respondents reported missing, relevant content among all three of the HRQoL instruments. Results identified three content areas of missing information: (1) Perceived sense of self, (2) Relationships, and (3) Parenthood. CONCLUSIONS Existing HRQoL instruments do not take into account the progression and interdependence of emotional development impacted by a cancer diagnosis. The themes derived from our qualitative interviews may serve as a foundation for the generation of new items in future HRQoL instruments for YASCC populations. Further testing is required to examine the prevalence, frequency, and breadth of these items in a larger sample.
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Affiliation(s)
- Gwendolyn P Quinn
- Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, MRC CANCONT, Tampa, FL 33612, USA.
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