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Guo YJ, Xue P, Gu WW, Su XQ, Li JM, Kuai BX, Xu JS, Xie HW, Han PP. Development and validation of Adaptability to Return-to-Work Scale (ARTWS) for cancer patients. Front Psychol 2024; 14:1275331. [PMID: 38741785 PMCID: PMC11090167 DOI: 10.3389/fpsyg.2023.1275331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/21/2023] [Indexed: 05/16/2024] Open
Abstract
Introduction The research on cancer patients returning to work in China is still in its infancy, and there is no research and discussion on the adaptability to return-to-work for cancer patients. It is critical to develop the Adaptability to Return-to-Work Scale (ARTWS) for cancer patients and evaluate its psychometric properties. Methods The items of the initial scale were compiled based on the theoretical model and literature review results. Through two rounds of Delphi expert consultation (N = 15) and a pilot survey (N = 40), the initial scale was further checked and revised. Conduct a large sample survey (N = 376) and the construct validity and reliability of the ARTWS were assessed by confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Results The final ARTWS consisted of 24 items. "Focusing on rehabilitation," "Rebuilding Self-efficiency," and "Adjusting plans" as common factors in determining adaptability to return to work for cancer patients, and the cumulative variance contribution rate for these three factors was 66.6%. The S-CVI of the total scale was 0.979. The Cronbach's α coefficient was 0.937 and the 2-week test-retest reliability was 0.814. Discussion ARTWS has good correlation validity and can be used as a tool to measure the adaptability of cancer patients' return to work. The presentation of the manuscript in Research Square (https://doi.org/10.21203/rs.3.rs-2323264/v1).
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Affiliation(s)
- Yu-Jie Guo
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Ping Xue
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
- Office of Joint Medicine, Taizhou Second People’s Hospital, Jiangyan District, Taizhou, Jiangsu, China
| | - Wen-wen Gu
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
- Department of Neurosurgery, Rudong People’s Hospital, Nantong, Jiangsu, China
| | - Xiao-qin Su
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Jia-mei Li
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Ben-xin Kuai
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Jia-shuo Xu
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Hui-wen Xie
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Ping-ping Han
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
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Ren R, Chen G, Yan J, Zhang S, Tan J, Yue JJ. Development and validation of a core competence instrument for clinical nursing teachers: A mixed-methods study. NURSE EDUCATION TODAY 2024; 132:106011. [PMID: 37931347 DOI: 10.1016/j.nedt.2023.106011] [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: 04/06/2023] [Revised: 10/11/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Competence-based education (CBE) highlights the important position of clinical nursing teachers and stipulates additional requirements for them. However, research on the core competence of clinical nursing teachers remains lacking, which has hindered their development and the cultivation of nursing students. OBJECTIVES Developing and verifying a core competence instrument to evaluate clinical nursing teachers' competence in clinical settings and provide empirical guidance for their development. DESIGN A mixed-methods study including qualitative and quantitative methods. SETTINGS Primarily, 9 universities and hospitals throughout China. PARTICIPANTS Fourteen nursing experts and 2 students participated in the qualitative study, and 626 nursing professionals ultimately participated in the quantitative study. METHODS The instrument was developed based on behavioral event interviews and expert consultation as well as exploratory factor analysis using a cross-sectional survey, following which the instrument was verified by confirmatory factor analysis. RESULTS A 4-factor core competence instrument for clinical nursing teachers was developed and verified; the four factors included education and teaching competence, clinical nursing competence, management competence and professional awareness and attitude, and the instrument included 25 items in total. The instrument has an explanatory degree of 90.58 %, and it exhibits good reliability and validity as well as a good fit to the data. CONCLUSIONS This instrument can provide theoretical guidance for the development of clinical nursing teachers and can be widely used as an effective tool in practice. Nursing administrators and educators should implement policies and programs to help clinical nursing teachers improve their competencies with regard to these four aspects, which can play an important role in the development of nurse education.
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Affiliation(s)
- Ran Ren
- Department of Clinical Microbiology and Immunology, Faculty of Pharmacy and Medical Laboratory Sciences, Third Military Medical University (Army Medical University), Chongqing 400038, China; Department of Nursing Management, School of Nursing, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Gang Chen
- Biomedical Analysis Center, College of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Jingmin Yan
- Department of Clinical Microbiology and Immunology, Faculty of Pharmacy and Medical Laboratory Sciences, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Suofei Zhang
- Department of Nursing Management, School of Nursing, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Jing Tan
- Department of Nursing Management, School of Nursing, Third Military Medical University (Army Medical University), Chongqing 400038, China.
| | - Juan-Juan Yue
- Department of Clinical Microbiology and Immunology, Faculty of Pharmacy and Medical Laboratory Sciences, Third Military Medical University (Army Medical University), Chongqing 400038, China.
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Liang MZ, Liu ML, Tang Y, Molassiotis A, Knobf MT, Chen P, Hu GY, Sun Z, Yu YL, Ye ZJ. Heterogeneity in resilience patterns and its prediction of 1-year quality of life outcomes among patients with newly diagnosed cancer: An exploratory piecewise growth mixture model analysis. Eur J Oncol Nurs 2023; 66:102374. [PMID: 37499404 DOI: 10.1016/j.ejon.2023.102374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 05/25/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE This study was designed to explore the impact of a new cancer diagnosis on resilience of patients and whether the resilience patterns could predict Quality of Life (QoL) in the first year. METHODS An exploratory linear piecewise growth mixture modeling (PGMM) with one hypothetical dot (3 months since diagnosis, T1) was employed to identify different resilience patterns and growth in 289 patients with different cancer diagnoses at five assessment occasions (T0-T4). Logistic regression analysis was performed to select potential predictors and receiver operating characteristic (ROC) curve analysis was utilized to test PGMM's discriminative ability against 1-year QoL. RESULTS Five discrete resilience trajectories with two growing trends were identified, including "Transcendence" (7.3%), "Resilient" (47.4%), "Recovery" (18.7%), "Damaged" (14.9%) and "Maladaption" (11.8%). Advanced stage, colorectal cancer, and receiving surgery therapy were significant predictors of negative resilience trajectories ("Damaged" or "Maladaption"). Discriminative ability was good for PGMM (AUC = 0.81, 95%CI, 0.76-0.85, P < 0.0001). CONCLUSION Heterogeneity is identified in resilience growth before and after 3 months since diagnosis. 26.7% newly diagnosed patients need additional attention especially for those with advanced colorectal cancer and receiving surgery therapy.
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Affiliation(s)
- Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, China
| | - Mei Ling Liu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Alex Molassiotis
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - M Tish Knobf
- School of Nursing, Yale University, Orange, CT, United States
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, China
| | - Zeng Jie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China.
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Ye ZJ. Editorial: Resilience in chronic disease, volume II. Front Psychiatry 2023; 14:1209709. [PMID: 37304437 PMCID: PMC10248497 DOI: 10.3389/fpsyt.2023.1209709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 06/13/2023] Open
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Sense of coherence, resilience, and habitual optimism in cancer patients. Int J Clin Health Psychol 2023; 23:100358. [DOI: 10.1016/j.ijchp.2022.100358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/14/2022] [Indexed: 11/21/2022] Open
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Wongpakaran T, Yang T, Varnado P, Siriai Y, Mirnics Z, Kövi Z, Wongpakaran N. The development and validation of a new resilience inventory based on inner strength. Sci Rep 2023; 13:2506. [PMID: 36782008 PMCID: PMC9925219 DOI: 10.1038/s41598-023-29848-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
There are a number of resilience scales with good psychometric properties. However, the various scales differ in their item content in accordance with the model of resilience the developer had in mind. Culture is one of the reasons for the difference. Thailand, one of the Buddhist cultures, has a different view on resilience compared with Western culture. This study aimed to develop and validate a resilience inventory created based on the inner strength concept using a confirmatory factor analysis (CFA) and Rasch measurement model. The resilience inventory (RI) was developed by creating new items representing inner strengths attributed to resilience. The inner strength was adopted to form the resilience construct, including perseverance, wisdom, patience, mindfulness, loving-kindness and equanimity. In addition, face and content validity were examined by experts in both mental health and Buddhism. The final RI comprised nine items with a 5-point Likert-type scale. The RI-9 was completed by 243 medical students who participated in the study, along with other measurements, i.e., Inner Strength-Based Inventory (iSBI), measuring the ten characteristics of perfection or inner strength, and the Core Symptom Index, measuring anxiety, depression and somatization symptoms. CFA, internal consistency and the Polytomous Rasch rating model were used to investigate the RI-9 construct validity. The mean age of the participants was 22.7 years (SD, 0.8); one-half were male (50%). The RI-9 construct demonstrated item hierarchy as follows: perseverance, patience (tolerance), mindfulness and equanimity, wisdom and loving-kindness. CFA showed that the unidimensional model fitted the data well. Rasch analysis showed no misfitting items and local dependence. The reliability of the person and item was good, and no disordered threshold was observed. Two items were found to exhibit differential item functioning due to sex. RI-9 scores were significantly related to all ten strengths from the iSBI, whereas they were negatively related to depression, anxiety, somatization and interpersonal difficulties. The RI-9 demonstrated validity and reliability. It constitutes a promising tool for outcome assessment in nonclinical populations. Further investigation on external validity as well as psychometric validation in other different cultures, should be encouraged.
