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Laane E, Salek S, Oliva EN, Bennink C, Clavreul S, Richardson PG, Scheid C, Weisel K, Ionova T. Guidelines for the Use and Reporting of Patient-Reported Outcomes in Multiple Myeloma Clinical Trials. Cancers (Basel) 2023; 15:5764. [PMID: 38136310 PMCID: PMC10741926 DOI: 10.3390/cancers15245764] [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: 11/06/2023] [Revised: 11/28/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
In the era of personalized medicine there is an increasing need for the assessment of patient-reported outcomes (PROs) to become a standard of patient care. Patient-reported outcome measures (PROM) are important in assessing significant and meaningful changes as a result of an intervention based on a patient's own perspective. It is well established that active multiple myeloma (MM) can be characterized by a high burden of disease and treatment-related symptoms, with considerable worsening of quality of life (QoL). In general, and over the past decade, the focus has shifted to obtaining the most durable remissions with the best QoL as primary goals for MM treatment. Patients place considerable value on their QoL and communicating about QoL data prior to treatment decisions allows them to make informed treatment choices. Consequently, optimization of QoL of patients with MM is an important therapeutic goal and the incorporation of PROs into clinical trials has the potential of improving treatment outcomes. In this regard, guidance for the use and reporting of PROMs in MM in clinical trials is warranted. Under the auspices of the European Hematology Association, evidence-based guidelines for the use and reporting of PROs in patients with MM have been developed according to the EHA's core Guidelines Development Methodology. This document provides general considerations for the choice of PROMs in MM clinical trials as well as a series of recommendations covering a selection of PROMs in MM clinical trials; the mode of administration; timing of assessments; strategies to minimize missing data; sample size calculation; reporting of results; and interpretation of results.
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Affiliation(s)
- Edward Laane
- Hematology-Oncology Clinic, Tartu University, 50406 Tartu, Estonia
| | - Sam Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK;
| | - Esther Natalie Oliva
- U.O.C. Ematologia, Grande Ospedale Metropolitano Bianchi Melacrino Morelli, 89124 Reggio di Calabria, Italy;
| | - Christine Bennink
- Department of Hematology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands;
| | | | - Paul G Richardson
- Jerome Lipper Multiple Myeloma Center, Dana Farber Cancer Institute, Boston, MA 02215, USA;
| | - Christof Scheid
- Department of Internal Medicine I, University of Cologne, 50923 Cologne, Germany;
| | - Katja Weisel
- Department of Hematology, Oncology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Tatyana Ionova
- Quality of Life Unit, Saint Petersburg State University Hospital, 190103 Saint Petersburg, Russia;
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Long-term survivors demonstrate superior quality of life after haploidentical stem cell transplantation to matched sibling donor transplantation. J Transl Med 2022; 20:596. [DOI: 10.1186/s12967-022-03803-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
It has been well-documented that haplo-identical hematopoietic stem cell transplantation (HID-HSCT) can provide outcomes comparable to conventional matched sibling donor (MSD) HSCT, however, little is known about the effects on quality of life (QoL) in long-term survivors. This study is to investigate the differences in longitudinal performance of QoL between HID and MSD HSCT using a comprehensive assessment system.
Methods
This prospective study enrolled consecutive patients who had received allogenic-HSCT (allo-HSCT) between January 2018 and December 2019 in our center. All patients were informed to complete QoL questionnaires including the Mos 36-Item Short-Form Health Survey (SF-36) and the Functional Assessment of Cancer Therapy Bone Marrow Transplant (FACT-BMT, version 4), using an online applet, before transplantation and at scheduled time points after transplantation. The linear mixed-effects model was used to analyze the variation trend of different dimensions of both SF-36 and FACT-BMT with different follow-up times.
Results
Of the 425 participants, recipients of HID and MSD who survived more than 1 year (n = 230) were included in the final analysis of QoL (median age [range]: 36, [15, 66]). The 3 year overall survival (OS) of HID and MSD was 82.42% and 86.46%, respectively. QoL was assessed using both SF-36 and FACT-BMT and there was longitudinal recovery with clinical significance in the cohort. Compared to MSD-HSCT patients, HID-HSCT recipients demonstrated superior QoL performance in some subscales describing physical and mental wellness. Specifically, the difference in physical performance is more remarkable using FACT-BMT whereas that in mental wellness is more significant using SF36. In the subsequent stratified analysis, patients with a history of aGVHD or CMV reactivation demonstrated inferior QoL.
Conclusions
Long-term survivors of HID HSCT achieved better QoL in some sub-scales compared to MSD HSCT. In addition, SF-36 and FACT-BMT demonstrated different performance thus combination of both improved capacity of the evaluation system.
