The EORTC information questionnaire, EORTC QLQ-INFO25. Validation study for Spanish patients

Cancer patient satisfaction regarding the quality of information received: psychometric validity of EORTC QLQ-INFO25

OBJECTIVES

to psychometrically validate the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire EORTC QLQ-INFO25 instrument and identify the domains that influence patients' perception of the information received.

METHODS

a cross-sectional methodology with cancer patients in a Brazilian philanthropic hospital institution. Sociodemographic and clinical instruments, EORTC QLQ-C30, EORTC QLQ-INFO25 and Supportive Care Needs Survey - Short Form 34 were used. Analysis occurred using Cronbach's alpha coefficients, intraclass correlation, test-retest and exploratory factor analysis.

RESULTS

128 respondents participated. Cronbach's alpha coefficient was 0.85. The test-retest obtained p-value=0.21. In the factor analysis, one item was excluded. Satisfaction with the information received was 74%, with three areas with averages below 70%. In open-ended questions, there was a greater desire for information.

CONCLUSIONS

validity evidence was obtained with instrument reliability, consistency and stability. Respondents expressed satisfaction with the information received.

Effect of receiving a customizable brochure on breast cancer patients' knowledge about their diagnosis and treatment: A randomized clinical trial

BACKGROUND

Patients' lack of knowledge about their own disease may function as a barrier to shared decision-making and well-being. This study aimed to evaluate the impact of written educational materials on breast cancer patients.

METHODS

This multicenter, parallel, unblinded, randomized trial included Latin American women aged ≥18 years with a recent breast cancer diagnosis yet to start systemic therapy. Participants underwent randomization in a 1:1 ratio to receive a customizable or standard educational brochure. The primary objective was accurate identification of molecular subtype. Secondary objectives included identification of clinical stage, treatment options, participation in decision-making, perceived quality of information received, and illness uncertainty. Follow-up occurred at 7-21 and 30-51 days post-randomization.

CLINICALTRIALS

gov identifier: NCT05798312.

RESULTS

One hundred sixty-five breast cancer patients with a median age of 53 years and 61 days from diagnosis were included (customizable: 82; standard: 83). At first available assessment, 52%, 48%, and 30% identified their molecular subtype, disease stage, and guideline-endorsed systemic treatment strategy, respectively. Accurate molecular subtype and stage identification were similar between groups. Per multivariate analysis, customizable brochure recipients were more likely to identify their guideline-recommended treatment modalities (OR: 4.20,p = 0.001). There were no differences between groups in the perceived quality of information received or illness uncertainty. Customizable brochure recipients reported increased participation in decision-making (p = 0.042).

CONCLUSIONS

Over one third of recently diagnosed breast cancer patients are incognizant of their disease characteristics and treatment options. This study demonstrates a need to improve patient education and shows that customizable educational materials increase patients' understanding of recommended systemic therapies according to individual breast cancer characteristics.

Confiabilidade do EORTC QLQ-INFO25 para Avaliar a Necessidade de Informação de Pacientes Oncológicos

Introdução: A maioria dos pacientes não possui um grau satisfatório de compreensão acerca do câncer. Para que o processo de comunicação de informações seja verdadeiramente efetivo, e necessário identificar anteriormente o nível de conhecimento do paciente. Objetivo: Verificar a estabilidade teste-reteste do instrumento EORTC QLQ-INFO25 em sua versão em português do Brasil, para avaliação da necessidade de informação do paciente oncológico. Método: O instrumento foi aplicado em 253 pacientes hospitalizados nas enfermarias clinicas e cirúrgicas de um hospital de alta complexidade no tratamento do câncer situado no município do Rio de Janeiro, por meio de um questionário com entrevista individual. Para testar a adequação do processo de aferição, 85 pacientes aderiram ao reteste, com intervalo de sete a 15 dias. Os dados foram inseridos em um banco de dados por dupla digitação independente no programa Microsoft Excel. A análise foi realizada por meio da estatística Kappa simples e ponderada. Resultados: As respostas mostraram-se estáveis, e as estimativas de confiabilidade teste-reteste variaram de boas a excelentes (0,66 a 0,99). O instrumento também demonstrou boa estabilidade quando aplicado em outras populações e em pacientes com diferentes tipos de câncer. Conclusão: O instrumento EORTEC QLQ-INFO25 pode contribuir para a mensuração da satisfação do paciente em relação a sua necessidade de informação, uma vez que os resultados sugerem alta estabilidade das informações, tornando viável a sua aplicabilidade na população brasileira.