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Affiliation(s)
- Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd. Tambon Sriphum, Amphoe Mueng, Chiang Mai, 50200, Thailand
| | - Tong Yang
- Master of Science Program (Mental Health), Graduate School, Chiang Mai University, 239 Huaykaew Rd., Tambon Suthep, Amphoe Mueng, Chiang Mai, 50200, Thailand
| | - Pairada Varnado
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd. Tambon Sriphum, Amphoe Mueng, Chiang Mai, 50200, Thailand
| | - Yupapan Siriai
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd. Tambon Sriphum, Amphoe Mueng, Chiang Mai, 50200, Thailand
| | - Zsuzsanna Mirnics
- Department of Personality and Health Psychology, Institute of Psychology, Károli Gáspár University of the Reformed Church, Bécsi Street 324, Budapest, 1037, Hungary
| | - Zsuzsanna Kövi
- Department of Personality and Health Psychology, Institute of Psychology, Károli Gáspár University of the Reformed Church, Bécsi Street 324, Budapest, 1037, Hungary
| | - Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd. Tambon Sriphum, Amphoe Mueng, Chiang Mai, 50200, Thailand.
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Wang N, Chen H, Zhang M, Wang Y, Xue Z, Hao X, Liu Y. Validation of the Chinese version of the resilience scale for the oldest-old. Front Psychol 2023; 14:1055301. [PMID: 36874822 PMCID: PMC9982108 DOI: 10.3389/fpsyg.2023.1055301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/30/2023] [Indexed: 02/19/2023] Open
Abstract
Background Resilience is one of the most important variables associated with adaptive ability. The resilience scale for the oldest-old age (RSO) has been designed to measure the resilience among the oldest-old people. Originally developed in Japan, this scale has not been used in China. The objective of this study was to translate the RSO into Chinese and investigate its validity and reliability among the community's oldest-old adults aged ≥80 years. Methods A total of 473 oldest-old people who came from communities were recruited by convenience sampling for the assessment of construct validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). In addition, internal consistency reliability, test-retest reliability, face validity, and content validity were used to evaluate the psychometric characteristics of RSO. Results The RSO demonstrated good face validity and content validity. The content validity index of the Chinese version of the RSO was 0.890. Moreover, one factor was extracted by exploratory factor analysis, which accounted for 61.26% of the variance. The RSO had high internal consistency with a Cronbach's alpha = 0.927. The test-retest reliability was 0.785. The item-total correlations ranged from 0.752 to 0.832. Conclusion The results of the study indicate that the Chinese version of the RSO questionnaire has good reliability and validity and can be recommended for use by health and social service agencies as a method for assessing the resilience of the oldest-old in the community.
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Affiliation(s)
- Ning Wang
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Hongyu Chen
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Minyi Zhang
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yuanyuan Wang
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Zhihan Xue
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xixi Hao
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yan Liu
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China
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Liang MZ, Chen P, Knobf MT, Molassiotis A, Tang Y, Hu GY, Sun Z, Yu YL, Ye ZJ. Measuring resilience by cognitive diagnosis models and its prediction of 6-month quality of life in Be Resilient to Breast Cancer (BRBC). Front Psychiatry 2023; 14:1102258. [PMID: 36873211 PMCID: PMC9978149 DOI: 10.3389/fpsyt.2023.1102258] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Objective The application of advanced Cognitive Diagnosis Models (CDMs) in the Patient Reported Outcome (PRO) is limited due to its complex statistics. This study was designed to measure resilience using CDMs and its prediction of 6-month Quality of Life (QoL) in breast cancer. Methods A total of 492 patients were longitudinally enrolled from Be Resilient to Breast Cancer (BRBC) and administered with 10-item Resilience Scale Specific to Cancer (RS-SC-10) and Functional Assessment of Cancer Therapy-Breast (FACT-B). Generalized Deterministic Input, Noisy "And" Gate (G-DINA) was performed to measure cognitive diagnostic probabilities (CDPs) of resilience. Integrated Discrimination Improvement (IDI) and Net Reclassification Improvement (NRI) were utilized to estimate the incremental prediction value of cognitive diagnostic probabilities over total score. Results CDPs of resilience improved prediction of 6-month QoL above conventional total score. AUC increased from 82.6-88.8% to 95.2-96.5% in four cohorts (all P < 0.001). The NRI ranged from 15.13 to 54.01% and IDI ranged from 24.69 to 47.55% (all P < 0.001). Conclusion CDPs of resilience contribute to a more accurate prediction of 6-month QoL above conventional total score. CDMs could help optimize Patient Reported Outcomes (PROs) measurement in breast cancer.
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Affiliation(s)
- Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, Guangdong, China
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - M. Tish Knobf
- School of Nursing, Yale University, Orange, CT, United States
| | - Alex Molassiotis
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guang Yun Hu
- School of Nursing, Army Medical University, Chongqing, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yuan Liang Yu
- Mental Health Education and Counseling Center, South China University of Technology, Guangzhou, Guangdong, China
| | - Zeng Jie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- *Correspondence: Zeng Jie Ye,
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Liang M, Chen P, Molassiotis A, Jeon S, Tang Y, Hu G, Zhu Y, Sun Z, Yu Y, Knobf TM, Ye Z. Measurement invariance of the 10-item resilience scale specific to cancer in Americans and Chinese: A propensity score-based multidimensional item response theory analysis. Asia Pac J Oncol Nurs 2022; 10:100171. [PMID: 36632445 PMCID: PMC9827362 DOI: 10.1016/j.apjon.2022.100171] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
Objective Little is known about the measurement invariance (MI) of resilience instruments in cancer care. This study was designed to examine MI of 10-Item Resilience Scale (RS-SC-10) in Americans and Chinese with cancer using propensity score-based multidimensional item response theory (MIRT) analysis. Methods A sample of 924 patients were enrolled in the Be Resilient to Cancer trial involving 1 hospital in America and 3 hospitals in China. Data were collected from the RS-SC-10 and Hospital Anxiety and Depression Scale. Propensity score matching and MIRT were performed to evaluate Differential Item Function. Integrated Discrimination Improvement and Net Reclassification Improvement were used to indirectly estimate the MI through incremental prediction ability of MIRT-based score over total score. Results RS-SC-10 retained 10 items with monotonous thresholds and its original two-factor structure. Nonuniform Differential Item Function was recognized in Item 4 (P = 0.0011, Δ%β1 = 4.15%) and Item 8 (P = 0.0017, Δ%β1 = 5.99%). Net Reclassification Improvement ranged from 9.04% to 35.01%, and Integrated Discrimination Improvement ranged from 8.82% to 20.60%. Conclusions Although partial MI has been identified between Americans and Chinese, RS-SC-10 remains a critical indicator to emotional distress in cancer care.
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Affiliation(s)
- Muzi Liang
- Guangdong Academy of Population Development, Guangzhou, China
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Alex Molassiotis
- College of Arts, Humanities & Education, University of Derby, Derby, UK
| | | | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, China
| | | | - Yunfei Zhu
- Shenzhen People's Hospital, Shenzhen, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuanling Yu
- South China University of Technology, Guangzhou, China
| | - Tish M. Knobf
- School of Nursing, Yale University, Orange, CT, USA,Corresponding authors.
| | - Zengjie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, China,Corresponding authors.
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Ateş E, Temel AB. Psychometric properties of the Turkish version of the Patient Health Engagement Scale. Int J Nurs Pract 2022; 28:e13106. [PMID: 36071672 DOI: 10.1111/ijn.13106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 08/15/2022] [Accepted: 08/24/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Patient Health Engagement Scale was designed to assess the emotional and psychological attitudes of patients' engagement along their healthcare management journey. AIM This study aimed to conduct psychometric testing of the Turkish version of the Patient Health Engagement Scale among patients with chronic diseases. DESIGN A cross-sectional validation study was conducted and reported according to the STROBE checklist. METHODS There were 520 patients who completed the scale between March 2017 and February 2018. The content, construct and concurrent validity were evaluated. The reliability of the scale was measured using internal consistency and construct reliability. Construct validity was examined using exploratory factor analysis and confirmatory factor analysis. RESULTS The scale's validity was enabled by the translation and back translation method. The content validity index of the scale was 0.88. Construct validity determined one factor. The total variance was calculated at 85.29%. The factor loads ranged between 0.86 and 0.95. The results of the confirmatory factor analysis showed goodness-of-fit indices in the excellent range according to the literature. The reliability of the scale was calculated at 0.95. CONCLUSION The scale was found to be a valid and reliable measurement tool to be used in identifying the engagement with health levels of patients with chronic diseases.