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Shen Z, Shi S, Li C, Ruan C. The influence of social constraints on the quality of life of hematopoietic stem cell transplantation survivors: The chain mediating effect of illness perceptions and the fear of cancer recurrence. Front Psychol 2022; 13:1017561. [PMID: 36506995 PMCID: PMC9732518 DOI: 10.3389/fpsyg.2022.1017561] [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: 08/12/2022] [Accepted: 11/11/2022] [Indexed: 11/26/2022] Open
Abstract
Objective This cross-sectional correlational study aims to explore the relationship between social constraints and the quality of life of hematopoietic stem cell transplantation (HCT) survivors. Additionally, we also seek to demonstrate the chain mediating effect of illness perceptions and the fear of cancer recurrence on this relationship. Methods Convenience sampling was employed in this study. A total of 232 HCT survivors were interviewed using the Social Constraints Scale, the Brief Illness Perception Questionnaire, the Fear of Cancer Recurrence Inventory (Short Form) and the Functional Assessment of Cancer Therapy-Bone Marrow Transplant. IBM SPSS 24.0 were used for data analyses, and PROCESS macro (Model 6) was used to examine the hypothesized chain mediation model. Results A positive relationship between social constraints and quality of life verified the mediating effect of illness perceptions and the fear of cancer recurrence on this relationship. Social constraints affect the quality of life of HCT survivors via three pathways: the mediating role of illness perceptions, the mediating role of fear of cancer recurrence and the chain mediating effect of both factors. Conclusion The chain mediating effect of illness perceptions and the fear of cancer recurrence on quality of life indicates that these two variables have important practical significance with respect to improving HCT survivors' physical and mental health. The study thus serves as a reference for health workers to improve HCT survivors' quality of life in the future.
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Affiliation(s)
- Zhiying Shen
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, China,Clinical Nursing Safety Management Research Center of Central South University, Third Xiangya Hospital, Central South University, Changsha, China,Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
| | - Shuangjiao Shi
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, China,Clinical Nursing Safety Management Research Center of Central South University, Third Xiangya Hospital, Central South University, Changsha, China,Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
| | - Chengyuan Li
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, China,Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
| | - Chunhong Ruan
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, China,Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China,*Correspondence: Chunhong Ruan,
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Xie J, Wan Z, Duan Y, Wang M, Luo Y, Xiao P, Kang Y, Zhou Y, Luo X, Sun Q, Cheng ASK. The efficacy of live music for adolescent and young adult patients during hematopoietic stem cell transplantation. Support Care Cancer 2022; 30:5789-5799. [PMID: 35347418 DOI: 10.1007/s00520-022-07001-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Music therapy can improve mood in patients undergoing hematopoietic stem cell transplantation (HSCT). However, live music (LM) delivered by professional music therapists is not common in developing countries owing to the shortage of professional music therapists. Thus, in this study, we explored the effects of a multidisciplinary collaborative intervention based on LM on physical and psychological well-being of adolescent and young adult (AYA) patients undergoing HSCT with a quasi-experimental design. METHODS A total of 62 AYA patients agreed to participate and were randomly assigned to the intervention group receiving 4-week LM therapy (n = 31) or control group receiving usual care (n = 31). Depression, salivary cortisol, fatigue, and quality of life were the main outcome indicators measured at baseline, immediately after the intervention, 1 month, and 3 months follow-up. The intervention effects were analyzed by generalized estimating equations. RESULTS Significant decrease in HADS-D scores occurred in the intervention group compared with wait-list controls at immediately after intervention (p < 0.05). Participants in the LM group had greater improvement in quality of life and lower salivary cortisol level than those in the wait-list control group at immediately, 1 month, and 3 months after intervention (p < 0.05). However, the interaction effects of the BFI scores were not significant. CONCLUSIONS LM therapy significantly alleviated depression and salivary cortisol levels as well as improved quality of life of AYA patients undergoing HSCT.
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Affiliation(s)
- Jianfei Xie
- The Third Xiangya Hospital, Central South University, Changsha, China.,Xiangya Nursing School, Central South University, No. 172 Tongzipo Road, Changsha, 410013, China
| | - Ziyu Wan
- Xiangya Nursing School, Central South University, No. 172 Tongzipo Road, Changsha, 410013, China
| | - Yinglong Duan
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Miao Wang
- School of Architecture and Art, Central South University, Changsha, China
| | - Yating Luo
- Xiangya Nursing School, Central South University, No. 172 Tongzipo Road, Changsha, 410013, China
| | - Panpan Xiao
- Xiangya Nursing School, Central South University, No. 172 Tongzipo Road, Changsha, 410013, China
| | - Yue Kang
- Xiangya Nursing School, Central South University, No. 172 Tongzipo Road, Changsha, 410013, China
| | - Yi Zhou
- Xiangya Nursing School, Central South University, No. 172 Tongzipo Road, Changsha, 410013, China
| | - Xiaofei Luo
- Xiangya Nursing School, Central South University, No. 172 Tongzipo Road, Changsha, 410013, China
| | - Qian Sun
- Xiangya Nursing School, Central South University, No. 172 Tongzipo Road, Changsha, 410013, China.
