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DeLone AM, Fisher RS, Traino KA, Basile NL, Buchanan CL, Cheng EY, Poppas DP, Baraldi AN, Wisniewski AB, Mullins LL. Exploratory factor analysis of the Illness Intrusiveness Rating Scale for parents of children with atypical genital appearance due to differences of sex development (DSD). J Pediatr Psychol 2024; 49:482-490. [PMID: 38578612 PMCID: PMC11258802 DOI: 10.1093/jpepsy/jsae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE Illness intrusiveness refers to the subjective cognitive appraisal of a chronic health condition interfering in daily, valued activities and may be highly relevant for parents of children with atypical genital appearance due to differences of sex development (DSD). However, a measure of illness intrusiveness has not been validated for this population. The current study aimed to evaluate the factor structure of the Illness Intrusiveness Scale for Parents (IIS-P) and examine convergent validity. METHODS Participants included 102 parents (Mage = 33.39 years, SD = 6.48; 58% mothers) of 65 children (<2 years old) diagnosed with DSD participating in a larger, longitudinal study. Parents completed the IIS-P as well as self-report measures of stigma, and anxious and depressive symptoms. An exploratory factor analysis (EFA) was conducted. RESULTS EFA results supported a 1-factor intrusiveness solution (α = .93), as well as a 2-factor solution measuring intrusiveness on daily living (α = .92) and community connectedness (α = .85). The 1-factor solution and both factors of the 2-factor solution demonstrated significant convergent validity with stigma as well as anxious and depressive symptoms. CONCLUSIONS Support emerged for both 1- and 2-factor solutions of the IIS-P in parents of children with DSD. The decision to evaluate illness intrusiveness as a total score or to examine the subscales of daily living and community connectedness should be tailored to the unique aims of researchers and clinicians. Future research should conduct a confirmatory factor analysis with both 1- and 2-factor models with larger, more diverse samples of caregivers.
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Affiliation(s)
- Alexandra M DeLone
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Rachel S Fisher
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Katherine A Traino
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Nathan L Basile
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Cindy L Buchanan
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, United States
| | - Earl Y Cheng
- Department of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, United States
| | - Dix P Poppas
- James Buchanan Brady Department of Urology, Komansky Children’s Hospital, New York Presbyterian Hospital-Weill Cornell Medicine, New York, United States
| | - Amanda N Baraldi
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Amy B Wisniewski
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
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Curran L, Mahoney A, Hastings B. A Systematic Review of Trajectories of Clinically Relevant Distress Amongst Adults with Cancer: Course and Predictors. J Clin Psychol Med Settings 2024:10.1007/s10880-024-10011-x. [PMID: 38704756 DOI: 10.1007/s10880-024-10011-x] [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: 02/14/2024] [Indexed: 05/07/2024]
Abstract
To improve interventions for people with cancer who experience clinically relevant distress, it is important to understand how distress evolves over time and why. This review synthesizes the literature on trajectories of distress in adult patients with cancer. Databases were searched for longitudinal studies using a validated clinical tool to group patients into distress trajectories. Twelve studies were identified reporting trajectories of depression, anxiety, adjustment disorder or post-traumatic stress disorder. Heterogeneity between studies was high, including the timing of baseline assessments and follow-up intervals. Up to 1 in 5 people experienced persistent depression or anxiety. Eight studies examined predictors of trajectories; the most consistent predictor was physical symptoms or functioning. Due to study methodology and heterogeneity, limited conclusions could be drawn about why distress is maintained or emerges for some patients. Future research should use valid clinical measures and assess theoretically driven predictors amendable to interventions.
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Affiliation(s)
- Leah Curran
- Health@Business Research Network, School of Management and Governance, University of New South Wales, High Street, Kensington, Australia.
- The Kinghorn Cancer Centre, St Vincent's Hospital Network, 370 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia.
| | - Alison Mahoney
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital Network, 390 Victoria Street, Darlinghurst, Australia
- School of Psychiatry, University of New South Wales, High Street, Kensington, Australia
| | - Bradley Hastings
- Health@Business Research Network, School of Management and Governance, University of New South Wales, High Street, Kensington, Australia
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Gromisch ES, Neto LO, DelMastro HM, Dhari Z, Pisa M, Turner AP. Physical Activity and Life Stress Are Associated With Illness Intrusiveness in Persons With Multiple Sclerosis. Arch Phys Med Rehabil 2024; 105:876-883. [PMID: 37967667 DOI: 10.1016/j.apmr.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/13/2023] [Accepted: 10/30/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVES To explore which modifiable lifestyle behaviors contribute to illness intrusiveness in persons with multiple sclerosis (MS). DESIGN Cohort study. SETTING Community-based comprehensive MS center. PARTICIPANTS Adults with MS (N=154) who completed an online battery of self-report questionnaires. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Illness intrusiveness was measured with the 13-item Illness Intrusiveness Ratings Scale. Lifestyle behaviors were measured using the respective components of the Simple Lifestyle Indicator Questionnaire (ie, Diet, Physical Activity, Alcohol, Smoking, and Life Stress) and self-reported body mass index (BMI). RESULTS After controlling for age, race, sex, disease duration, and level of physical disability ("disability"), life stress was associated with greater illness intrusiveness (b=4.65, P<.001), and physical activity was associated with less illness intrusiveness (b=-0.67, P=.009). Exploratory mediation analyses revealed physical activity had an indirect effect on illness intrusiveness through disability (b=-0.39, 95% CI: -0.68, -0.16). Conversely, disability also displayed an indirect effect on illness intrusiveness through physical activity (b=0.57, 95% CI: 0.12, 1.16). CONCLUSIONS Life stress and physical activity are 2 modifiable lifestyle behaviors that contribute to illness intrusiveness, with the latter also having an indirect effect through disability. These findings may help inform future behavioral interventions for improving health-related quality of life in persons with MS.