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Affiliation(s)
- Esin Ateş
- Department of Public Health Nursing, Faculty of Nursing, Ege University, Izmir, Turkey
| | - Ayla Bayık Temel
- Department of Nursing, Istanbul Health and Technology University, Istanbul, Turkey
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Liang MZ, Tang Y, Knobf MT, Molassiotis A, Chen P, Hu GY, Sun Z, Yu YL, Ye ZJ. Resilience index improves prediction of 1-year decreased quality of life in breast cancer. J Cancer Surviv 2022; 17:759-768. [PMID: 35932356 DOI: 10.1007/s11764-022-01239-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/20/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Resilience is important in cancer survivorship and has great potential to predict long-term quality of life (QoL) in breast cancer. The study was designed to develop a new prediction model to estimate pretest probability (PTP) of 1-year decreased QoL combing Resilience Index (RI) and conventional risk factors. METHODS RI was extracted from 10-item Resilience Scale Specific to Cancer (RS-SC-10) based on the Principal Component Analysis (PCA). Patients were enrolled from Be Resilient to Breast Cancer (BRBC) and the prediction model was developed based on a sample of 506 consecutive patients and validated in an internal cohort (N1 = 314) and two external cohorts (N2 = 223 and N3 = 189). Integrated Discrimination Improvement (IDI) and Net Reclassification Improvement (NRI) were utilized to estimate the incremental value of RI. RESULTS RI improved prediction above conventional risk factors. AUC increased from 0.745 to 0.862 while IDI and NRI were 8.39% and 18.44% respectively (P < 0.0001 for all). Five predictors were included in the final model: RI, age, N stage, M stage, and baseline QoL. The new model demonstrated good calibration ability in the internal and external cohorts resulting in C-indexes of 0.862 (95%CI, 0.815-0.909), 0.828 (95%CI, 0.745-0.910), 0.880 (95%CI, 0.816-0.944), and 0.869 (95%CI, 0.796-0.941). CONCLUSION RI contributed to a more accurate estimation for PTP of 1-year decreased QoL above conventional risk factors and could help optimize decision making of treatment for breast cancer. IMPLICATIONS FOR CANCER SURVIVORS A promising prognostic indicator of RI could improve QoL-related management in Chinese patients with breast cancer.
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Affiliation(s)
- Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, 510600, Guangdong Province, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China
| | - M Tish Knobf
- School of Nursing, Yale University, Orange, CT, 06477, USA
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, Guizhou Province, China
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, 400038, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong Province, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, 510641, Guangdong Province, China
| | - Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China.
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Mei X, Wang H, Wang X, Wu X, Wu J, Ye Z. Associations among neuroticism, self-efficacy, resilience and psychological distress in freshman nursing students: a cross-sectional study in China. BMJ Open 2022; 12:e059704. [PMID: 35697443 PMCID: PMC9196198 DOI: 10.1136/bmjopen-2021-059704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The current study examines the mediating roles of resilience and self-efficacy and the moderating role of gender in the association between neuroticism and psychological distress in Chinese freshman nursing students (FNSs). METHODS A total of 1220 FNSs were enrolled from the Be Resilient to Nursing Career (ChiCTR2000038693) Programme and the following instruments were administered to them: NEO Five-Factor Inventory, General Self-Efficacy Scale, Connor-Davidson Resilience Scale and Kessler Psychological Distress Scale. A moderated mediation analysis and a generalised additive model analysis were performed. RESULTS The direct and indirect effects of neuroticism on psychological distress were significantly mediated by self-efficacy (B = 0.200, 95% CI 0.001 to 0.039), resilience (B = 0.021, 95% CI 0.007 to 0.038) and the interaction between self-efficacy and resilience (B = 0.016, 95% CI 0.005 to 0.028). The interactions between neuroticism and gender (β = 0.102, 95% CI 0.001 to 0.203, p<0.05) and between resilience and gender were significant (β = 0.160, 95% CI 0.045 to 0.275, p<0.01). A non-linear and positive association was confirmed between neuroticism and psychological distress. CONCLUSIONS Self-efficacy and resilience significantly mediate the relationship between neuroticism and psychological distress. Gender moderates the relationships between neuroticism and resilience and between resilience and psychological distress.
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Affiliation(s)
- Xiaoxiao Mei
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Huiyuan Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xinqin Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaona Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jieyi Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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13
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Page SD, Lee C, Aryal S, Freedland K, Stromberg A, Vellone E, Westland H, Wiebe DJ, Jaarsma T, Riegel B. Development and testing of an instrument to measure contextual factors influencing self-care decisions among adults with chronic illness. Health Qual Life Outcomes 2022; 20:83. [PMID: 35606792 PMCID: PMC9125861 DOI: 10.1186/s12955-022-01990-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 05/12/2022] [Indexed: 11/24/2022] Open
Abstract
Background Decisions about how to manage bothersome symptoms of chronic illness are complex and influenced by factors related to the patient, their illness, and their environment. Naturalistic decision-making describes decision-making when conditions are dynamically evolving, and the decision maker may be uncertain because the situation is ambiguous and missing information. Contextual factors, including time stress, the perception of high stakes, and input from others may facilitate or complicate decisions about the self-care of symptoms. There is no valid instrument to measure these contextual factors. The purpose of this study was to develop and test a self-report instrument measuring the contextual factors that influence self-care decisions about symptoms. Methods Items were drafted from the literature and refined with patient input. Content validity of the instrument was evaluated using a Delphi survey of expert clinicians and researchers, and cognitive interviews with adults with chronic illness. Psychometric testing included exploratory factor analysis to test dimensionality, item response theory-based approaches for item recalibration, confirmatory factor analysis to generate factor determinacy scores, and evaluation of construct validity. Results Ten contextual factors influencing decision-making were identified and multiple items per factor were generated. Items were refined based on cognitive interviews with five adults with chronic illness. After a two round Delphi survey of expert clinicians (n = 12) all items had a content validity index of > 0.78. Five additional adults with chronic illness endorsed the relevance, comprehensiveness, and comprehensibility of the inventory during cognitive interviews. Initial psychometric testing (n = 431) revealed a 6-factor multidimensional structure that was further refined for precision, and high multidimensional reliability (0.864). In construct validity testing, there were modest associations with some scales of the Melbourne Decision Making Questionnaire and the Self-Care of Chronic Illness Inventory.
Conclusion The Self-Care Decisions Inventory is a 27-item self-report instrument that measures the extent to which contextual factors influence decisions about symptoms of chronic illness. The six scales (external, urgency, uncertainty, cognitive/affective, waiting/cue competition, and concealment) reflect naturalistic decision making, have excellent content validity, and demonstrate high multidimensional reliability. Additional testing of the instrument is needed to evaluate clinical utility. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-01990-2.
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Affiliation(s)
| | - Christopher Lee
- Boston College William F. Connell School of Nursing, Chestnut Hill, MA, US.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Subhash Aryal
- University of Pennsylvania School of Nursing, Philadelphia, PA, US
| | | | - Anna Stromberg
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | | | | | - Douglas J Wiebe
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, US
| | - Tiny Jaarsma
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden.,University Medical Center Utrecht, Utrecht, the Netherlands
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, Philadelphia, PA, US.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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14
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Chen HL, Wang HY, Lai SF, Ye ZJ. The Associations Between Psychological Distress and Academic Burnout: A Mediation and Moderation Analysis. Psychol Res Behav Manag 2022; 15:1271-1282. [PMID: 35614879 PMCID: PMC9126292 DOI: 10.2147/prbm.s360363] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background Psychological distress is reported to be associated with academic burnout in students while the mediation and moderation effect of resilience and personality are less explored. Purpose The current study was designed to estimate the mediating effect of resilience and the moderation effect of personality between psychological distress and academic burnout. Participants and methods A total of 613 students were enrolled from two medical universities between December 2020 and January 2021. They were administered with Academic Burnout Scale, 10-item Kessler Psychological Distress Scale (K10), Connor-Davidson Resilience Scale (CD-RISC-10) and NEO Five-Factor Inventory (NEO-FFI). Latent profile analysis and moderated mediation analysis were performed. Results Three personalities were identified and named as resilient (13.4%), over-controlled (50.2%) and under-controlled (36.4%). Resilience significantly mediated the relationship between psychological distress and academic burnout while personality significantly moderated the relationship between psychological distress and resilience. Conclusion Resilience and personality may be two important mediators between psychological distress and academic burnout. More attentions should be paid to students with under-controlled personality and resilience-enhancing interventions could be developed to prevent or alleviate academic burnout in future research.