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong
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Validity and reliability of the Turkish version of the functional assessment of cancer therapy-bone marrow transplant (FACT-BMT) quality of life questionnaire in patients undergoing bone marrow transplantation. Palliat Support Care 2021; 20:556-563. [PMID: 34289928 DOI: 10.1017/s1478951521001097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The Functional Assessment of Cancer Therapy-Bone Marrow Transplant Version 4 (FACT-BMT) is a widely used instrument to assess quality of life in individuals treated with bone marrow transplantation (BMT). Our aim was to determine the reliability and validity of the Turkish version of the FACT-BMT in patients undergoing BMT. METHOD Patients between the age of 20 and 65 years and who had undergone BMT at least 3 months before the study were included. Validity was determined using exploratory and confirmatory factor analysis. To determine convergent validity, the European Cancer Research and Treatment Organization Quality of Life Questionnaire-Cancer30 (EORTC QLQ-C30), the Brief Fatigue Inventory (BFI), and the Eastern Cooperative Oncology Group (ECOG) performance score were used. Cronbach's alpha, intra-class correlation coefficient (ICC), and item-total correlation (ITC) values were calculated to assess the reliability of the FACT-BMT. RESULTS Totally, 114 patients (F/M: 47/67) treated with BMT (mean age: 49.50 ± 12.50 years) were included. Confirmatory and exploratory factor analysis revealed that the FACT-BMT and the Bone Marrow Transplantation Subscale (BMTS) had sufficient fit. The FACT-BMT was moderately to strongly correlated with the EORTC QLQ-C30, the BFI, and the ECOG performance score (p < 0.001). Cronbach's alpha and ICC values of the FACT-BMT were acceptable (0.925 and 0.956, respectively). The ITC values of each item of the FACT-BMT were also acceptable (ranged from 0.296 to 0.737). Patients undergoing autologous BMT had a significantly higher BMTS score than those undergoing allogeneic BMT (p < 0.05). SIGNIFICANCE OF RESULTS The Turkish version of the FACT-BMT is valid, reliable, and sensitive to changes in quality of life in patients undergoing BMT.
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Kilgour JM, Wali G, Gibbons E, Scherwath A, Barata Badiella A, Peniket A, Schoemans H, Matin RN. Systematic Review of Patient-Reported Outcome Measures in Graft-versus-Host Disease. Biol Blood Marrow Transplant 2020; 26:e113-e127. [DOI: 10.1016/j.bbmt.2020.01.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/23/2020] [Accepted: 01/28/2020] [Indexed: 11/12/2022]
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Patients’ quality of life: Validation of the functional assessment of cancer therapy-bone marrow transplant (FACT-BMT) instrument for the Mexican population. Palliat Support Care 2020; 18:557-568. [DOI: 10.1017/s1478951520000085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveThe functional assessment of cancer therapy-bone marrow transplant (FACT-BMT) is a widely used instrument to assess quality of life (QOL) in hematopoietic stem cell transplant (HSCT) patients, but there is little evidence of its validity in Latin American populations. This study evaluated the psychometric properties of the Spanish language version of the FACT-BMT in Mexican patients.MethodFirst, the original version was piloted with 15 HSCT patients to obtain an adequate cultural version, resulting in the adaptation of one item. After that, the new version was completed by 139 HSCT patients.ResultsThe results showed a FACT factor structure that explains 70.84% of the total variance, a factor structure similar to the original FACT structure, and with a high internal consistency (Cronbach's alpha = 0.867). For the BMT subscale, the best factor structure included 17 items which explain 61.65% of the total variance with an adequate internal consistency (Cronbach's alpha = 0.696).Significance of the resultsThe FACT-BMT was found to be a valid and reliable instrument to evaluate QOL in Mexican patients. Our results constitute new FACT-BMT empirical evidence that supports its clinical and research uses.
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Longitudinal Analysis of the Relationships Between Social Support and Health-Related Quality of Life in Hematopoietic Stem Cell Transplant Recipients. Cancer Nurs 2019; 42:251-257. [DOI: 10.1097/ncc.0000000000000616] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Soudy H, Maghfoor I, Elhassan TAM, Abdullah E, Rauf SM, Al Zahrani A, Akhtar S. Translation and validation of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) version 4 quality of life instrument into Arabic language. Health Qual Life Outcomes 2018. [PMID: 29530033 PMCID: PMC5848601 DOI: 10.1186/s12955-018-0861-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) has been translated from English into several languages. Currently, there is no validated translation of FACT-BMT in Arabic. Here, we are reporting the first Arabic translation and validation of the FACT-BMT. Methods The study was approved by the Institutional Research Advisory Council. The Arabic translation followed the standard Functional Assessment of Chronic Illness Therapy (FACIT.org) translation methodology (with permission). Arabic FACT-BMT (50- items) was statistically validated. Cronbach’s alpha for internal consistency, Spearman’s rank correlation coefficients method for Inter-scale correlations and Principal Component Analysis for factorial construct validity was used. Results One hundred and eight consecutive relapsed /refractory lymphoma patients who underwent high dose chemotherapy and autologous stem cell transplant were enrolled. There were 68 males (63%) and 40 females (37%) with a median age of 29 years (range 14–62). After Arabic questionnaire pre-testing (Cronbach’s alpha 0.744), the study included 108 patients. Cronbach’s alpha for the entire FACT-BMT indicated an excellent internal consistency (0.90); range (0.67 to 0.91). Cronbach’s alpha for sub-groups of social (0.78), emotional (0.67) and functional wellbeing was (0.88). Cronbach’s alpha for bone marrow transplant (0.81), FACT-General (0.89), and FACT- Trial Outcome Index (TOI); (0.91) also revealed excellent internal consistency. Patients had high scores in all domains of quality of life, indicating that most patients were leading a normal life. This translation of FACT-BMT in Arabic was reviewed and approved for submission by the FACIT.org. Conclusions Our data reports the first translated, validated and approved Arabic version of FACT-BMT. This will help large numbers of Arabic speaking patients undergoing stem cell/bone marrow transplantation, across the globe. Electronic supplementary material The online version of this article (10.1186/s12955-018-0861-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hussein Soudy