Informação Clínica e sua Relação com a Qualidade de Vida em Pacientes com Câncer de Cabeça e Pescoço

Introdução: O tratamento do câncer de cabeça e pescoço tem grande impacto na qualidade de vida dos pacientes pelas sequelas físicas, psicológicas, estéticas, sociais e emocionais. A informação prestada pelos profissionais de saúde no continuum do processo clinico desses pacientes e tida como um fator-chave dos cuidados de saúde de qualidade e com múltiplos benefícios na sua qualidade de vida. Objetivo: Averiguar a percepção dos pacientes com câncer de cabeça e pescoço relativamente a informação prestada e a existência de correlação com a sua qualidade de vida. Método: Estudo transversal com amostra de 38 pacientes com câncer de cabeça e pescoço, selecionados por conveniência de amostra potencial de 347 pacientes. Recorreram-se aos questionários EORTC QLQ-C30 e EORTC QLQ-INFO25, aplicados dois a quatro meses após o termino das terapias oncológicas. Todos os cálculos foram efetuados com recurso ao SPSS, versão 24, utilizando-se a estatística descritiva para caracterização da amostra e testes não paramétricos para avaliar a possível correlação entre as variáveis em estudo. Resultados: A percepção dos pacientes, relativa a informação prestada e a sua qualidade de vida, e razoável, existindo correlação entre ambas. Conclusão: Os dados obtidos vão ao encontro dos referidos na literatura, podendo-se aferir que a informação prestada pelos profissionais de saúde e importante para a qualidade de vida dos pacientes. O conhecimento das necessidades informativas permite adequar as estratégias dos profissionais de saúde no sentido de uma melhor prestação de cuidados de saúde e, consequentemente, da qualidade de vida dos pacientes.

The Relationship Between Hope and Received Information About Cancer Among Women with Breast Cancer: A Descriptive-Correlational Study

Background: In Western culture, information about different aspects of cancer is directly provided to the individual, but in Eastern culture, health professionals and families do not prefer to inform the patient from diagnosis, treatment, test results, causes of the disease, and the effect of treatment on sexual intercourse in front of patients in order to maintain their hope. Objectives: This study aimed at investigating the relationship between hope and received information about cancer (RIAC) among patients with breast cancer. Methods: Using a descriptive-correlational design, this study was conducted from July to December 2019 on 200. Patients with breast cancer were consecutively recruited from 2 hospitals affiliated with the Iran University of Medical Sciences, Tehran, Iran. The participants completed a demographic and clinical characteristics questionnaire, the European Organization of Research and Treatment of Cancer Quality of Life Information module (EORTC QLQ-INFO25), and the Herth hope index. Results: The response rate was 100% and participants’ mean age was 49.0 ± 10.33. The mean scores of participants’ RIAC and hope were 40.17 ± 11.52 (in the possible range of 0 - 100) and 36.77 ± 4.61 (in the possible range of 12 - 48), respectively. The mean score of hope had significant positive relationships with the mean score of RIAC (r = 0.305; P < 0.001), and educational level (P = 0.004). Moreover, the mean score of RIAC had a significant positive relationship with educational level (0.049). Conclusions: Greater RIAC is associated with greater hope among patients with breast cancer. Therefore, healthcare providers need to establish effective communication with these patients and provide them with necessary education and information in order to promote their engagement in care plans, improve their self-efficacy, and boost their hope.

Development and Validation of the Hospital Outpatients' Information Needs Questionnaire (HOINQ)

PURPOSE

The main objective was to develop and validate a "Hospital Outpatients' Information Needs Questionnaire" (HOINQ). Secondly, to identify patients' preferred sources of information. Finally, to establish differences depending on the disease, as well as between sociodemographic and clinical variables.