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Affiliation(s)
- Hui Ling Chen
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Hui Yuan Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Sheng Feng Lai
- School of Nursing, Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Zeng Jie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Correspondence: Zeng Jie Ye, School of Nursing, Guangzhou University of Chinese Medicine, Out Ring Road No. 262, Panyu District, Guangzhou, 510006, People’s Republic of China, Tel +86 15914411786, Email
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15
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Mei XX, Wu XN, Wang HY, Wu JY, Wang XQ, Ye ZJ. Heterogeneity in Psychological Resilience and Mental Health among Newly Graduated Nursing Students: A Latent Profile and Generalized Additive Model Analysis. Psychol Res Behav Manag 2022; 15:597-606. [PMID: 35300205 PMCID: PMC8922342 DOI: 10.2147/prbm.s348661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/25/2022] [Indexed: 02/02/2023] Open
Abstract
Background Psychological resilience is important to mental health and professional development in newly graduated nursing students (NGNSs). However, the association between psychological resilience and mental health in NGNSs is less explored. Purpose The current study was designed to determine mental health profiles measured by the Kessler 10 scale (K10) and evaluate the non-linear association between psychological resilience and mental health in NGNSs. Methods A total of 472 NGNSs from the Be Resilient to Nursing Career program were assessed using the K10 and ten-item Connor–Davidson Resilience Scale (CD-RISC 10). Latent profile analysis and generalized additive model analysis were performed. Results A four-class model based on the K10 was identified: lowest (28.0%), lower-middle (36.4%), upper-middle (26.1%), and highest (9.5%) subgroups. Academic degree and psychological resilience were significant indicators of mental health profiles. Psychological resilience was negatively and nonlinearly correlated with mental health when the CD-RISC 10 score was >17. Conclusion There exists heterogeneity in NGNSs’ mental health. The negative and nonlinear association between psychological resilience and mental health can only be confirmed in NGNSs with moderate and high resilience levels.
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Affiliation(s)
- Xiao Xiao Mei
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
| | - Xiao Na Wu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
| | - Hui Yuan Wang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
| | - Jie Yi Wu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
| | - Xin Qin Wang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
| | - Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510006, People’s Republic of China
- Correspondence: Zeng Jie Ye, People’s Republic of China, Tel +86 15914411786, Email
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16
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Lin B, Teo EW, Yan T. Development and Validation of Chinese University Students’ Physical Activity Motivation Scale Under the Constraint of Physical Education Policies. Front Psychol 2022; 13:722635. [PMID: 35282236 PMCID: PMC8914083 DOI: 10.3389/fpsyg.2022.722635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
The accurate measurement of university students’ motivation to participate in physical activity (PA) is a prerequisite to developing better physical fitness programs. However, motivation driven by government policies, i.e., physical education policies, are often excluded from many existing scales. The purpose of this study was to develop and evaluate a psychometric instrument based on self-determination theory that exclusively measures the motivation of Chinese university students to participate in PA. A total of 1,215 university students who regularly participated in PA at five universities in China constituted the final valid sample. Sample 1 (n = 311) was used to determine the underlying factor structure of the initial Chinese University Students’ Physical Activity Motivation Scale (CUSPAMS) through exploratory factor analysis (EFA). Sample 2 (n = 330) was used to test the model fit of the EFA-derived factor structure and data through confirmatory factor analysis (CFA) and to test the internal consistency of each factor and of the whole scale. Sample 3 (n = 574) was used to confirm the model stability and criterion validity. Finally, 177 individuals were randomly selected from Sample 3 to perform test–retest reliability. Preliminary evidence showed that the nine-factor CUSPAMS, consisting of 32 items, yielded good psychometric characteristics. The development of the CUSPAMS provides an opportunity to improve current theories and practices regarding the assessment of PA motivation. The CUSPAMS is recommended for examining factors that influence motives as well as the impact of motives on PA among Chinese university students.
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Affiliation(s)
- Bo Lin
- Centre for Sport and Exercise Sciences, University of Malaya, Kuala Lumpur, Malaysia
- School of Physical Education, Henan Institute of Science and Technology, Xinxiang, China
| | - Eng Wah Teo
- Centre for Sport and Exercise Sciences, University of Malaya, Kuala Lumpur, Malaysia
- *Correspondence: Eng Wah Teo,
| | - Tingting Yan
- Centre for Sport and Exercise Sciences, University of Malaya, Kuala Lumpur, Malaysia
- School of Physical Education, Henan Institute of Science and Technology, Xinxiang, China
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17
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Ye ZJ. Editorial: Resilience in Chronic Disease. Front Psychiatry 2022; 13:846370. [PMID: 35237198 PMCID: PMC8882836 DOI: 10.3389/fpsyt.2022.846370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Zeng Jie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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18
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Liang MZ, Tang Y, Chen P, Liang J, Sun Z, Hu GY, Yu YL, Ye ZJ. New resilience instrument for family caregivers in cancer: a multidimensional item response theory analysis. Health Qual Life Outcomes 2021; 19:258. [PMID: 34794439 PMCID: PMC8600888 DOI: 10.1186/s12955-021-01893-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/07/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Resilience instruments specific to family caregivers (FCs) in cancer are limited. This study was designed to validate the 10-item Resilience Scale Specific to Cancer (RS-SC-10) in FCs using multidimensional item response theory (MIRT) analysis. METHODS 382 FCs were enrolled from Be Resilient to Cancer Program (BRCP) and administered with RS-SC-10 and 36-item Short Form Health Survey (SF-36). MIRT was performed to evaluate item parameters while Generalized Additive Model (GAM) and Latent Profile Analysis (LPA) were performed to test the non-linear relationship between resilience (RS-SC-10) and Quality of Life (QoL, SF-36). RESULTS RS-SC-10 retained 10 items with high multidimensional discrimination, monotonous thresholds and its original two-factor structure (Generic and Shift-Persist). Four latent resilience subgroups were identified and a non-linear dose-response pattern between resilience and QoL was confirmed (per-SD increase OR = 1.62, 95% CI 1.16-2.13, p = 0.0019). CONCLUSION RS-SC-10 is a brief and suitable resilience instrument for FCs in cancer. The resilience screening of patients and FCs can be performed simultaneously in clinical practice.
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Affiliation(s)
- Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, 510600, Guangdong Province, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, China
| | - Jian Liang
- Guangdong Provincial Key Laboratory of New Drug Development and Research of Chinese Medicine, Mathematical Engineering Academy of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong Province, China
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, 400038, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, 510641, Guangdong Province, China
| | - Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China.
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19
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Cui CY, Wang Y, Zhang Y, Chen S, Jiang N, Wang L. The development and validation of the psychological capital questionnaire for patients with Cancer the psychological capital questionnaire. BMC Cancer 2021; 21:1194. [PMID: 34758780 PMCID: PMC8579611 DOI: 10.1186/s12885-021-08960-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 11/03/2021] [Indexed: 01/17/2023] Open
Abstract
Background Studies increasingly show that positive psychological constructs affect the mental health of cancer patients. However, most scales that measure hope, resilience, optimism and self-efficacy have been developed based on general populations. The aim of our study was to develop a psychological capital (PsyCap) questionnaire for patients with cancer (PCQ-C) to gauge their mental state more accurately. Methods The items for the scale were selected by comprehensive literature review and semi-structured interviews, and the relevant terms were screened by an expert panel. A pilot study was then conducted on 202 patients to reduce the item pool, and the reliability and validity of the scale were evaluated using 500 completed questionnaires. The test-retest reliability was then assessed using a subsample of 100 patients. Finally, the completed questionnaires of 229 patients with breast cancer were used to assess the criterion validity of the PCQ-C, including measures of depression and anxiety. Results Item reduction and exploratory factory analysis resulted in 24 items for self-efficacy, hope, resilience and optimism, accounting for 56.72% of the variance. The Cronbach’s alpha for the scale was 0.886, and the test-retest reliability was 0.825. PsyCap showed a significant negative correlation with both depression (r = − 0.631, P < 0.01) and anxiety (r = − 0.601, P < 0.01). Conclusion The PCQ-C can objectively evaluate PsyCap in cancer patients and exhibits good psychometric properties.
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Affiliation(s)
- Chun Ying Cui
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China
| | - Yu Wang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China
| | - Ying Zhang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China
| | - Siqi Chen
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China
| | - Nan Jiang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China.
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20
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Liu L, Xu Y, Wu Y, Li X, Zhou C. Cross-Cultural Adaptation and Validation of the Emotional Inhibition Scale in a Chinese Cancer Sample. Front Psychol 2021; 12:654777. [PMID: 34539482 PMCID: PMC8446548 DOI: 10.3389/fpsyg.2021.654777] [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: 01/18/2021] [Accepted: 08/09/2021] [Indexed: 11/21/2022] Open
Abstract
The Emotional Inhibition Scale (EIS) is a brief measure based on a four-factor model with documented validity in a mood disorder sample that may be useful for assessing emotional inhibition in patient populations, such as individuals with cancer. The present study adapted the EIS to Chinese conditions and examined the psychometric characteristics of the EIS in patients with cancer. The recruited participants comprised a sample of 100 patients (sample 1) and a sample of 202 patients (sample 2) with cancer. The two samples (sample 1 and sample 2) with cancer completed surveys including the EIS. The Toronto Alexithymia Scale-20 was completed by the two sample groups to assess criterion validity. Statistical analyses included internal consistency (sample 1), exploratory factor analyses (EFAs; sample 1), and confirmatory factor analyses (CFAs; sample 2). The results showed that EFA and CFA confirmed the four-factor solution proposed by the original authors (verbal inhibition, self-control, disguise of feelings, and timidity). The internal consistency and test-retest reliability of the EIS were satisfactory. In conclusion, the EIS demonstrated acceptable reliability and validity for assessing emotional inhibition in Chinese-speaking patients with cancer and may be a useful measure for assessing the level of emotional inhibition and the effect of emotional disclosure interventions.