- Oncology Center, King Faisal Specialist Hospital & Research Center, P.O. Box 3354, MBC# 64, Riyadh, 11211, Kingdom of Saudi Arabia
| | - Irfan Maghfoor
- Oncology Center, King Faisal Specialist Hospital & Research Center, P.O. Box 3354, MBC# 64, Riyadh, 11211, Kingdom of Saudi Arabia
| | - Tusneem Ahmed M Elhassan
- Oncology Center, King Faisal Specialist Hospital & Research Center, P.O. Box 3354, MBC# 64, Riyadh, 11211, Kingdom of Saudi Arabia
| | - Eman Abdullah
- Department of Nursing Affairs, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Shahzad M Rauf
- Oncology Center, King Faisal Specialist Hospital & Research Center, P.O. Box 3354, MBC# 64, Riyadh, 11211, Kingdom of Saudi Arabia
| | - Ahmed Al Zahrani
- Oncology Center, King Faisal Specialist Hospital & Research Center, P.O. Box 3354, MBC# 64, Riyadh, 11211, Kingdom of Saudi Arabia
| | - Saad Akhtar
- Oncology Center, King Faisal Specialist Hospital & Research Center, P.O. Box 3354, MBC# 64, Riyadh, 11211, Kingdom of Saudi Arabia.
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Wang YC, Lin CC. Spiritual Well-being May Reduce the Negative Impacts of Cancer Symptoms on the Quality of Life and the Desire for Hastened Death in Terminally Ill Cancer Patients. Cancer Nurs 2017; 39:E43-50. [PMID: 26378401 DOI: 10.1097/ncc.0000000000000298] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Spirituality is a central component of the well-being of terminally ill cancer patients. OBJECTIVE The aim of this study was to examine the mediating or moderating role of spiritual well-being in reducing the impact of cancer-related symptoms on quality of life and the desire for hastened death in terminally ill cancer patients. METHODS Eighty-five terminally ill cancer patients were assessed using the Taiwanese version of the M. D. Anderson Symptom Inventory, the Functional Assessment of Cancer Therapy-General, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being, the Beck Hopelessness Scale, and the Schedule of Attitudes Toward Hastened Death. RESULTS Spiritual well-being was significantly negatively correlated with symptom severity (r = -0.46, P < .01). Symptom severity negatively correlated with quality of life (r = -0.54) and positively correlated with hopelessness (r = 0.51, P < .01) and the desire for hastened death (r = 0.61, P < .01). Spiritual well-being was a partial mediator and moderator between symptom severity and quality of life. Spiritual well-being was a partial mediator between symptom severity and the desire for hastened death. The meaning subscale of spiritual well-being was a more significant predictor of the desire for hastened death and quality of life than the faith subscale was. CONCLUSION Spiritual well-being may reduce the negative impacts of cancer on quality of life and the desire for hastened death. IMPLICATIONS FOR PRACTICE Appropriate spiritual care may reduce the negative impact of severe cancer symptoms on quality of life and the desire for hastened death in terminally ill cancer patients.
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Affiliation(s)
- Yin-Chih Wang
- Author Affiliations: Graduate Institute of Nursing (Ms Wang) and School of Nursing (Dr Lin), College of Nursing, Taipei Medical University, Taipei, Taiwan, Republic of China
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Choi EPH, Wong CKH, Tsu JHL, Chin WY, Kung K, Wong CKW, Yiu MK. Health-related quality of life of Chinese patients with prostate cancer in comparison to general population and other cancer populations. Support Care Cancer 2015; 24:1849-56. [PMID: 26452488 DOI: 10.1007/s00520-015-2980-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/30/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to compare the health-related quality of life (HRQOL) of Chinese patients with prostate cancer against the general population and patients with colorectal cancer, breast cancer, nasopharyngeal cancer, and leukemia. METHODS Chinese male patients (n = 291) with a confirmed diagnosis of prostate cancer were recruited from a urological specialist outpatient clinic in Hong Kong. HRQOL was measured by a condition-specific Functional Assessment of Cancer Therapy-Prostate (FACT-P) and a generic Chinese (HK) SF-12 Health Survey Version 2 (SF-12v2) questionnaire. Mean HRQOL scores of condition-specific and generic questionnaires were compared to available scores derived from other cancers and age-matched male general population, respectively. RESULTS Chinese patients with prostate cancer had lower general health and vitality domains and lower mental component summary scores than the age-matched Hong Kong normative population. Patients with prostate cancer reported better condition-specific HRQOL (physical well-being, emotional well-being and function well-being) when compared to general cancer population, patients with breast cancer, colorectal cancer, nasopharyngeal cancer, and leukemia in Hong Kong. CONCLUSIONS Patients with prostate cancer substantially perceived their HRQOL to be better, compared to patients with other cancers, with overall health, energy, and mental health below of Hong Kong general population. Interventions should target at these domains in order to improve the HRQOL of patients with prostate cancer. It is reassuring to find that prostate cancer had less negative impact on HRQOL than other cancer types did.