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Affiliation(s)
- Elizabeth S Gromisch
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT; Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT; Department of Neurology, University of Connecticut School of Medicine, Farmington, CT.
| | - Lindsay O Neto
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT
| | - Heather M DelMastro
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT
| | - Zaenab Dhari
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT
| | - Marco Pisa
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
| | - Aaron P Turner
- Multiple Sclerosis Center of Excellence West, Veterans Affairs, Seattle, WA; Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA
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León-Salas B, Bilbao-González A, de Pascual y Medina AM, Esteva M, Toledo-Chávarri A, Fuentes-Sánchez C, Bohn-Sarmiento U, Padrón-Peña P, González-Sánchez S, Valcárcel-López R, Trujillo-Martín MDM. Cross-cultural adaptation, reliability and validity of the Spanish version of the long-term quality of life questionnaire. Front Oncol 2024; 14:1375125. [PMID: 38567161 PMCID: PMC10985178 DOI: 10.3389/fonc.2024.1375125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose The aim of this study was to translate, culturally adapt, and evaluate the psychometric properties of the Spanish Long-Term Quality of Life (LTQL) questionnaire. Methods The LTQL was initially translated into Spanish and cross-culturally adapted based on established guidelines. The Spanish LTQL was administered to patients with breast cancer who had completed their initial treatment 5 years earlier, along with other self-report measures: Quality of Life in Adult Cancer Survivors (QLACS), Hospital Anxiety and Depression Scale (HADS) and EORT-QLQ-BR23. Reliability was evaluated using internal consistency and test-retest. Convergent and known-groups validity were examined. Structural validity as determined by confirmatory factor analysis (CFA) and Rasch analyses was used to assess the unidimensionality and item-functioning of the LTQL domains. Results Cronbach's alpha were above 0.7 in all domains. Test-retest coefficients were between 0.72 to 0.96 for LTQL domains. LTQL total score was correlated with others total scores of other measures: QLACS (r=-0.39), HADS depression (r=-0.57), HADS anxiety (-0.45) and EORTC-QLQ-BR23 (r=-0.50). CFA provided satisfactory fit indices, with RMSEA value of 0.077 and TLI and CFI values of 0.901 and 0.909, respectively. All factor loadings were higher than 0.40 and statistically significant (P<0.001). Rasch analysis showed that Somatic Concerns domain had 4 misfitting items, and Philosophical/Spiritual View of Life and social Support domains only 1 misfit item. However, unidimensionality was supported for the four domains. Conclusion The findings support the validity and reliability of the Spanish version of LTQL questionnaire to be used in long-term cancer female survivors.
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Affiliation(s)
- Beatriz León-Salas
- Canary Islands Health Research Institute Foundation (FIISC), Santa Cruz de Tenerife, Spain
- Research Network on Chronic Diseases, Primary Care, and Health Promotion (RICAPPS), Carlos III Health Institute (Instituto de Salud Carlos III), Madrid, Spain
| | - Amaia Bilbao-González
- Research Network on Chronic Diseases, Primary Care, and Health Promotion (RICAPPS), Carlos III Health Institute (Instituto de Salud Carlos III), Madrid, Spain
- Osakidetza Basque Health Service, Basurto University Hospital, Research and Innovation Unit, Bilbao, Spain
- Research Unit, Kronikgune Health Services Research Institute, Barakaldo, Spain
- Department of Medicine, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | | | - Magdalena Esteva
- Majorca Primary Care Management. Research Unit, Palma de Mallorca, Spain
- Health Research Institute of Balearic Islands (IdIsBA), Palma de Mallorca, Spain
| | - Ana Toledo-Chávarri
- Canary Islands Health Research Institute Foundation (FIISC), Santa Cruz de Tenerife, Spain
- Research Network on Chronic Diseases, Primary Care, and Health Promotion (RICAPPS), Carlos III Health Institute (Instituto de Salud Carlos III), Madrid, Spain
| | - Claudio Fuentes-Sánchez
- Department of Medical Oncology, Nuestra Señora de Candelaria University Hospital, Santa Cruz de Tenerife, Spain
| | - Uriel Bohn-Sarmiento
- Department of Medical Oncology, Gran Canaria Dr. Negrin General University Hospital, Las Palmas de Gran Canaria, Spain
| | - Pilar Padrón-Peña
- Nursing Service, University Hospital of Canary Islands, Santa Cruz de Tenerife, Spain
| | | | - Rafael Valcárcel-López
- Canary Islands Primary Care, Canary Islands Health Service (SCS), Santa Cruz de Tenerife, Spain
| | - María del Mar Trujillo-Martín
- Canary Islands Health Research Institute Foundation (FIISC), Santa Cruz de Tenerife, Spain
- Research Network on Chronic Diseases, Primary Care, and Health Promotion (RICAPPS), Carlos III Health Institute (Instituto de Salud Carlos III), Madrid, Spain
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Ruiz-Parra E, Manzano-García G, Mediavilla R, Rodríguez-Vega B, Lahera G, Moreno-Pérez AI, Torres-Cantero AM, Rodado-Martínez J, Bilbao A, González-Torres MÁ. The Spanish version of the reflective functioning questionnaire: Validity data in the general population and individuals with personality disorders. PLoS One 2023; 18:e0274378. [PMID: 37023214 PMCID: PMC10079014 DOI: 10.1371/journal.pone.0274378] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/26/2022] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION Mentalization or reflective functioning (RF) is the capacity to interpret oneself or the others in terms of internal mental states. Its failures have been linked to several mental disorders and interventions improving RF have a therapeutic effect. Mentalizing capacity of the parents influences the children's attachment. The Reflective Functioning Questionnaire (RFQ-8) is a widely used tool for the assessment of RF. No instrument is available to assess general RF in Spanish-speaking samples. The aim of this study is to develop a Spanish version of the RFQ-8 and to evaluate its reliability and validity in the general population and in individuals with personality disorders. METHODS 602 non-clinical and 41 personality disordered participants completed a Spanish translation of the RFQ and a battery of self-reported questionnaires assessing several RF related constructs (alexithymia, perspective taking, identity diffusion and mindfulness), psychopathology (general and specific) and interpersonal problems. Temporal stability was tested in a non-clinical sub-sample of 113 participants. RESULTS Exploratory and confirmatory factor analyses suggested a one-factor structure in the Spanish version of the RFQ-8. RFQ-8 understood as a single scale was tested, with low scorings reflecting genuine mentalizing, and high scorings uncertainty. The questionnaire showed good internal consistence in both samples and moderate temporal stability in non-clinical sample. RFQ correlated significantly with identity diffusion, alexithymia, and general psychopathology in both samples; and with mindfulness, perspective taking, and interpersonal problems in clinical sample. Mean values of the scale were significantly higher in the clinical group. DISCUSSION This study provides evidence that the Spanish version of the RFQ-8, understood as a single scale, has an adequate reliability and validity assessing failures in reflective functioning (i.e., hypomentalization) in general population and personality disorders.