PATIENTS AND METHODS

This is a transversal study based on a questionnaire. All adult hospital outpatients' who collected their medication at the Pharmacy Service were consecutively recruited, regardless of their diagnosis time, treatment or disease. The Spanish version of the internationally validated European Organization for Research and Treatment Cancer Quality of Life Questionnaire (EORTC QLQ-25) aimed at oncology patients was used as the starting point. In order to be applicable on new target population, it was crucial to make several changes and ensure that it complies with the validity, viability and reliability criteria. The questionnaire prepared for validation was then obtained by a literature review (face validity), submitting the EORTC QLQ-25 to an expert committee (content validity), by piloting (viability) and Cronbach's alpha statistical analysis (reliability). Once the questionnaire was completed, Cronbach's alpha of the final study (reliability) and factor analysis (construct validity) were performed. Then, pertinent modifications were applied to obtain the HOINQ.

RESULTS

A total of 153 outpatients filled the questionnaire, which was widely accepted and required 5-10 min to complete. Cronbach's alpha coefficients met criteria >0.7. Three factors were established by factor analysis: aspects about the disease, pharmacological and no-pharmacological treatment and satisfaction and perception of the information received. Participants felt satisfied (41-52%) with the information amount, quality and usefulness, although 1 out of 3 stated wanting to know more about the different information areas. Younger patients (P-value <0.05) and those who had been attending the Pharmacy Service for a longer time span (P-value <0.01) reported receiving more information. On a 0 to 7 scale, medical specialists (mean = 6.28, SD = 1.38) followed by the rest of health care professionals (mean = 4.23-4.63, SD = 2.25-2.29) were selected as the preferred sources of information. HIV patients reported being more informed, while those with rheumatoid arthritis felt less informed (P-value <0.05).

CONCLUSION

The HOINQ was developed. It is a self-completed questionnaire, composed of three blocks: the 16-item information needs questionnaire, demographic and clinical variables, and patients' preferred sources of information. It is an easy tool to use and replicate, both for patients and professionals.

Effects of Behavioral Activation on the Quality of Life and Emotional State of Lung Cancer and Breast Cancer Patients During Chemotherapy Treatment

Research suggests that the progressive abandonment of activities in cancer patients are related to depression and worse quality of life. Behavioral activation (BA) encourages subjects to activate their sources of reinforcement and modify the avoidance responses. This study assesses the effectiveness of BA in improving quality of life and preventing emotional disorders during chemotherapy treatment. One sample of lung cancer patients and another of breast cancer patients were randomized into a BA experimental group (E.G._lung/4sess.n = 50; E.G._breast/6sess.n = 33) and a control group (C.G._lung/4sess.n = 40; C.G._{breast/6sess.}n = 35), respectively. In each session and in follow-ups (3/6/9 months), all participants completed different assessment scales. The results converge to show the effectiveness of BA, encouraging cancer patients to maintain rewarding activities which can activate their sources of day-to-day reinforcement and modify their experience avoidance patterns. BA appears to be a practical intervention which may improve social and role functioning and the emotional state of cancer patients during chemotherapy treatment.

Validation study of the EORTC information questionnaire (EORTC QLQ-INFO25) in Iranian cancer patients

INTRODUCTION

Developing a tool for measuring patient's needs is a vital step in the process of cancer treatment and research. In recent years, the European Organization for Research and Treatment of Cancer (EORTC) made a questionnaire to measure cancer patients' received information. Since validity and reliability of any instrument should be evaluated in the new environment and culture, the aim of this study was to assess the validity and reliability of the EORTC QLQ-INFO25 in Iranian cancer patients.

MATERIALS AND METHODS

One hundred seventy-three patients with different stages of cancer filled questionnaire EORTC QLQ-INFO25, EORTC QLQ-C30, and EORTC IN-PATSAT32. Twenty-five patients answered the questionnaire twice at an interval of 2 weeks. Reliability and validity of the questionnaire was measured by Cronbach's alpha, interclass correlation, test retest, inter-rater agreement (IRA), and exploratory factorial analyses.