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Affiliation(s)
- Edmond P H Choi
- School of Nursing, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Carlos K H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong
| | - James H L Tsu
- Division of Urology, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong
| | - W Y Chin
- Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong
| | - Kenny Kung
- Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong
| | - Charles K W Wong
- Division of Urology, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong
| | - M K Yiu
- Division of Urology, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong
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Hyde MK, Chambers SK, Shum D, Ip D, Dunn J. Psycho-oncology assessment in Chinese populations: a systematic review of quality of life and psychosocial measures. Eur J Cancer Care (Engl) 2015; 25:691-718. [PMID: 26292029 DOI: 10.1111/ecc.12367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2015] [Indexed: 11/26/2022]
Abstract
This systematic review describes psychosocial and quality of life (QOL) measures used in psycho-oncology research with cancer patients and caregivers in China. Medline and PsycINFO databases were searched (1980-2014). Studies reviewed met the following criteria: English language; peer-reviewed; sampled Chinese cancer patients/caregivers; developed, validated or assessed psychometric properties of psychosocial or QOL outcome measures; and reported validation data. The review examined characteristics of measures and participants, translation and cultural adaptation processes and psychometric properties of the measures. Ninety five studies met review criteria. Common characteristics of studies reviewed were they: assessed primarily QOL measures, sampled patients with breast, colorectal, or head and neck cancer, and validated existing measures (>80%) originating in North America or Europe. Few studies reported difficulties translating measures. Regarding psychometric properties of the measures >50% of studies reported subscale reliabilities <α = 0.70, <50% reported test-retest reliability, and <30% reported divergent validity. Few reported sensitivity, specificity or responsiveness. Improved accuracy and transparency of reporting for translation, cultural adaptation and psychometric testing of psychosocial measures is needed. Developing support structures for translating and validating psychosocial measures would enable this and ensure Chinese psycho-oncology clinical practice and research keeps pace with international focus on patient reported outcome measures and data management.
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Affiliation(s)
- M K Hyde
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia
| | - S K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia.,Health and Wellness Institute, Edith Cowan University, Perth, WA, Australia.,Centre for Clinical Research, The University of Queensland, Herston, Qld, Australia.,Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia
| | - D Shum
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| | - D Ip
- The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - J Dunn
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia.,School of Social Science, The University of Queensland, St Lucia, Qld, Australia
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Morishita S, Kaida K, Yamauchi S, Wakasugi T, Ikegame K, Kodama N, Ogawa H, Domen K. Early-phase differences in health-related quality of life, psychological status, and physical function between human leucocyte antigen-haploidentical and other allogeneic haematopoietic stem cell transplantation recipients. Eur J Oncol Nurs 2015; 19:443-50. [PMID: 25911269 DOI: 10.1016/j.ejon.2015.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 02/04/2015] [Accepted: 02/09/2015] [Indexed: 12/15/2022]
Abstract
PURPOSE This study investigated the differences between allogeneic haematopoietic stem cell transplantation (allo-HSCT) patients receiving HSC from human leucocyte antigen (HLA)-haploidentical donors (HID) and other donors that included HLA-matched sibling, matched unrelated, and unrelated umbilical cord blood donors in the 6 weeks after HSCT with respect to quality of life (QOL), psychological status, and physical function. METHODS The study included 126 patients (HID group, n = 100; other donor group, n = 26) who underwent allo-HSCT between July 2007 and December 2012. Patients were evaluated for health-related QOL using the Medical Outcome Study 36-item Short Form Health Survey. Psychological status was measured by Hospital Anxiety and Depression Scale. Physical function was assessed using tests for handgrip strength, knee extensor strength, and the 6-min walk test. RESULTS After HSCT, the HID group showed significantly greater improvements in the general health subscale and Mental Component Summary (MCS) of QOL than the other donor group (P < 0.01). Multivariate analysis confirmed that complete remission and age were associated with changes in the general health subscale before and after HSCT (P < 0.05). With regard to physical function, the HID group showed significantly more decline than the other donor group with respect to handgrip strength and knee extensor muscle strength after HSCT (P < 0.05). Total corticosteroid dose was associated with decreased handgrip strength before and after HSCT (P < 0.05). CONCLUSIONS The donor type affects QOL, psychological status, and physical function in allo-HSCT recipients; these findings may provide insights for customised rehabilitation strategies for HSCT recipients.