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Affiliation(s)
- Eduardo Ruiz-Parra
- Department of Neurosciences, Faculty of Medicine and Nursing, University of the Basque Country, Bilbao, Spain
- Department of Psychiatry, Basurto University Hospital, Osakidetza Basque Health Service, Bilbao, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
| | | | - Roberto Mediavilla
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, School of Medicine, Autonomous University of Madrid (UAM), Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Beatriz Rodríguez-Vega
- Department of Psychiatry, School of Medicine, Autonomous University of Madrid (UAM), Madrid, Spain
- La Paz Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Guillermo Lahera
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Psychiatry, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - Ana I. Moreno-Pérez
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Psychiatry, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - Alberto M. Torres-Cantero
- Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
- Department of Preventive Medicine, Virgen de la Arrixaca University Clinical Hospital, El Palmar, Murcia, Spain
| | - Juan Rodado-Martínez
- Department of Psychiatry, School of Medicine, University of Murcia, Murcia, Spain
- Department of Psychiatry, Reina Sofía University Hospital, Murcia, Spain
| | - Amaia Bilbao
- Research Unit, Basurto University Hospital, Osakidetza Basque Health Service, Bilbao, Bizkaia, Spain
- Health Service Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | - Miguel Ángel González-Torres
- Department of Neurosciences, Faculty of Medicine and Nursing, University of the Basque Country, Bilbao, Spain
- Department of Psychiatry, Basurto University Hospital, Osakidetza Basque Health Service, Bilbao, Spain
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain
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Coyne AE, Gros DF. Comorbidity as a moderator of the differential efficacy of transdiagnostic behavior therapy and behavioral activation for affective disorders. Psychother Res 2022; 32:886-897. [PMID: 34996343 PMCID: PMC10028601 DOI: 10.1080/10503307.2021.2022236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Transdiagnostic psychotherapies have been proposed as an effective means for addressing the needs of patients with multiple, comorbid disorders. Yet, it remains unknown whether transdiagnostic approaches empirically outperform disorder-specific psychotherapies for patients with comorbid disorders. Thus, this study tested whether comorbidity moderated the efficacy of transdiagnostic behavior therapy (TBT) and behavioral activation (BA) for patients with various affective disorders. METHODS Data derived from a randomized controlled trial in which 93 treatment-seeking veterans received 12 sessions of TBT (n = 46) or BA (n = 47). Baseline comorbidity was assessed with a diagnostic interview. Patients rated their symptoms and functioning throughout treatment, and therapists recorded premature treatment discontinuation. RESULTS Multilevel models revealed significant interactive effects on changes in symptoms and functioning, but not on the posttreatment levels of these outcomes; whereas patients with more comorbidity experienced greater reductions in distress and symptom interference in TBT compared to BA, those with one disorder had better outcomes in BA. Similarly, whereas patients with more comorbidity were less likely to prematurely discontinue TBT compared to BA, those with one disorder were less likely to prematurely discontinue BA. CONCLUSIONS The results lend empirical support to previously untested hypotheses for potential benefits of transdiagnostic psychotherapies.Trial registration: ClinicalTrials.gov identifier: NCT01947647.
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Affiliation(s)
- Alice E Coyne
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Daniel F Gros
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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The Combined Effects of Youth and Parent Illness Intrusiveness on Depressive Symptoms in Adolescents with Inflammatory Bowel Disease. J Clin Psychol Med Settings 2022; 30:238-247. [PMID: 35668287 DOI: 10.1007/s10880-022-09886-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Abstract
Inflammatory bowel disease (IBD) presents physical and emotional challenges for families and imposes significant lifestyle intrusions on both youth and parents. The present study examined the effects of IBD disease activity and youth illness intrusiveness on depressive symptoms in adolescents, and the moderating influence of parent illness intrusiveness on these associations. Adolescents and parents completed measures of illness intrusiveness; youth completed a measure of depressive symptoms. Physicians provided estimates of IBD disease activity. Mediation analysis revealed an IBD disease activity → youth intrusiveness → youth depressive symptoms indirect effect. Moderated mediation analyses revealed this indirect effect to be greater among youth whose parents endorsed more IBD-related intrusions. Youth encountering greater activity disruptions related to IBD are vulnerable to depressive symptoms. When parents also experience IBD-induced intrusions, youth are at even greater risk for depressive symptoms. Clinical implications are discussed within the context of youths' and parents' experiences of IBD.
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A Concept Analysis of Illness Intrusiveness in Chronic Disease: Application of the Hybrid Model Method. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105900. [PMID: 35627435 PMCID: PMC9141028 DOI: 10.3390/ijerph19105900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/17/2022]
Abstract
This study clarifies the concept of illness intrusiveness in patients with a chronic disease using the hybrid model method. To clarify the dimension, attributes, and definition of illness intrusiveness in chronic disease, three phases of analysis were conducted. In the theoretical phase, a working definition was devised through a systematic review. In the fieldwork phase, individual in-depth interviews were conducted with nine participants with chronic diseases. In the final analytic phase, the results were integrated through comparison and review. There are four domains and eleven attributes of illness intrusiveness in chronic disease. The domains include physical, psychological, social/contextual, and spiritual. The physical domain consists of four attributes: pain, fatigue, physical malfunction, and change of body image. The psychological domain consists of three attributes: psychological weakness, uncertainty, and stigma. The social/contextual domain is made up of three attributes: withdrawal of role play, limit of daily life, and burden of changing health habits. Finally, the spiritual domain had one attribute: unstable spiritual state. Thus, based on the study findings, it is necessary to develop a suitable illness intrusiveness in chronic disease assessment scale to assess chronic disease patients.
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Pratt-Chapman ML, Alpert AB, Castillo DA. Health outcomes of sexual and gender minorities after cancer: a systematic review. Syst Rev 2021; 10:183. [PMID: 34154645 PMCID: PMC8218456 DOI: 10.1186/s13643-021-01707-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/18/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Cancer research on sexual and gender minority (SGM) populations is gaining momentum. The purpose of this systematic review was to examine what is currently known in the research literature regarding patient-reported health outcomes after cancer treatment among SGM populations. METHODS In March 2021, a medical librarian conducted a systematic keyword search on PubMed, Embase, Scopus, Web of Science, PsycINFO, ClinicalTrials.gov , and the Cochrane Central Register of Controlled Trials. The primary inclusion criterion was assessment of at least one physical, psychosocial, emotional, or functional patient-reported health outcome related to the impacts of cancer diagnosis and/or treatment. Articles that met inclusion criteria were reviewed in their entirety, charted in a Word Table, and assessed for quality. Quality considerations included study design, sampling approach, diversity of sample, measures used, and analytic procedures. Studies were synthesized based on type of cancer study participants experienced. RESULTS Sixty-four studies were included in the final analysis: most were quantitative, secondary analyses or cross-sectional studies with convenience samples, and focused on people with a history of breast or prostate cancer. Differences between sexual minority men and women in terms of coping and resilience were noted. Few studies reported on experiences of transgender persons and none reported on experiences of intersex persons. CONCLUSIONS A growing literature describes the patient-reported health outcomes of SGM people with a history of cancer. This study summarizes important between-group differences among SGM and heterosexual, cisgender counterparts that are critical for clinicians to consider when providing care. IMPLICATIONS FOR CANCER SURVIVORS Sexual orientation and gender identity are relevant to cancer survivors' health outcomes. Subgroups of SGM people have differential experiences and outcomes related to cancer and its impacts.