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Affiliation(s)
- Liping Liu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yikai Xu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yanni Wu
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoxia Li
- Department of Plastic and Cosmetic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chunlan Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, China
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21
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Sun Y, Sun J, Zhao Y, Cheng A, Zhou J. A new comprehensive oral health literacy scale: development and psychometric evaluation. BMC Oral Health 2021; 21:429. [PMID: 34482838 PMCID: PMC8419934 DOI: 10.1186/s12903-021-01795-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 08/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It has been widely accepted that oral health status is related to oral health literacy. The need to measure oral health literacy has led to the development of measurement instruments. This study aimed to develop a comprehensive instrument for adults and to examine its reliability and validity in China. METHODS A three-step design process was used. First, a literature review and expert panel discussion were used to draw up a 37-item pool covering oral health knowledge, belief, practice, skill, and functional oral health literacy. The Delphi method was used to delete and modify questions in the item pool. The draft instrument was evaluated by nine experts and the consensus among them was calculated using the content validity index. The scale was then used to conduct a psychometric study among 370 participants from community health centers in Beijing. Construct validity, discriminant validity and concurrent validity were examined. The Cronbach's alpha coefficient, and test-retest methods were used to assess reliability. RESULTS The final scale included 30 items across four dimensions. The item-level content validity index was 0.90. Exploratory factor analysis extracted four fixed factors, and the result of the Kaiser-Meyer-Olkin and Bartlett's tests was 0.752, with the model explaining 35.21% of the total variance. The four dimensions were associated with oral health knowledge, perceptions of oral health issues, oral health practice and skills, and functional oral health literacy. The mean score of the lowest 27% was significantly lower than the highest 27% (P < 0.01), suggesting adequate discriminant validity. The associations between comprehensive oral health literacy scores and educational level, income and self-reported literacy level were significant (P < 0.001), showing adequate overall concurrent validity. Internal consistency and test-retest reliability were acceptable, with a Cronbach's alpha of 0.72 and a total test-retest reliability coefficient of 0.979. CONCLUSIONS Initial testing of the comprehensive oral health literacy instrument suggested that it is a valid and reliable instrument to evaluate individuals' oral health literacy, with four dimensions for evaluating knowledge, belief, skills, and functional oral health literacy.
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Affiliation(s)
- Yue Sun
- Department of Nursing, Peking University First Hospital, Beijing, China
| | - Jing Sun
- Department of Community Nursing, School of Nursing, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, China.
| | - Yan Zhao
- The School of Biomedicine, Beijing City University, Beijing, China
| | - Aixiao Cheng
- Department of Stomatology, Beijing Zhongguancun Hospital, Beijing, China
| | - Junhong Zhou
- Department of Stomatology, Beijing Zhongguancun Hospital, Beijing, China
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22
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Abstract
BACKGROUND The treatment-related decision-making process is a highly emotional time for parents of children with incurable cancer, and they tend to continue the cancer-directed treatment even when they realize that there is no cure for their child. OBJECTIVE To evaluate whether parents involved in different treatment decisions regretted their treatment decision after their child's death. METHODS We collected prospective data from 418 parents of children who died of incurable cancer after receiving cancer care at 1 of 4 hospitals. We assessed parent decisional regret and its association with the type of treatment decision made (non-cancer-directed vs cancer-directed). Propensity score-matched analysis (at a ratio of 1:1) was performed. RESULTS One hundred forty-eight parents (35.4%) reported heightened regret. Two isonumerical arms with 103 (non-cancer-directed) and 103 (cancer-directed) resulted after propensity score matching. Parents with a cancer-directed treatment decision (relative risk, 1.53; 95% confidence interval, 1.24-1.90; P = .002) were more likely to report decisional regret compared with those with a non-cancer-directed decision. CONCLUSION Bereaved parents with a cancer-directed treatment decision are more likely to experience increased regret for their decision than bereaved parents involved in a non-cancer-directed treatment decision. IMPLICATIONS Shared-decision aids should be prepared for young parents with low education to improve disease-related knowledge, accurate risk perceptions, and options congruent with parents' values.
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Sharif M, Zaidi A, Waqas A, Malik A, Hagaman A, Maselko J, LeMasters K, Liaqat R, Bilal S, Bibi T, Ahmad I, Sikander S, Rahman A. Psychometric Validation of the Multidimensional Scale of Perceived Social Support During Pregnancy in Rural Pakistan. Front Psychol 2021; 12:601563. [PMID: 34211414 PMCID: PMC8239233 DOI: 10.3389/fpsyg.2021.601563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 05/14/2021] [Indexed: 11/30/2022] Open
Abstract
Background: The Multidimensional Scale of Perceived Social Support (MSPSS) is a short and reliable instrument that assesses perceived social support from the social network of an individual. A previous study in Pakistan among postpartum women has demonstrated a unidimensional factor structure in contrast to the original three-factor structure. The emergence of a one-factor structure for postpartum women in Pakistan may be due to traditional postpartum practices unique to the women of the subcontinent. Building upon the previous evidence, this study aims to explore the psychometric properties of MSPSS among pregnant women in their third trimester in rural Pakistan. Methods: A cross-sectional survey was conducted from October 2014 to February 2016, in rural Pakistan. A sample of 1,154 pregnant women (aged ≥ 18 years) in their third trimester who were registered with the local Lady Health Worker Program and were living in the north of the Punjab Province was included in this study. They were assessed using Urdu translated scales of Patient Health Questionnaire, MSPSS, Maternal Social Support Index, and Perceived Stress Scale. Principal Axis Factoring was used to assess the construct validity of the MSPSS. Results: The MSPSS scale showed an excellent internal consistency, yielding a Cronbach's α-value of 0.933. The MSPSS scale exhibited an excellent construct validity, and confirmatory factor analysis retained three factors (family, friends, and significant others) for both the depressed and non-depressed samples. Internal reliability and construct validity were also established. Conclusion: The psychometric findings suggest that the tridimensional structure of MSPSS is a valid and reliable measure of perceived social support among the Pakistani population with and without perinatal depression. The perceived social support is an important predictor of maternal mental well-being and psychopathologies, and the MSPSS can serve as a useful tool in mental health research in Pakistan.
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Affiliation(s)
- Maria Sharif
- Human Development Research Foundation, Islamabad, Pakistan
| | - Ahmed Zaidi
- Human Development Research Foundation, Islamabad, Pakistan
| | - Ahmed Waqas
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Abid Malik
- Faculty of Research, Rawalpindi Medical University, Rawalpindi, Pakistan.,Department of Population Health Science, Global Institute of Human Development, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Ashley Hagaman
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Katherine LeMasters
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Samina Bilal
- Human Development Research Foundation, Islamabad, Pakistan
| | - Tayyaba Bibi
- Human Development Research Foundation, Islamabad, Pakistan
| | - Ikhlaq Ahmad
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
| | - Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan.,Department of Public Health, Health Services Academy, Islamabad, Pakistan
| | - Atif Rahman
- Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
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24
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Ye ZJ, Zhang Z, Tang Y, Liang J, Sun Z, Hu GY, Liang MZ, Yu YL. Resilience patterns and transitions in the Be Resilient To Breast Cancer trial: an exploratory latent profile transition analysis. Psychooncology 2021; 30:901-909. [PMID: 33689199 DOI: 10.1002/pon.5668] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Be Resilient to Breast Cancer (BRBC), a theoretically-derived, resilience-based, culturally-tailored, supportive-expressive group therapy (SEGT), has been developed to help promote patients' resilience in breast cancer. Data from patients receiving BRBC intervention was utilized to explore and define characteristics of resilience patterns and their transitions over time. METHODS Resilience was used as a primary outcome and 391 patients completed Resilience Scale Specific to Cancer at enrollment (T0), 2 months (T1), 6 months(T2), and 12 months (T3) after intervention. latent profile transition analysis was performed to model the change in resilience and predict positive transitioning probabilities between resilience patterns (from one pattern to another pattern with a higher level) over time. RESULTS One hundred and forty four resilience patterns were identified after BRBC intervention. 33.1%, 50.3%, and 40.5% of patients experienced positive resilience transitions from T0 to T1, T1 to T2, and T2 to T3, respectively. Patients with middle age, unmarried status, higher education level, and less advanced tumor stage were more likely to experience positive resilience transitions. CONCLUSION Different transitions of resilience patterns are observed after BRBC intervention. Age, marital status, education, and tumor stage may be four factors affecting the efficacy of SEGT intervention in breast cancer.