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Affiliation(s)
- Shinichiro Morishita
- Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan.
| | - Katsuji Kaida
- Division of Haematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
| | - Shinya Yamauchi
- Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan.
| | - Tatsushi Wakasugi
- Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan.
| | - Kazuhiro Ikegame
- Division of Haematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
| | - Norihiko Kodama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
| | - Hiroyasu Ogawa
- Division of Haematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
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Chow KM, Chan CW, Chan JC, Choi KK, Siu K. A feasibility study of a psychoeducational intervention program for gynecological cancer patients. Eur J Oncol Nurs 2014; 18:385-92. [DOI: 10.1016/j.ejon.2014.03.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 03/14/2014] [Accepted: 03/26/2014] [Indexed: 10/25/2022]
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Janicsák H, Masszi T, Reményi P, Ungvari GS, Gazdag G. Quality of life and its socio-demographic and psychological determinants after bone marrow transplantation. Eur J Haematol 2013; 91:135-40. [PMID: 23614507 DOI: 10.1111/ejh.12126] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVES A host of medical, socio-demographic, and psychological factors that affect bone marrow transplantation (BMT) patients' quality of life (QOL) have been identified, but due to the methodological diversity of the studies, the findings have been contradictory. The aim of this study was to examine the influence of somatic status, social characteristics, and psychological symptoms on QOL in BMT patients. METHODS The study had a cross-sectional design. QOL was evaluated using the Hungarian version of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) scale. Anxiety and depression were assessed using Spielberger's State and Trait Anxiety Inventory (SSTAI) and the Beck Depression Inventory (BDI). A questionnaire designed for the study was used to record socio-demographic variables. RESULTS One hundred and twenty-one patients formed the study sample. Patients' QOL was better in our sample than in another study with similar mean time after BMT. BDI scores indicated mild depression; SSTAI scores corresponded with healthy population levels. QOL was strongly influenced by psychological symptoms (depression P < 0.001; anxiety P = 0.001; psychiatric comorbidity P = 0.001), employment status (P = 0.042), and gender (P = 0.05). The somatic factors influenced only separate aspects of QOL; somatic comorbidity only affected cancer-associated QOL (P = 0.004). CONCLUSION This is the first study on a Hungarian BMT sample that included economic factors in the assessment of QOL. Psychological variables were the strongest determinants of QOL in this study.
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Affiliation(s)
- Henriett Janicsák
- 1st Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc Hospital, Budapest, Hungary
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Morishita S, Kaida K, Setogawa K, Kajihara K, Ishii S, Ikegame K, Kodama N, Ogawa H, Domen K. Safety and feasibility of physical therapy in cytopenic patients during allogeneic haematopoietic stem cell transplantation. Eur J Cancer Care (Engl) 2012; 22:289-99. [PMID: 23252444 DOI: 10.1111/ecc.12027] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2012] [Indexed: 12/01/2022]
Abstract
This study aimed to investigate the safety and feasibility of physical therapy in cytopenic patients undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT), and to investigate the effect of physical therapy on physiological functions and quality of life (QOL) in allo-HSCT patients. The study cohort included 321 patients who underwent allo-HSCT. To investigate the safety and feasibility of physical therapy during cytopenia, patients were assigned to the physical therapy group (n = 227) or the control group (n = 94). To determine the effects of physical therapy, patients were divided according to the frequency with which they underwent physical therapy (n = 51 per group). Handgrip strength, knee extensor strength and a 6-min walk test were used as measures of physiological function. Short-Form 36 was used to assess QOL. The physical therapy group had higher rate of achieving engraftment and lower death rate than the control group (P < 0.05). After HSCT, the high-frequency physical therapy group showed significantly less decline than the low-frequency physical therapy group with respect to physical functioning of QOL (P < 0.01). Physical therapy is quite beneficial and can be performed safely and feasibly in cytopenic patients during allo-HSCT.
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Affiliation(s)
- S Morishita
- Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan.
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17
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Farage MA, Rodenberg C, Chen J. Translation and validation of the Farage Quality of Life (FQoL™) instrument for consumer products into traditional Chinese. Glob J Health Sci 2012; 5:1-12. [PMID: 23283031 PMCID: PMC4777008 DOI: 10.5539/gjhs.v5n1p1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 10/07/2012] [Indexed: 11/12/2022] Open
Abstract
The Farage Quality of Life™ questionnaire (FQoL™) was developed specifically to assess the impact of consumer products. The objective of this investigation was to achieve a Chinese language instrument. The FQoL™ underwent a forward and backward translation, with cognitive testing by 13 subjects. Slight modifications were made to the instrument, and an implementation study was conducted with 800 participants having a mean (±SD) age of 34.22 (±9.28) years. The subjects were randomly assigned to use 1 of 4 ultra absorbency pad products for the length of one menstrual cycle. Three pads (coded N, S and C) were products currently available on the retail market, a fourth (coded M) was an experimental product improvement on Product N. Subjects were asked to complete the FQoL™ once before (T1) and once after (T2) the start of their period, and the Least Square (LS) Means were determined. Within group comparisons for each item and FQoL™ subscale were conducted by comparing the LS Means for T1 vs. T2. Participants using Product N showed the highest number of significant (p<0.05) changes (11 items), demonstrating these subjects felt worse about items mainly in the subdomains for Emotions, Personal Pleasure, and Physical State. Participants using Product C showed significant changes in 7 items mainly in the subdomains for Emotion and Physical State. Participants using Product S and the experimental Product M showed significant changes in only 4 and 3 individual items, respectively. These were not associated with any particular domain or subdomain. Between group comparisons were conducted by comparing the LS Means for the T2 responses for each group. The group using Product N had LS Mean responses that were significantly worse than the group using Product M for the Emotion, Personal Pleasure and Physical State subdomains, the Energy/Vitality domain, and 2 individual items. The Product S group was worse than the Product M group for 2 individual items. The Product C group was worse than the Product M group for the Personal Pleasure and Physical State subdomains and 5 individual items. We found that the Chinese language FQoL™ detected changes in HRQoL during menstruation compared with before menstruation. Further, the measure was able to detect differences among groups of subjects using different menstrual protection products.