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Affiliation(s)
- Mandi L. Pratt-Chapman
- The George Washington University, School of Medicine and Health Sciences, Washington, DC USA
- The GW Cancer Center, The George Washington University, 2600 Virginia Avenue, Suite #324, Washington, DC 20037 USA
| | - Ash B. Alpert
- Wilmot Cancer Institute, Division of Hematology and Medical Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, USA
| | - Daniel A. Castillo
- Edward G. Miner Library, University of Rochester Medical Center, Rochester, USA
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Abstract
PURPOSE Cancer research on sexual and gender minority (SGM) populations is gaining momentum. The purpose of this systematic review was to examine what is currently known in the research literature regarding patient-reported health outcomes after cancer treatment among SGM populations. METHODS In March 2021, a medical librarian conducted a systematic keyword search on PubMed, Embase, Scopus, Web of Science, PsycINFO, ClinicalTrials.gov , and the Cochrane Central Register of Controlled Trials. The primary inclusion criterion was assessment of at least one physical, psychosocial, emotional, or functional patient-reported health outcome related to the impacts of cancer diagnosis and/or treatment. Articles that met inclusion criteria were reviewed in their entirety, charted in a Word Table, and assessed for quality. Quality considerations included study design, sampling approach, diversity of sample, measures used, and analytic procedures. Studies were synthesized based on type of cancer study participants experienced. RESULTS Sixty-four studies were included in the final analysis: most were quantitative, secondary analyses or cross-sectional studies with convenience samples, and focused on people with a history of breast or prostate cancer. Differences between sexual minority men and women in terms of coping and resilience were noted. Few studies reported on experiences of transgender persons and none reported on experiences of intersex persons. CONCLUSIONS A growing literature describes the patient-reported health outcomes of SGM people with a history of cancer. This study summarizes important between-group differences among SGM and heterosexual, cisgender counterparts that are critical for clinicians to consider when providing care. IMPLICATIONS FOR CANCER SURVIVORS Sexual orientation and gender identity are relevant to cancer survivors' health outcomes. Subgroups of SGM people have differential experiences and outcomes related to cancer and its impacts.
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Affiliation(s)
- Mandi L Pratt-Chapman
- The George Washington University, School of Medicine and Health Sciences, Washington, DC, USA. .,The GW Cancer Center, The George Washington University, 2600 Virginia Avenue, Suite #324, Washington, DC, 20037, USA.
| | - Ash B Alpert
- Wilmot Cancer Institute, Division of Hematology and Medical Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, USA
| | - Daniel A Castillo
- Edward G. Miner Library, University of Rochester Medical Center, Rochester, USA
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Wynter E, Perich T. Use of self‐care strategies in the management of bipolar disorder and their relationship to symptoms, illness intrusiveness, and quality of life. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Edward Wynter
- School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, Australia,
| | - Tania Perich
- School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, Australia,
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia,
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Leach CR, Vereen RN, Rao AV, Ross K, Diefenbach MA. Impact of individual- and area-level race/ethnicity on illness intrusiveness among cancer survivors. Transl Behav Med 2020; 9:1208-1215. [PMID: 31228204 DOI: 10.1093/tbm/ibz088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Many cancer survivors experience illness intrusion or disruption in various life domains from cancer. The socioecological model posits that individual health status is produced by the interaction of individual biology and their surrounding physical, social, and cultural environment. Despite evidence of the need to consider such hierarchical influences, little is known about the impact of area-level factors on cancer-related outcomes, including illness intrusiveness. Data from 993 breast, colorectal, and prostate cancer survivors within the first year of completing treatment were analyzed. Individual-level data for the Illness Intrusiveness Ratings Scale were linked to census tract-level data to characterize neighborhood conditions. Logistic regression modeled the association between individual-level variables, neighborhood-level racial composition, and the interaction between individual and area-level race on illness intrusiveness. A significant number of survivors (232, 23.4%) reported relatively high illness intrusiveness (score >28). The model including the interaction between area- and individual-level race exhibited significantly improved model fit (p < .05). The final model showed that racial minorities living in areas with a higher percentage of racial minorities had higher odds of greater illness intrusion when compared to Whites living in areas with a low percentage of racial minorities (adjusted odds ratio: 1.65, confidence interval: 1.01, 2.68). Results suggest that area-level factors can have profound effects on survivors' processing of their past cancer experience. Findings may support the collective resources model which posits that the effect of area deprivation is greater in certain sociodemographic groups who may find it difficult to seek resources outside of their living area.