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Affiliation(s)
- Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zhang Zhang
- Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Jian Liang
- Guangdong Provincial Key Laboratory of New Drug Development and Research of Chinese Medicine, Mathematical Engineering Academy of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, China
| | - Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, Guangdong Province, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, Guangdong Province, China
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25
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Tamura S, Suzuki K, Ito Y, Fukawa A. Factors related to the resilience and mental health of adult cancer patients: a systematic review. Support Care Cancer 2021; 29:3471-3486. [PMID: 33512578 DOI: 10.1007/s00520-020-05943-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 12/10/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE It has been reported that maintaining the mental health of cancer patients is a critically important issue, and that resilience is related to mental health. This study conducted a systematic literature review in order to fully understand the relationships between resilience and anxiety, depression, and quality of life (QOL) in adult cancer patients, as well as identify factors associated with resilience. METHODS The PubMed, CINAHL, Psychology Database, and ICHUSHI Web databases were searched for articles related to resilience in cancer patients published between 2014 and 2019 using the keywords "cancer" and "resilience," connected with "and." The extracted articles that met inclusion criteria were organized using a matrix. To understand the resilience status of adult cancer patients, meta-analyses were performed using resilience scores measured with the most commonly used resilience scale, Connor-Davidson Resilience Scale 25. RESULTS Thirty-nine articles were included in the analysis. A higher resilience score is associated with lower anxiety and depression scores and higher QOL scores. Factors related to resilience include personal factors such as age and gender, disease-related factors such as the presence or absence and severity of physical symptoms, and internal factors such as self-efficacy and hopefulness. CONCLUSIONS It was found that it is important for cancer patients to improve resilience to maintain mental health and QOL. The findings suggest that providing interventions for factors that will reduce resilience will provide support for patients with cancer.
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Affiliation(s)
- Saori Tamura
- Doctoral Program, Graduate School of Nursing, Osaka Medical College, 7-6, Hatchonishimachi, Takatsuki City, Osaka, 569-0095, Japan.
| | - Kumi Suzuki
- Faculty of Nursing, Osaka Medical College, 7-6, Hatchonishimachi, Takatsuki City, 569-0095, Osaka, Japan
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki City, 569-8686, Osaka, Japan
| | - Akiko Fukawa
- Faculty of Nursing, Osaka Medical College, 7-6, Hatchonishimachi, Takatsuki City, 569-0095, Osaka, Japan
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26
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Mosquera MJ, Kaat A, Ring M, Agarwal G, Glickson S, Victorson D. Psychometric properties of a new self-report measure of medical student stress using classic and modern test theory approaches. Health Qual Life Outcomes 2021; 19:2. [PMID: 33388065 PMCID: PMC7778790 DOI: 10.1186/s12955-020-01637-0] [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: 04/20/2020] [Accepted: 12/02/2020] [Indexed: 11/25/2022] Open
Abstract
Background Medical students face significant
stressors related to the intense rigors of their training and education. Accurate measurement of their stress is important to quickly identify, characterize and ameliorate these challenges. Existing measures have limitations that modern measurement approaches, such as item response theory (IRT), are able to address. This study presents the calibration and validation of a new IRT-based measure called the Medical Student Stress Scale (MSSS). Methods Following rigorous measurement development procedures described elsewhere, the authors created and tested a pool of 35 items with 348 1st – 4th year medical students along with demographic and external validity measures. Psychometric analysis included exploratory and confirmatory factor analyses, IRT modeling, and correlations with legacy measures. Results Of the original 35 items, 22 were retained based on their ability to discriminate, provide meaningful information, and perform well against legacy measures. The MSSS differentiated stress scores between male and female students, as well as between year in school. Conclusion Developed with input from medical students, the MSSS represents a student-centered measurement tool that provides precise, relevant information about stress and holds potential for screening and outcomes-related applications.
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Affiliation(s)
- Matthew J Mosquera
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Avenue, Boston, MA, 02115, USA.
| | - Aaron Kaat
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Melinda Ring
- Osher Center for Integrative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gaurava Agarwal
- Department of Medical Education and Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sydney Glickson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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27
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Tang L, Zhang Y, Pang Y, Zhou Y, Li J, Song L, He Y, Li Z, Wang Y. Validation of Death and Dying Distress Scale-Chinese Version and Prevalence of Death Anxiety Among Patients With Advanced Cancer. Front Psychiatry 2021; 12:715756. [PMID: 34744816 PMCID: PMC8564352 DOI: 10.3389/fpsyt.2021.715756] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/13/2021] [Indexed: 01/25/2023] Open
Abstract
Purpose: Death anxiety is commonly experienced by individuals with advanced cancer who have a limited life expectancy. The Death and Dying Distress Scale (DADDS) is a validated measure that was created to capture this experience; but no Chinese version is available to date. We conducted a cross-sectional study to explore the psychometric properties of a Chinese version DADDS (DADDS-C) and address prevalence of death anxiety among patients with advanced cancer. Methods: Patients with advanced cancer were recruited from Peking University Cancer Hospital. Measures administered included: DADDS-C, Patient Health Questionnaire (PHQ-9), General Anxiety Disorder-7(GAD-7), Quality of Life at End of Life in Cancer (QUAL-EC), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-sp). McDonald's Omega, Cronbach's alpha, Exploratory Factor Analysis and Confirmatory Factor Analysis were used to test DADDS-C's reliability and validity. Logistic regression analysis was used to identify risk factors for death anxiety. Results: Of 300 patients approached, 256 (85%) provided informed consent and completed the questionnaires. Of these participants, 43 (16.8%) had moderate death anxiety based on scores of ≥45 on the DADDS-C. Three factors (feeling shortness of time, dying and death distress, being a burden to others) explained 71.643% of shared variation with factor loadings ranging from 0.629 to 0.822. Cronbach's alpha was 0.939; Omega total was 0.959. DADDS-C had acceptable convergent and discriminant validity. Logistic regression analysis indicated that two factors (better relationship with healthcare providers and preparation for end of life) protected patients from death anxiety. Conclusion: DADDS-C is a valid tool for measuring death anxiety in Chinese patients with advanced cancer. The presence of at least moderate death anxiety in a substantial minority of these patients calls for screening for this symptom and for more routine psychological interventions to alleviate and prevent such distress in this population.
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Affiliation(s)
- Lili Tang
- Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Yening Zhang
- Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Ying Pang
- Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Yuhe Zhou
- Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Jinjiang Li
- Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Lili Song
- Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Yi He
- Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Zimeng Li
- Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Yan Wang
- Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
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Ye ZJ, Zhang Z, Tang Y, Liang J, Zhang XY, Hu GY, Sun Z, Liang MZ, Yu YL. Minimum clinical important difference for resilience scale specific to cancer: a prospective analysis. Health Qual Life Outcomes 2020; 18:381. [PMID: 33298059 PMCID: PMC7724855 DOI: 10.1186/s12955-020-01631-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/23/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The minimum clinical important differences (MCIDs) of resilience instruments in patients with cancer have not been comprehensively described. This study was designed to evaluate MCIDs of 10-item and 25-item resilience scales specific to cancer (RS-SC-10 and RS-SC-25). METHODS From June 2015 to December 2018, RS-SCs were longitudinally measured in 765 patients with different cancer diagnoses at baseline (T0) and 3 months later (T1). The EORTC QLQ-C30, Connor-Davidson Resilience Scale, Hospital Anxiety and Depression Scale, and Allostatic Load Index were measured concurrently as anchors. Anchor-based methods (linear regression, within-group), distribution-based methods(within-group), and receiver operating characteristic curves (ROCs, within-subject) were performed to evaluate the MCIDs. RESULTS 623 of 765 (84.1%) patients had paired RS-SCs scores. Moderate correlations were identified between the change in RS-SCs and change in anchors (r = 0.38-0.44, all p < 0.001). Linear regression estimated + 8.9 and - 6.7 as the MCIDs of RS-SC-25, and + 3.4 and - 2.5 for RS-SC-10. Distribution-based methods estimated + 9.9 and - 9.9 as the MCIDs of RS-SC-25, and + 4.0 and - 4.0 for RS-SC-10. ROC estimated + 5.5 and - 4.5 as the MCIDs of RS-SC-25, and + 2.0 and - 1.5 for RS-SC-10. CONCLUSIONS The most reliable MCID is around 5 points for RS-SC-25 and 2 points for RS-SC-10. RS-SCs are more responsive to the worsening status of resilience in patients with cancer and these estimates could be useful in future resilience-based intervention trials.