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Morishita S, Kaida K, Yamauchi S, Wakasugi T, Yoshihara S, Taniguchi K, Ishii S, Ikegame K, Kodama N, Ogawa H, Domen K. Gender differences in health-related quality of life, physical function and psychological status among patients in the early phase following allogeneic haematopoietic stem cell transplantation. Psychooncology 2012; 22:1159-66. [PMID: 22736382 DOI: 10.1002/pon.3128] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 05/22/2012] [Accepted: 06/07/2012] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The aim of this study was to examine gender differences in quality of life (QOL), physical function and psychological status before and in the early phase after allogeneic haematopoietic stem cell transplantation (allo-HSCT). METHODS One hundred patients (66 men, 34 women) who underwent allo-HSCT between July 2007 and June 2011 at Hyogo College of Medicine Hospital were included in this study. Patients were evaluated for health-related QOL using the Medical Outcome Study 36-item Short Form Health Survey; exercise capacity was measured with the 6-min walk test, hand grip strength and knee extensor strength. Fatigue and psychological status were measured by the Piper Fatigue Scale and Hospital Anxiety and Depression Scale, respectively. RESULTS Women had significantly lower scores for physical function and general health on health-related QOL tests compared with men (p < 0.01). No difference between genders was found in decline of physical function. In women, exercise capacity was strongly associated with QOL (p < 0.01). In men, depression and anxiety were closely related to QOL (p < 0.01). CONCLUSIONS Gender-appropriate rehabilitation in allo-HSCT patients is important. Women may need more endurance exercises and training for activities of daily life. Men may need rehabilitation including a psychological approach.
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Affiliation(s)
- Shinichiro Morishita
- Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan.
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Morishita S, Kaida K, Tanaka T, Itani Y, Ikegame K, Okada M, Ishii S, Kodama N, Ogawa H, Domen K. Prevalence of sarcopenia and relevance of body composition, physiological function, fatigue, and health-related quality of life in patients before allogeneic hematopoietic stem cell transplantation. Support Care Cancer 2012; 20:3161-8. [DOI: 10.1007/s00520-012-1460-5] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 03/26/2012] [Indexed: 11/28/2022]
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20
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Impaired physiological function and health-related QOL in patients before hematopoietic stem-cell transplantation. Support Care Cancer 2011; 20:821-9. [DOI: 10.1007/s00520-011-1156-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 03/28/2011] [Indexed: 11/27/2022]
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Li W, Chen K, Halfyard B, Qian B, Li H, Wang PP. Validation study of the Chinese version of the Illness Intrusiveness Ratings Scale. J Psychosom Res 2011; 70:67-72. [PMID: 21193103 DOI: 10.1016/j.jpsychores.2010.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2007] [Revised: 05/06/2010] [Accepted: 05/11/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The Illness Intrusiveness Ratings Scale (IIRS) measures illness-induced disruptions to 13 different aspects of lifestyles, activities, and interests. A stable three-factor structure has been well documented in studies conducted in Western countries. However, in Asia, the general validity of this scale has not been examined. METHODS This study investigated the factor structure of the Chinese version of the IIRS in 641 inpatients at a Chinese hospital for cancer patients. The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was also administered and compared with the IIRS. RESULTS Exploratory principal component analysis identified a two-factor structure, "health and living" and "relationships and personal development", which accounted for 58.65% of the total variance. A "goodness-of-fit" test supported a two-factor solution (P=.070). The IIRS was significantly correlated with scores of every scale in the EORTC QLQ-C30. CONCLUSION These findings support the validity of the Chinese version of the IIRS but did not support a cross-cultural equivalence of the factor structure. This study was only performed in hospitalized cancer patients; therefore, further evaluation involving patients with other diseases is warranted.
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Affiliation(s)
- Wei Li
- Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China.
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King MT, Stockler MR, Cella DF, Osoba D, Eton DT, Thompson J, Eisenstein AR. Meta-analysis provides evidence-based effect sizes for a cancer-specific quality-of-life questionnaire, the FACT-G. J Clin Epidemiol 2010; 63:270-81. [DOI: 10.1016/j.jclinepi.2009.05.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Revised: 04/28/2009] [Accepted: 05/11/2009] [Indexed: 10/20/2022]
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Victorson D, Barocas J, Song J, Cella D. Reliability across studies from the functional assessment of cancer therapy-general (FACT-G) and its subscales: a reliability generalization. Qual Life Res 2008; 17:1137-46. [PMID: 18841493 DOI: 10.1007/s11136-008-9398-2] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Accepted: 09/17/2008] [Indexed: 01/18/2023]
Abstract
PURPOSE The aim of this study was to conduct a reliability generalization of the Functional Assessment of Cancer Therapy-General (FACT-G) and its subscales to examine variation in score reliability across all published studies. METHODS We reviewed 344 publications based on predetermined criteria. About 78 published studies reported Cronbach's Alpha reliability coefficients from their study in which data were collected. Sample size based weights were applied, and studies were coded on several scale and demographic characteristics. Using independent samples t tests, we examined associations between study characteristics and internal consistency variability. RESULTS Average FACT-G score reliability was .88 (subscales ranged between .71-.83). Three variables produced small, statistically significant (P < or = .05) eta squared effects (ranging between .06-.21) due to different sources of variation in the FACT-G and subscales: ethnicity, cancer type, and study type-all of which appeared to be related to disproportionate representation of studies with the majority including Caucasian samples, mixed cancer samples, and validation type studies. CONCLUSIONS The FACT-G and its subscales demonstrated acceptable reliability evidence across observed studies, without substantial variability due to scale or demographic characteristics.