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Affiliation(s)
- Corinne R Leach
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA, USA
| | - Rhyan N Vereen
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA, USA
| | - Arthi V Rao
- Center for Quality Growth and Regional Development Georgia Institute of Technology, Atlanta, GA, USA
| | - Katherine Ross
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
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13
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Wong JH, Pierratos A, Oreopoulos DG, Mohammad R, Benjamin–Wong F, Chan CT. The Use of Nocturnal Home Hemodialysis as Salvage Therapy for Patients Experiencing Peritoneal Dialysis Failure. Perit Dial Int 2020. [DOI: 10.1177/089686080702700613] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Failure of peritoneal dialysis (PD) results in poor quality of life and worsening morbidity in patients with end-stage renal disease (ESRD). Traditionally, hospital-based conventional hemodialysis has been the only option for this patient population. We hypothesized that nocturnal home hemodialysis (NHD), 3 – 6 sessions per week, 6 – 8 hours per session, is a suitable alternative salvage therapy for this vulnerable patient group. Methods This is a descriptive cohort study of all consecutive ESRD patients failing PD that were converted to NHD at the University Health Network and Humber River Regional Hospital from 2003 to 2005. Our primary objective was to describe the changes in clinical and biochemical indices before and after conversion from PD to NHD. Results 69 patients required transfer from PD to another form of renal replacement therapy during the period of interest. Our pilot cohort included 8 ESRD patients (5 males, 3 females; age 53 ± 7 years). Mean duration on PD was 4.8 ± 4.6 years. NHD delivered a higher dose of dialysis, as reflected by lower plasma creatinine concentration 1 year after beginning NHD (from 1107 ± 312 μmol/L with PD to 649 ± 309 μmol/L, p = 0.01) and a rise in standardized Kt/V (from 2.21 ± 0.73 with PD to 4.49 ± 1.92 after 6 months of NHD, to 4.51 ± 1.77 after 1 year of NHD; p < 0.001). There was a progressive and sustained rise in plasma albumin after conversion to NHD (from 31 ± 4 g/L with PD to 36 ± 4 g/L after 6 months of NHD, to 39 ± 2 g/L after 1 year of NHD; p = 0.001). Hemoglobin concentrations increased (from 102 ± 13 to 125 ± 7 g/L, p = 0.03), while erythropoietin requirement tended to fall (from 17500 ± 8669 to 9197 ± 7573 U/week). Plasma phosphate fell (from 2.1 ± 0.6 to 1.1 ± 0.3 mmol/L, p = 0.01) despite a decrease in phosphate binder requirement. Blood pressure profile also tended to improve after conversion to NHD. Conclusion Nocturnal HD represents a promising, viable, alternative renal replacement therapy for patients experiencing PD failure. The clinical impact of transferring ESRD patients failing PD to NHD deserves further investigation.
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Affiliation(s)
- Joseph H.S. Wong
- Division of Nephrology, Queen Elizabeth Hospital, Hong Kong, China
| | | | | | - Reem Mohammad
- Division of Nephrology, University Health Network, Toronto, Ontario, Canada
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14
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Renn BN, Hundt NE, Sansgiry S, Petersen NJ, Kauth MR, Kunik ME, Cully JA. Integrated Brief Cognitive Behavioral Therapy Improves Illness Intrusiveness in Veterans With Chronic Obstructive Pulmonary Disease. Ann Behav Med 2019; 52:686-696. [PMID: 29860524 DOI: 10.1093/abm/kax045] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Progressive illnesses such as chronic obstructive pulmonary disease (COPD) impart a high level of physical and psychological burden. Evidence-based psychotherapies hold the potential to improve perceptions of physical health impairment, yet few studies have documented these effects. Purpose To evaluate the effect of brief cognitive behavioral therapy (bCBT) on disease-related illness intrusiveness. Methods Participants were 175 Veterans with COPD and clinically elevated symptoms of depression and/or anxiety enrolled in a larger randomized trial (n = 99 randomized to bCBT, n = 76 to enhanced usual care; EUC). bCBT included up to six treatment sessions and optional booster sessions over a 4-month period. EUC entailed an assessment with documentation in the medical record. Primary outcomes focused on posttreatment changes on the Illness Intrusiveness Rating Scale (IIRS), an established measure of perceived impairment from a chronic health condition. Results Illness intrusiveness improved for bCBT participants relative to EUC, after controlling for baseline IIRS scores, depression, and anxiety (p = .03, partial η2 = .03). Specific improvement was observed in the Instrumental subscale (p = .02), encompassing improved intrusiveness of COPD on daily activities and daily functioning. IIRS scores improved in the absence of changes in physical functioning. Conclusions Illness intrusiveness was high among Veterans with COPD but improved over the course of bCBT. Integrated behavioral health interventions hold the potential to reduce disease intrusiveness. The IIRS may be a valuable tool to augment traditional assessment and measurement-based care approaches of behavioral health interventions for medically ill patients.
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Affiliation(s)
- Brenna N Renn
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Natalie E Hundt
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center (MEDVAMC 152), Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
| | - Shubhada Sansgiry
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center (MEDVAMC 152), Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA.,Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA
| | - Nancy J Petersen
- VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center (MEDVAMC 152), Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA.,Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA
| | - Michael R Kauth
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center (MEDVAMC 152), Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
| | - Mark E Kunik
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center (MEDVAMC 152), Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA.,Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey A Cully
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center (MEDVAMC 152), Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
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15
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A randomized controlled trial comparing Transdiagnostic Behavior Therapy (TBT) and behavioral activation in veterans with affective disorders. Psychiatry Res 2019; 281:112541. [PMID: 31514043 PMCID: PMC10061230 DOI: 10.1016/j.psychres.2019.112541] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/26/2019] [Accepted: 08/26/2019] [Indexed: 11/24/2022]
Abstract
This randomized controlled trial (RCT) compared the efficacy of Transdiagnostic Behavior Therapy (TBT) to Behavioral Activation Treatment for Depression (BATD) in veterans diagnosed with affective disorders. TBT is a transdiagnostic psychotherapy designed to address depressive, anxiety, and post-traumatic stress disorder (PTSD) symptoms. Preliminary findings have been promising; however, no RCT has been completed to date. 105 treatment-seeking veterans were recruited and completed diagnostic and self-report measures, and then randomized into TBT or BATD treatment conditions for 12 weekly psychotherapy sessions. Assessment measures were re-administered at immediate post-treatment and 6-month follow-up. Of the 93 participants initiating treatment, 50 participants completed the full treatment protocol (TBT n = 29; BATD n = 21). No differences were observed in treatment completion across groups. Participants demonstrated significant treatment improvements across all assessments, including measures of depression, anxiety (general, cognitive, and somatic), stress, PTSD symptoms, and transdiagnostic impairment. Group differences with small effect sizes were observed in most of the studied measures, favoring TBT compared to BATD. Together, the findings support the growing literature on the efficacy of transdiagnostic psychotherapies, compared to disorder-specific treatments (DSTs). Related to the outcome findings, the benefits for transdiagnostic protocols in terms of symptom coverage, dissemination, and access were discussed.
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16
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Abstract
This study supports the efficacy of transdiagnostic behavior therapy across various affective disorders, including depression and PTSD. These findings suggest a possible reduction in the number of treatment protocols providers need to learn in order to treat patients with affective disorders.