RESULTS

Using a conservative approach, the IRA for the overall relevancy and clarity of the tool was 87/86% and 83.33%, respectively. Overall appropriateness and clarity were 94.13 and 91.87%, respectively. Overall integrity of the instrument was determined to be 85%. Cronbach's alpha coefficients for all domains and total inventory were top 70 and 90%, respectively. Interclass correlation index ranges between 0.708 and 0.965. Exploratory factorial analyses demonstrate six fields suitable for instrument. Correlation between areas of the questionnaires EORTC QLQ-INFO25 and EORTC in-Patsat32 represents the convergent validity of the questionnaire. Also, results show a standard divergent validity in all domains of the questionnaire (Rho <0.3). Low correlation between the areas of the questionnaires EORTC QLQ-INFO25 and EORTC QLQ-C30 (<0.3) demonstrates the divergence validity of the questionnaire.

CONCLUSION

The results showed that Persian version of the questionnaire EORTC QLQ-INFO25 is a reliable and valid instrument for measuring the perception of information in cancer patients.

Pilot Testing and Preliminary Psychometric Validation of the Polish Translation of the EORTC INFO25 Questionnaire: Validation of the Polish version of INFO25-pilot study

The quality of information that oncological patients receive from health care professionals is an underestimated issue in Poland and Eastern European countries. There is lack of sufficient data on this subject. The European Organization for Research and Treatment of Cancer (EORTC) supplies a new tool for measuring the quality of information provided to cancer patients. The purpose of the study is the translation into Polish, pilot testing and preliminary validation of the EORTC information module (INFO25). Following the EORTC translation procedures, forward and back translations of the questionnaire were performed (English → Polish, Polish → English). The intermediate version of the INFO25 was pilot-tested together with the general questionnaire of quality of life (EORTC QLQ-C30). Reliability, validity and known-group comparison tests were performed. A total of 21 patients with different cancer diagnoses were recruited into the study (7 women and 14 men; mean age of 60,2 years, age range 25-73 years). Apart from filling out the INFO25, patients were interviewed about the difficulties with answering every questionnaire item. Patients' comments were analyzed and minor language changes were made to the initial translation. The internal consistency of the INFO25 showed a reliability of 0,78. The final version of the Polish translation of the INFO25 module was obtained and approved by the EORTC Quality of Life Department. It can now be used in clinical setting and for scientific purposes.

Efectos del tipo de tratamiento y grupo de riesgo en la calidad de vida y la información en pacientes con cáncer de próstataEfectos del tipo de tratamiento y grupo de riesgo en la calidad de vida y la información en pacientes con cáncer de próstata

Objetivo: Comprobar las diferencias en la calidad de vida y la información de los pacientes con cáncer de próstata según el tratamiento y grupo de riesgo, y valorar su asociación con las variables sociodemográficas y clínicas. Metodo: entre 2015-2016, 176 hombres con cáncer de próstata seleccionados aleatoriamente, que habían recibido tratamientos locales, hormonales o combinados fueron evaluados mediante entrevista y los cuestionarios EORTC QLQ-C30, EORTC QLQ-PR25 y EORTC QLQ-INFO25. Resultados: La calidad de vida estaba más deteriorada en las escalas física, de rol, social y sexual en el grupo de riesgo avanzado y los tratados con hormonoterapia. La prostatectomía era la que producía más problemas urinarios, y los tratamientos combinados mayor sintomatología hormonal. Los tratados con radioterapia consideraban la información más útil y se sentían más informados sobre la enfermedad, pruebas médicas y tratamientos que los que recibían tratamiento hormonal y estaban más satisfechos que los intervenidos con prostatectomía. Los mayores o con estudios básicos recibieron menos información y la consideraron menos útil. Conclusiones: La calidad de vida es satisfactoria y la sintomatología baja. Los hombres en riesgo avanzado y/o los que reciben hormonoterapia presentan mayor déficit en la calidad de vida. La información es deficitaria, sobre todo en los hombres con problemas urinarios y con peor calidad de vida. Hay poca o ninguna información en las áreas “otros servicios”, “lugares de cuidado” y “pautas de autocuidado”. Es necesario evaluar y tratar a los hombres más vulnerables. Además de formar en información al personal sanitario.