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Affiliation(s)
- Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China.
| | - Zhang Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China
| | - Jian Liang
- Guangdong Provincial Key Laboratory of New Drug Development and Research of Chinese Medicine, Mathematical Engineering Academy of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China
| | - Xiao Ying Zhang
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 510275, Guangdong Province, China
| | - Guang Yun Hu
- Army Medical University, Chongqing Municipality, 400038, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong Province, China
| | - Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, 510600, Guangdong Province, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, 510641, Guangdong Province, China
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Meng Y, Li Y, Cao H, Xu Y, Wang B. Development of two psychological experience questionnaires for screening violence-related mental health disorders of non-psychiatric inpatients. Health Qual Life Outcomes 2020; 18:151. [PMID: 32450852 PMCID: PMC7249322 DOI: 10.1186/s12955-020-01399-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 05/07/2020] [Indexed: 11/10/2022] Open
Abstract
Background Increased violent events happen in the general hospitals in China and yet non-psychiatric departments do not have tools for violence-tendency screening. Methods The current study developed and evaluated two Inpatient Psychological Experience Questionnaires (IPEQs) for the screening of violence-related six mental health disorders: (Inpatient Psychological Experience Questionnaire-1 (IPEQ-1): anxiety, depression and suicidality; Inpatient Psychological Experience Questionnaire-2 (IPEQ-2): paranoid personality disorder, emotionally unstable personality disorder and histrionic personality disorder). Two initial IPEQs (IPEQ-1: 37 items and IPEQ-2: 30 items) were developed and assessed by domain experts. Then 1210 inpatients were recruited and divided into three groups (160, 450 and 600 samples, respectively) for IPEQs item selection and evaluation. During the two-stage item selection, three statistical methods including Pearson’s correlation coefficient, exploratory factor analysis and item response theory were applied. For the item evaluation, Cronbach’s alpha coefficient, test-retest reliability, criterion-related validity and construct validity of the final questionnaires were measured. Results Twelve items were selected for each IPEQs. Cronbach’s alpha coefficients were 0.91 and 0.78 for IPEQ-1 and IPEQ-2, respectively. Test-retest replication ratios were 0.95 and 0.87 for IPEQ-1 and IPEQ-2, respectively. Correlation coefficients between different disorders and their related-tools scores were [0.51, 0.44] and [0.40, 0.44] for IPEQ-1 and IPEQ-2, respectively and were significant (P < 0.01). Confirmatory factor analysis supported the validity of the final IPEQs (P < 0.05), and the model fit index met the criterion generally. Conclusion The IPEQs developed in this study could be effective and easy-to-use tools for screening inpatients with violence-intendancy in non-psychosomatic departments.
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Affiliation(s)
- Yanjun Meng
- Nursing College, Shanxi Medical University, 56 Xinjian South Road, Taiyuan, Shanxi, 030001, People's Republic of China.,Nursing College, Shanxi University of Chinese Medicine, Taiyuan, Shanxi, People's Republic of China
| | - Yuling Li
- Nursing College, Shanxi Medical University, 56 Xinjian South Road, Taiyuan, Shanxi, 030001, People's Republic of China
| | - Hongbao Cao
- School of Systems Biology, George Mason University (GMU), Fairfax, VA, USA
| | - Yong Xu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.
| | - Binquan Wang
- Nursing College, Shanxi Medical University, 56 Xinjian South Road, Taiyuan, Shanxi, 030001, People's Republic of China. .,Department of Otolaryngology, Head and Neck Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.
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30
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Ye ZJ, Zhang Z, Zhang XY, Tang Y, Chen P, Liang MZ, Sun Z, Yu YL. State or trait? Measuring resilience by generalisability theory in breast cancer. Eur J Oncol Nurs 2020; 46:101727. [PMID: 32339909 DOI: 10.1016/j.ejon.2020.101727] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Whether resilience should be conceptualised as a state or trait is debated. The precise distinction between state versus trait aspects of resilience can help identify dynamic targets for resilience-based intervention trials involving cancer patients. This study was designed to disentangle the state and trait components of resilience in patients with breast cancer with the help of Generalisability Theory (GT) methods. METHODS The relative contributions of state (temporary) and trait (enduring) aspects of resilience were calculated using a 10-item Resilience Scale Specific to Cancer (RS-SC-10) and GT methods. In all, 391 patients were enrolled from the 'Be Resilient to Breast Cancer ' (BRBC) trial, and data from 317 patients (81.7%) were collected at baseline, 3 months, 6 months, and 12 months after the intervention. RESULTS The subscale of Generic Elements demonstrated high generalisability value (relative G-coefficient = 0.81) across different occasions and captured 79% of the variance attributed to enduring aspects of resilience. The subscale of Shift-Persist showed low generalisability value (relative G-coefficient = 0.31) and identified 59% of the variance attributed to temporary aspects of resilience. The GT studies suggested that 5-7 items per scale and three measurement occasions were adequate for score reliability evaluation. CONCLUSION Resilience should be conceptualised as a state-trait mixed psychological variable in breast cancer patients. The subscale of Shift-Persist in RS-SC-10 is amenable to intervention and could be utilised as a primary outcome in resilience-based intervention trials. CLINICAL TRIAL REGISTRATION None.
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Affiliation(s)
- Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China.
| | - Zhang Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, 510060, China
| | - Xiao Ying Zhang
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong Province, 510275, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China
| | - Peng Chen
- Basic Medical School, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, 550025, China
| | - Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, Guangdong Province, 510600, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510405, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, Guangdong Province, 510641, China
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Luo D, Eicher M, White K. Individual resilience in adult cancer care: A concept analysis. Int J Nurs Stud 2020; 102:103467. [DOI: 10.1016/j.ijnurstu.2019.103467] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 02/07/2023]
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Ye ZJ, Zhang Z, Zhang XY, Tang Y, Liang J, Sun Z, Liang MZ, Yu YL. Effectiveness of adjuvant supportive-expressive group therapy for breast cancer. Breast Cancer Res Treat 2020; 180:121-134. [PMID: 31950384 DOI: 10.1007/s10549-020-05526-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/09/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Randomized control trials exploring adjuvant supportive-expressive group therapy (SEGT) for breast cancer have yielded conflicting survival results. This retrospective cohort study was designed to explore the association of adjuvant SEGT performed at diagnosis with survival in real-world patients. METHODS 3327 patients with breast cancer were divided between those who received oncologic treatment combined with SEGT-based intervention (referred to as BRBC [n = 354]) and those who only received oncologic treatment (referred to as OT [n = 2973]). Primary outcome was overall survival (OS) at 1-year, 3-year, 5-year. Propensity score-matched analysis (at a ratio of 1:3) and instrumental variable analysis (IVA) were performed. RESULTS The median overall survival was 7.3 years (95% CI 7.0-7.7 years) in BRBC and 7.1 years (95% CI 6.9-7.4 years) in OT. BRBC was not significantly associated with improved 1-year (HR 0.74, 95% CI 0.49-1.10, P = 0.1748; NNT = 44.8, 95% CI - 118.5 to 22.6), 3-year (HR 0.98, 95% CI 0.75-1.27, P = 0.8640; NNT = 273.7, 95% CI - 21.0 to 21.3), or 5-year survival (HR 0.79, 95% CI 0.61-1.02, P = 0.0908; NNT = 36.0, 95% CI - 384.5 to 19.1) compared with OT. IVA indicated that BRBC had a survival benefit over OT in the 1-year, 3-year, and 5-year of 1.5% (95% CI 1.2-1.9%), 0.7% (95% CI 0.6-0.8%), and 2.6% (95% CI 2.0-3.4%), respectively. CONCLUSION Adjuvant SEGT cannot significantly prolong 5-year survival in breast cancer, though a longer observation period is warranted according to the marginal survival benefit identified at the end of the follow-up.
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Affiliation(s)
- Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China.
| | - Zhang Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong Province, China
| | - Xiao Ying Zhang
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, 510275, Guangdong Province, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China
| | - Jian Liang
- Guangdong Provincial Key Laboratory of New Drug Development and Research of Chinese Medicine, Mathematical Engineering Academy of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong Province, China
| | - Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, 510600, Guangdong Province, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, 510641, Guangdong Province, China
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Ye ZJ, Zhang Z, Tang Y, Liang J, Sun Z, Zhang XY, Liang MZ, Yu YL. Development and psychometric analysis of the 10-item resilience scale specific to cancer: A multidimensional item response theory analysis. Eur J Oncol Nurs 2019; 41:64-71. [PMID: 31358259 DOI: 10.1016/j.ejon.2019.06.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 04/04/2019] [Accepted: 06/10/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE Resilience is an important concept in the cancer literature and is a salient indicator of cancer survivorship. Classic theory test (CTT) and item response theory (IRT) were performed to develop and validate the 25-item Resilience Scale Specific to Cancer (RS-SC). This study was designed to develop and validate a short form of RS-SC (RS-SC-10) with a multidimensional IRT (MIRT) analysis. METHODS MIRT analysis was performed to test two models (three- and five-factor) derived from previous studies and assess the item parameters of RS-SC and RS-SC-10. RESULTS A total of 451 Chinese patients with different cancer diagnoses were analyzed. The three-factor structure showed better goodness of fit compared with the five-factor structure in RS-SC. RS-SC-10 retained 10 items with high discriminative parameters from RS-SC and consisted of two factors, Generic and Shift-Persist. Item information function indicated that RS-SC-10 had the highest discrimination ability among patients with low to moderate levels of resilience. CONCLUSIONS MIRT provided useful information on RS-SC and RS-SC-10 by combining the approaches of CTT and IRT. RS-SC-10 showed great potential in clinical settings owing to the low scale of burden on patients. More studies on the Minimum Clinically Important Difference of RS-SC-10 are warranted.