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Affiliation(s)
- Daniel F Gros
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, and Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
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17
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A Naturalistic Comparison of Group Transdiagnostic Behaviour Therapy (TBT) and Disorder-Specific Cognitive Behavioural Therapy Groups for the Affective Disorders. Behav Cogn Psychother 2018; 47:39-51. [PMID: 29807553 DOI: 10.1017/s1352465818000309] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Transdiagnostic psychotherapies are designed to apply the same underlying treatment principles across a set of psychiatric disorders, without significant tailoring to specific diagnoses. Several transdiagnostic psychotherapy protocols have been developed recently, each of which has its own strengths and weaknesses. One promising treatment is Transdiagnostic Behaviour Therapy (TBT), in that it is one of the few transdiagnostic treatments to date shown to be effective in patients with depressive and anxiety disorders. However, TBT has only been investigated via individual psychotherapy. AIMS The present study investigated the effectiveness of a group protocol for TBT, compared with disorder-specific group psychotherapies, in a naturalistic setting. METHOD 109 participants with various diagnoses of affective disorders completed either group TBT (n = 37) or a disorder-specific group psychotherapy (n = 72). Measures included assessments of psychiatric symptomatology and transdiagnostic impairment at baseline and post-treatment. RESULTS Overall, participants in the TBT group demonstrated significant improvements across all measures. When compared with disorder-specific groups, no statistical differences were observed between groups across symptoms; however, participants in the TBT group demonstrated roughly twice the treatment effect sizes in transdiagnostic impairment compared with participants in the disorder-specific groups. In addition, when participants from the most well-represented diagnosis and disorder-specific treatment (social anxiety disorder) were investigated separately, participants in the TBT group demonstrated significantly larger improvements in comorbid depressive symptoms than participants in the disorder-specific treatment. CONCLUSIONS Pending replication and additional comparison studies, group TBT may provide an effective group treatment option for patients with affective disorders.
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18
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Devins GM, Mah K, Messner HA, Xenocostas A, Gauvin L, Lipton JH. Quality of life trajectories during the first year following hematopoietic cell transplantation: an inception cohort study. Support Care Cancer 2018; 26:2379-2386. [PMID: 29423678 DOI: 10.1007/s00520-018-4059-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 01/16/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Allogeneic hematopoietic cell transplantation (HCT) affects quality of life (QOL). Patient-reported outcomes examine symptoms, side effects, distress, and physical and social problems, but positive outcomes have been ignored. This inception cohort study followed people over the first year following HCT to document positive and negative outcomes. METHODS People with hematologic cancers treated by HCT completed complementary self-report instruments at four milestones: (a) pre-transplant (N = 88); (b) engraftment (N = 80); (c) short-term post-discharge (N = 60); and (d) long-term post-discharge (N = 45). We examined symptoms, side effects, illness intrusiveness, depressive symptoms, positive and negative affect, and self-esteem. We compared QOL in HCT with diverse published values. RESULTS QOL deteriorated following HCT. Most variables returned to baseline by short-term post-discharge, but self-esteem and illness intrusiveness required more time. Illness intrusiveness at 1 year post-discharge was higher in HCT than other cancer groups; negative affect, too, was higher, but HCT survivors also reported higher positive affect. HCT and other cancer survivors reported similar depressive symptom levels. Compared to healthy people, HCT survivors reported more severe depressive symptoms, but similar positive and negative affect. CONCLUSIONS QOL changes dramatically following HCT. People report more interference with valued activities and interests after 1 year than survivors of other cancers, but depressive symptoms are not higher. Positive and negative affect are equivalent to healthy community residents. Continued involvement in psychologically meaningful activities may preserve QOL.
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Affiliation(s)
- Gerald M Devins
- Princess Margaret Cancer Centre, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Kenneth Mah
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Hans A Messner
- Princess Margaret Cancer Centre, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Anargyros Xenocostas
- London Health Sciences Centre, London, ON, Canada.,University of Western Ontario, London, ON, Canada
| | - Lise Gauvin
- Université de Montréal, Montreal, QC, Canada
| | - Jeffrey H Lipton
- Princess Margaret Cancer Centre, Toronto, ON, Canada. .,University of Toronto, Toronto, ON, Canada.
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19
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Tang E, Bansal A, Novak M, Mucsi I. Patient-Reported Outcomes in Patients with Chronic Kidney Disease and Kidney Transplant-Part 1. Front Med (Lausanne) 2018; 4:254. [PMID: 29379784 PMCID: PMC5775264 DOI: 10.3389/fmed.2017.00254] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 12/21/2017] [Indexed: 01/31/2023] Open
Abstract
Chronic kidney disease (CKD) is a complex medical condition that is associated with several comorbidities and requires comprehensive medical management. Given the chronic nature of the condition, its frequent association with psychosocial distress, and its very significant symptom burden, the subjective patient experience is key toward understanding the true impact of CKD on the patients’ life. Patient-reported outcome measures are important tools that can be used to support patient-centered care and patient engagement during the complex management of patients with CKD. The routine collection and use of patient-reported outcomes (PROs) in clinical practice may improve quality of care and outcomes, and may provide useful data to understand the disease from both an individual and a population perspective. Many tools used to measure PROs focus on assessing health-related quality of life, which is significantly impaired among patients with CKD. Health-related quality of life, in addition to being an important outcome itself, is associated with clinical outcomes such as health care use and mortality. In Part 1 of this review, we provide an overview of PROs and implications of their use in the context of CKD. In Part 2, we will review the selection of appropriate measures and the relevant domains of interest for patients with CKD.