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Affiliation(s)
- David Victorson
- Center on Outcomes, Research and Education, Northwestern University Feinberg School of Medicine, 1001 University Place, Evanston, IL, 60201, USA.
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Yoo H, Lee K, Lee J, Eremenco S, Choi S, Kim H, Lee J. Korean Translation and Validity of FACT-BMT Version 4 and the Quality of Life in Allogeneic Bone Marrow Transplantation Patients. Qual Life Res 2006; 15:559-64. [PMID: 16547794 DOI: 10.1007/s11136-005-1769-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2005] [Indexed: 11/29/2022]
Abstract
We undertook to translate and cross-culturally adapt the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) scale Version 4, an assessment tool for BMT patients' quality of life (QoL). The translation procedure followed the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology. At baseline, prior to BMT, 70 allogeneic BMT patients were administered the FACT-BMT scale version 4, as well as the Eastern Cooperative Oncology Group Performance Status Rating (ECOG-PSR), Functional Living Index-Cancer (FLIC), and the Shortened Forms of the Profile of Mood States (BPOMS). Forty seven of these patients were also administered these questionnaires 3 months after BMT, thirty eight patients did 6 months after BMT, and finally 35 patients did 1 year after their BMT. Our results indicated that the FACT-BMT scale Version 4 gave convergent and divergent validity, and had a high internal consistency with its Cronbach's alpha coefficients ranging from 0.64 (EWB at pre-BMT) to 0.94 (the FACT-BMT total). These data support that Korean FACT-BMT is a reliable and valid assessment for measuring the QoL of BMT patients. In the future study, we have to increase the number of cases with larger sample of allogeneic bone marrow transplantation patients, and the duration of long term follow-up should be at least more than 1 year.
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Affiliation(s)
- Heejung Yoo
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnab Dong, Songpa Gu, Seoul, 38-736, Korea.
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Rajagopal A, Vassilopoulou-Sellin R, Palmer JL, Kaur G, Bruera E. Symptomatic hypogonadism in male survivors of cancer with chronic exposure to opioids. Cancer 2004; 100:851-8. [PMID: 14770444 DOI: 10.1002/cncr.20028] [Citation(s) in RCA: 159] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Profound hypogonadism has been noted in patients receiving intrathecal opioids. The purpose of the current study was to determine whether chronic consumption of oral opioids by male survivors of cancer also would lead to central hypogonadism and whether this hypogonadism was associated with symptoms of sexual dysfunction, fatigue, anxiety, and depression. METHODS A case-control study was conducted at The University of Texas M. D. Anderson Cancer Center (Houston, TX), in which 20 patients who were chronically consuming opioids were compared with 20 matched controls. Patients completed the Sexual Desire Inventory (SDI), the Hospital Anxiety and Depression Scale (HADS), the Functional Assessment of Chronic Illness Therapy with general and fatigue subscales (FACT-G/FACIT-F), and the Edmonton Symptom Assessment System (ESAS) questionnaires. Serum samples were collected for testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). RESULTS Comparing the opioid group with the control group, 18 of the 20 patients (90%; 95% confidence interval [CI], 65-98%) exhibited hypogonadism, compared with 8 of the 20 control patients (40%; 95% CI, 19-64%). The median testosterone level was 145 ng/dL versus 399.5 ng/dL (5.0 nmol/L vs. 13.9 nmol/L; P < 0.0001), the median FSH level was 2.85 milli-International Units (mIU)/mL versus 5.3 mIU/mL (P = 0.08), the median LH level was 1.8 mIU/mL versus 4.2 mIU/mL (P = 0.0014), the median SDI-dyadic score was 18.5 versus 40 (P = 0.01), the median SDI-solitary score was 0 versus 5 (P = 0.007), the HADS (anxiety) score was 8.5 versus 5.5 (P = 0.053), the HADS (depression) score was 7.5 versus 1.5 (P = 0.0002), the FACT-G score was 64 versus 96.3 (P = 0.0001), and the FACIT-F score was 24 versus 46 (P = 0.0003). CONCLUSIONS Survivors of cancer who chronically consumed opioids experienced symptomatic hypogonadism with significantly higher levels of depression, fatigue, and sexual dysfunction. With the increasing use of opioids among patients with cancer, further research in improving quality-of-life outcomes is warranted.
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Affiliation(s)
- Arun Rajagopal
- Section of Cancer Pain Management, Department of Anesthesiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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