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Affiliation(s)
- Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China.
| | - Zhang Zhang
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, 510060, China
| | - Ying Tang
- Institute of Tumor, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China
| | - Jian Liang
- Guangdong Provincial Key Laboratory of New Drug Development and Research of Chinese Medicine, Mathematical Engineering Academy of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510405, China
| | - Xiao Ying Zhang
- The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen,Guangdong Province, 510275, China
| | - Mu Zi Liang
- Guangdong Academy of Population Development, Guangzhou, Guangdong Province, 510600, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, Guangdong Province, 510641, China
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Development and psychometric testing of the Chinese version of the Resilience Scale for Southeast Asian immigrant women who divorced in Taiwan. PLoS One 2019; 14:e0211451. [PMID: 30716088 PMCID: PMC6361505 DOI: 10.1371/journal.pone.0211451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 01/15/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Only a few studies exist on the resilience of divorced women. Furthermore, relevant instruments for assessing the resilience of divorced immigrant Southeast Asian women are rare. Accordingly, the aim of this study was to develop and examine a new Resilience Scale-Chinese version (RS-C) that is specific to divorced immigrant Southeast Asian women in Taiwan. METHODS The study was conducted in two phases. In phase 1, 20 items were used to evaluate face and content validities. In phase 2, a cross-sectional study was conducted. In total, 118 immigrant women participated in this study and were recruited from three nongovernmental organizations providing services for immigrants in Taipei City and Miaoli and Chiayi Counties. Psychometric properties of the instrument (i.e., internal consistency, test-retest reliability, item-to-total correlation, construct validity, and convergent validity) were examined. Significance was set at p < 0.05 for all statistical tests. RESULTS The final 16-item RS-C resulted in a three-factor model. The three factors, namely personal competence, family identity, and social connections, were an acceptable fit for the data and explained 54.60% of the variance. Cronbach's α of the RS-C was 0.85, and those of its subscales ranged from 0.77 to 0.82. The correlation value of the test-retest reliability was 0.87. The RS-C was significantly associated with the General Self-Efficacy scale and the Chinese Health Questionnaire-12. CONCLUSION The RS-C is a brief and specific self-report tool for evaluating the resilience of divorced immigrant Southeast Asian women and demonstrated adequate reliability and validity in this study. This RS-C instrument has potential applications in both clinical practice and research with strength-based resiliency interventions. However, additional research on the RS-C is required to further establish its reliability and validity.
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Symptoms and management of children with incurable cancer in mainland China. Eur J Oncol Nurs 2018; 38:42-49. [PMID: 30717935 DOI: 10.1016/j.ejon.2018.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/22/2018] [Accepted: 11/21/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE This study was designed to report information regarding symptomology of incurable pediatric cancer to promote proactive medicine and support for children and their families in the palliative phase in Mainland China. METHOD A multi-center retrospective cohort study including 205 children who died from incurable cancer between June 2008 and September 2013 were analyzed. RESULTS An incurable diagnosis was confirmed between 0 and 1726 (median, 279) days from initial diagnosis with death occurring between 1 and 239(median, 83) days. The most frequent symptoms were fatigue (93.7%), pain (87.3%), and poor appetite (76.1%). The earliest symptoms were pain and fatigue. Children with leukemia and lymphoma also complained early of nausea/vomiting, and children with solid tumors complained early of disturbed sleep. Later in the palliative phase, altered consciousness and seizures were found in children with central nervous system tumors and solid tumors, while children with leukemia and lymphoma were found to have fever, diarrhea, and bleeding. However, these symptoms only persisted for a short time. DNR discussions were held in 89 cases (43.4%) at a median of 37 (range, 4-178) days before death. A total of 154 patients (75.1%) died at home and 51 patients (24.9%) in the hospital. CONCLUSIONS This study provides new knowledge about symptomology to health care professionals and parents of children in Mainland China. Given our results, an improved alternative care plan should be developed and implemented earlier to facilitate end-of-life planning.
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Hinz A, Friedrich M, Kuhnt S, Zenger M, Schulte T. The influence of self-efficacy and resilient coping on cancer patients’ quality of life. Eur J Cancer Care (Engl) 2018; 28:e12952. [DOI: 10.1111/ecc.12952] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/07/2018] [Accepted: 09/16/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - Susanne Kuhnt
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - Markus Zenger
- Faculty of Applied Human Studies; University of Applied Sciences Magdeburg and Stendal; Stendal Germany
- Integrated Research and Treatment Center Adiposity Diseases; Leipzig University Medical Center; Leipzig Germany
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Ye ZJ, Peng CH, Zhang HW, Liang MZ, Zhao JJ, Sun Z, Hu GY, Yu YL. A biopsychosocial model of resilience for breast cancer: A preliminary study in mainland China. Eur J Oncol Nurs 2018; 36:95-102. [PMID: 30322517 DOI: 10.1016/j.ejon.2018.08.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE Patients diagnosed with breast cancer exhibited critical biopsychosocial functions following surgery or adjuvant treatment; therefore, it is important that they exhibit resilience. A Resilience Model for Breast Cancer (RM-BC) was developed using Chinese breast cancer patients to increase our understanding of how resilience outcomes are positively and negatively affected by protective and risk factors, respectively. METHODS Chinese women with breast cancer completed the questionnaires within 1 week of beginning treatment. Exploratory Structural Equation Modeling was used to evaluate the RM-BC using a sample size of 342 patients. RESULTS RM-BC suggested satisfactory goodness-of-fit indices and 67 percents of variance for resilience was explained. The Fit Indices for the measurement model were as follows: CFI = 0.909, GFI = 0.911, IFI = 0.897, NFI = 0.922, PNFI = 0.896, PCFI = 0.884, and RMSEA = 0.031. Three risk factors - emotional distress, physical distress, and intrusive thoughts - and four protective factors - self-efficacy, social support, courage-related strategy, and hope - were recognized. CONCLUSION The resilience model allows for a better understanding of Chinese breast cancer patients' resilience integration while undergoing treatment and provides an effective structure for the development of resilience-focused interventions that are grounded in their experiences. A randomized trial has provided evidences of feasibility in Chinese women with breast cancer and the resilience model could be used as a useful framework for more resilience intervention in the future.
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Affiliation(s)
- Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China.
| | - Chao Hua Peng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China
| | - Hao Wei Zhang
- Harbin Medical University-Daqing, Daqing, Heilongjiang Province, 163319, China
| | - Mu Zi Liang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510006, China.
| | - Jing Jing Zhao
- Department of Nursing, Chongqing Medical and Pharmaceutical College, Chongqing, Sichuan Province, 401331, China
| | - Zhe Sun
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510405, China
| | - Guang Yun Hu
- Guangdong Second Provincial Traditional Chinese Medicine Hospital, Guangzhou, Guangdong Province, 510095, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, Guangdong Province, 510641, China
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Ye ZJ, Liang MZ, Zhang HW, Li PF, Ouyang XR, Yu YL, Liu ML, Qiu HZ. Psychometric properties of the Chinese version of resilience scale specific to cancer: an item response theory analysis. Qual Life Res 2018; 27:1635-1645. [PMID: 29569015 DOI: 10.1007/s11136-018-1835-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Classic theory test has been used to develop and validate the 25-item Resilience Scale Specific to Cancer (RS-SC) in Chinese patients with cancer. This study was designed to provide additional information about the discriminative value of the individual items tested with an item response theory analysis. METHODS A two-parameter graded response model was performed to examine whether any of the items of the RS-SC exhibited problems with the ordering and steps of thresholds, as well as the ability of items to discriminate patients with different resilience levels using item characteristic curves. RESULTS A sample of 214 Chinese patients with cancer diagnosis was analyzed. The established three-dimension structure of the RS-SC was confirmed. Several items showed problematic thresholds or discrimination ability and require further revision. CONCLUSIONS Some problematic items should be refined and a short-form of RS-SC maybe feasible in clinical settings in order to reduce burden on patients. However, the generalizability of these findings warrants further investigations.
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Affiliation(s)
- Zeng Jie Ye
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China.
| | - Mu Zi Liang
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China.,Guangdong Academy of Population Development, Guangzhou, 510600, Guangdong Province, China
| | - Hao Wei Zhang
- Harbin Medical University- Daqing, Daqing, 163319, Heilongjiang Province, China
| | - Peng Fei Li
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China
| | - Xue Ren Ouyang
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong Province, China
| | - Yuan Liang Yu
- South China University of Technology, Guangzhou, 510641, Guangdong Province, China
| | - Mei Ling Liu
- Sun Yat-sen University Cancer Center, Guangzhou, 510060, Guangdong Province, China
| | - Hong Zhong Qiu
- College of Economics and Management, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong Province, China.
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