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Affiliation(s)
- Evan Tang
- Multi-Organ Transplant Program, Division of Nephrology, University Health Network, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Aarushi Bansal
- Multi-Organ Transplant Program, Division of Nephrology, University Health Network, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Marta Novak
- Centre for Mental Health, University Health Network, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Istvan Mucsi
- Multi-Organ Transplant Program, Division of Nephrology, University Health Network, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
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20
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Sharkey CM, Bakula DM, Baraldi AN, Perez MN, Suorsa KI, Chaney JM, Mullins LL. Grit, Illness-Related Distress, and Psychosocial Outcomes in College Students With a Chronic Medical Condition: A Path Analysis. J Pediatr Psychol 2017; 43:552-560. [DOI: 10.1093/jpepsy/jsx145] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/21/2017] [Indexed: 11/14/2022] Open
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21
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Bouchard V, Duquette P, Mayo NE. Path to Illness Intrusiveness: What Symptoms Affect the Life of People Living With Multiple Sclerosis? Arch Phys Med Rehabil 2017; 98:1357-1365. [DOI: 10.1016/j.apmr.2017.03.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 03/06/2017] [Indexed: 11/28/2022]
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22
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Validation of the Mini-OAKHQOL for use in patients with osteoarthritis in Spain. Clin Rheumatol 2017; 36:1855-1864. [PMID: 28353088 DOI: 10.1007/s10067-017-3611-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/08/2017] [Accepted: 03/19/2017] [Indexed: 10/19/2022]
Abstract
The Mini-Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQOL) questionnaire osteoarthritis is specific to individuals with knee or hip osteoarthritis. The objective of this study was to perform a validation of the Mini-OAKHQOL for use in Spain in terms of its psychometric properties of reliability, validity and responsiveness. Patients with osteoarthritis from the waiting list for a joint replacement completed the OAKHQOL, Short Form 36 Health Survey and Western Ontario and McMaster Universities Osteoarthritis Index. Reliability was assessed in terms of internal consistency and test-retest data, and convergent validity using Spearman's correlation coefficient. Structural validity was investigated by confirmatory factor analysis, and Rasch analysis was used to examine the unidimensionality of the scales. Responsiveness was assessed by calculating effect sizes. Confirmatory factor analysis confirmed the five-factor model, and the results of the Rasch analyses supported the unidimensionality assumption, with infit and outfit statistics. Cronbach's alpha ranged from 0.76 to 0.89 for all except the social dimensions. Statistically significant differences were observed between patients with different degrees of disease severity on all dimensions. There was convergent validity among dimensions expected to be correlated. The OAKHQOL questionnaire showed good responsiveness, with large changes for all dimensions apart from the two social dimensions, which had small effect sizes. Results of the study support the view that the Spanish version of the Mini-OAKHQOL questionnaire is a valid instrument to measure health-related quality of life in patients with osteoarthritis of the lower limb.
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23
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Gros DF, Szafranski DD, Shead SD. A real world dissemination and implementation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders. J Anxiety Disord 2017; 46:72-77. [PMID: 27158076 DOI: 10.1016/j.janxdis.2016.04.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 03/03/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
Dissemination and implementation of evidence-based psychotherapies is challenging in real world clinical settings. Transdiagnostic Behavior Therapy (TBT) for affective disorders was developed with dissemination and implementation in clinical settings in mind. The present study investigated a voluntary local dissemination and implementation effort, involving 28 providers participating in a four-hour training on TBT. Providers completed immediate (n=22) and six-month follow-up (n=12) training assessments and were encouraged to collect data on their TBT patients (delivery fidelity was not investigated). Findings demonstrated that providers endorsed learning of and interest in using TBT after the training. At six-months, 50% of providers reported using TBT with their patients and their perceived effectiveness of TBT to be very good to excellent. Submitted patient outcome data evidenced medium to large effect sizes. Together, these findings provide preliminary support for the effectiveness of a real world dissemination and implementation of TBT.
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Affiliation(s)
- Daniel F Gros
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
| | - Derek D Szafranski
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Sarah D Shead
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States
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24
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Lang PJ, McTeague LM, Bradley MM. RDoC, DSM, and the reflex physiology of fear: A biodimensional analysis of the anxiety disorders spectrum. Psychophysiology 2017; 53:336-47. [PMID: 26877123 DOI: 10.1111/psyp.12462] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/01/2015] [Accepted: 05/06/2015] [Indexed: 01/19/2023]
Abstract
Evidence is presented supporting a dimension of defensive reactivity that varies across the anxiety disorder spectrum and is defined by physiological responses during threat-imagery challenges that covary with objective measures of psychopathology. Previous imagery studies of anxiety disorders are reviewed, highlighting that, regardless of contemporary diagnostic convention, reliable psychophysiological patterns emerge for patients diagnosed with circumscribed fear compared to those diagnosed with pervasive anxious-misery disorders. Based on the heuristic outlined by the Research Domain Criteria (RDoC) initiative, an exploratory transdiagnostic analysis is presented, based on a sample of 425 treatment-seeking patients from across the spectrum of DSM-IV anxiety diagnoses. Using a composite index of startle reflex and heart rate reactivity during idiographic fear imagery for each patient, a defensive dimension was defined by ranking patients from most defensively reactive to least reactive and then creating five groups of equivalent size (quintile; N = 85). Subsequent analyses showed significant parallel trends of diminishing reactivity in both electrodermal and facial electromyographic reactions across this defensive dimension. Negative affectivity, defined by questionnaire and extent of functional interference, however, showed consistent, inverse trends with defensive reactivity-as reports of distress increased, defensive reactivity was increasingly attenuated. Notably, representatives of each principal diagnosis appeared in each quintile, underscoring the reality of pronounced within-diagnosis heterogeneity in defensive reactivity. In concluding, we describe our new RDoC research project, focusing on the assessment of brain circuit function as it determines hypo/hyperreactivity to challenge-somatic and autonomic-and may relate to patients' stress history and genetic inheritance.
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Affiliation(s)
- Peter J Lang
- Center for the Study of Emotion and Attention, University of Florida, Gainsville, Florida, USA
| | - Lisa M McTeague
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Margaret M Bradley
- Center for the Study of Emotion and Attention, University of Florida, Gainsville, Florida, USA
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25
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Kennedy CA, Warmington K, Flewelling C, Shupak R, Papachristos A, Jones C, Linton D, Beaton DE, Lineker S, Hogg-Johnson S. A prospective comparison of telemedicine versus in-person delivery of an interprofessional education program for adults with inflammatory arthritis. J Telemed Telecare 2016; 23:197-206. [PMID: 26957111 DOI: 10.1177/1357633x16635342] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction We evaluated two modes of delivery of an inflammatory arthritis education program ("Prescription for Education" (RxEd)) in improving arthritis self-efficacy and other secondary outcomes. Methods We used a non-randomized, pre-post design to compare videoconferencing (R, remote using telemedicine) versus local (I, in-person) delivery of the program. Data were collected at baseline (T1), immediately following RxEd (T2), and at six months (T3). Self-report questionnaires served as the data collection tool. Measures included demographics, disorder-related, Arthritis Self-Efficacy Scale (SE), previous knowledge (Arthritis Community Research and Evaluation Unit (ACREU) rheumatoid arthritis knowledge questionnaire), coping efficacy, Illness Intrusiveness, and Effective Consumer Scale. Analysis included: baseline comparisons and longitudinal trends (R vs I groups); direct between-group comparisons; and Generalized Estimating Equations (GEE) analysis. Results A total of 123 persons attended the program (I: n = 36; R: n = 87) and 111 completed the baseline questionnaire (T1), with follow-up completed by 95% ( n = 117) at T2 and 62% ( n = 76) at T3. No significant baseline differences were found across patient characteristics and outcome measures. Both groups (R and I) showed immediate effect (improved arthritis SE, mean change (95% confidence interval (CI)): R 1.07 (0.67, 1.48); I 1.48 (0.74, 2.23)) after the program that diminished over six months (mean change (95% CI): R 0.45 (-0.1, 0.1); I 0.73 (-0.25, 1.7)). For each of the secondary outcomes, both groups showed similar trends for improvement (mean change scores (95% CI)) over time. GEE analysis did not show any meaningful differences between groups (R vs I) over time. Discussion Improvements in arthritis self-efficacy and secondary outcomes displayed similar trends for I and R participant groups.
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Affiliation(s)
- Carol A Kennedy
- 1 Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, Canada.,2 Institute for Work and Health, Canada.,3 Department of Physical Therapy, University of Toronto, Canada
| | - Kelly Warmington
- 4 Knowledge Translation, The Hospital for Sick Children, Canada.,5 Learning Institute, The Hospital for Sick Children, Canada
| | | | - Rachel Shupak
- 7 Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital, Canada
| | - Angelo Papachristos
- 7 Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital, Canada
| | - Caroline Jones
- 7 Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital, Canada
| | - Denise Linton
- 1 Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, Canada
| | - Dorcas E Beaton
- 1 Musculoskeletal Health and Outcomes Research, St. Michael's Hospital, Canada.,2 Institute for Work and Health, Canada.,8 Graduate Department of Health Policy, Management and Evaluation, University of Toronto, Canada.,9 Graduate Department of Rehabilitation Science, University of Toronto, Canada.,10 Department of Occupational Science and Occupational Therapy, University of Toronto, Canada
| | | | - Sheilah Hogg-Johnson
- 2 Institute for Work and Health, Canada.,12 Dalla Lana School of Public Health, University of Toronto, Canada
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26
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Kreitzer MJ, Gross CR, Ye X, Russas V, Treesak C. Longitudinal Impact of Mindfulness Meditation on Illness Burden in Solid-Organ Transplant Recipients. Prog Transplant 2016; 15:166-72. [PMID: 16013466 DOI: 10.1177/152692480501500210] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background In 2001, more than 24000 solid-organ transplant surgeries were performed in the United States. Although survival rates have steadily risen over the past 2 decades, transplant recipients commonly experience a myriad of symptoms after transplantation that compromise quality of life. Anxiety, depression, and insomnia frequently occur despite excellent function of the transplanted organ. Use of complementary and alternative medicine has risen sharply over the past 10 years, particularly among people with chronic illnesses. Methods Twenty solid-organ transplant recipients were enrolled in a clinical trial of mindfulness-based stress reduction. During the 8-week course, subjects learned various forms of meditation and gentle hatha yoga. Participants were given audiotapes for home practice and maintained practice diaries. Longitudinal analysis focused on the impact of mindfulness-based stress reduction on symptom management, illness intrusion, and transplant-related stressors. Results Significant improvements in the quality and duration of sleep continued for 6 months after completion of the mindfulness-based stress reduction course. Improvements after the completion of the course were also noted in self-report measures of anxiety and depression. Conclusions Mindfulness-based stress reduction is an effective treatment in improving the quality and duration of sleep. Because sleep is highly correlated with positive mental health and overall well-being, these findings suggest that mindfulness-based stress reduction has the potential of being an effective, accessible and low-cost intervention that could significantly change transplant recipients' overall health and well-being.
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Bilbao A, Escobar A, García-Perez L, Navarro G, Quirós R. The Minnesota living with heart failure questionnaire: comparison of different factor structures. Health Qual Life Outcomes 2016; 14:23. [PMID: 26887590 PMCID: PMC4756518 DOI: 10.1186/s12955-016-0425-7] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 02/10/2016] [Indexed: 11/10/2022] Open
Abstract
Background The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is one of the most widely used health-related quality of life questionnaires for patients with heart failure (HF). It provides scores for two dimensions, physical and emotional, and a total score. However, there are some concerns about its factor structure and alternatives have been proposed, some including a third factor representing a social dimension. The objectives of the present study were to analyze the internal structure of the MLHFQ and the unidimensionality of the total score, and to compare the different factor structures proposed. Methods The MLHFQ was given to 2565 patients with HF. The structural validity of the questionnaire was assessed by confirmatory factor analysis (CFA), and Rasch analysis. These two approaches were also applied to the alternative structures proposed. Results The CFA results for the hypothesized model of two latent factors and the Rasch analysis confirmed the adequacy of the physical and emotional scales. Rasch analysis for the total score showed only two problematic items. The results of the CFA for other two-factor structures proposed were not better than the results for the original structure. The Rasch analyses applied to the different social factors yielded the best results for Munyombwe’s social dimension, composed of six items. Conclusions Our results support the validity of using the MLHFQ physical, emotional and total scores in patients with HF, for clinical practice and research. In addition, they confirmed the existence of a third factor, and we recommend the use of Munyombwe’s social factor.
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Affiliation(s)
- Amaia Bilbao
- Research Unit, Basurto University Hospital (Osakidetza), Bilbao, Bizkaia, Spain. .,Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Bizkaia, Spain.
| | - Antonio Escobar
- Research Unit, Basurto University Hospital (Osakidetza), Bilbao, Bizkaia, Spain. .,Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Bizkaia, Spain.
| | - Lidia García-Perez
- Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Bizkaia, Spain. .,Evaluation Service, Dirección del Servicio Canario de la Salud, Tenerife, Canary Islands, Spain.
| | - Gemma Navarro
- Epidemiologic Unit, Corporació Parc Tauli Clinic, Sabadell, Barcelona, Spain.
| | - Raul Quirós
- Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Bizkaia, Spain. .,Department of Internal Medicine, Costa del Sol Hospital, Marbella, Málaga, Spain.
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Crangle CJ, Latini DM, Hart TL. The effects of attachment and outness on illness adjustment among gay men with prostate cancer. Psychooncology 2015; 26:500-507. [PMID: 26626273 DOI: 10.1002/pon.4043] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 10/23/2015] [Accepted: 11/10/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Previous research has suggested that gay men facing prostate cancer may be particularly vulnerable to poor illness adjustment. Moreover, although attachment and greater disclosure of sexual orientation have been associated with health outcomes, their associations in this population have been largely unexamined. The purpose of the present study was to investigate whether greater outness about one's sexual orientation significantly mediated the associations between anxious and avoidant attachment and illness intrusiveness among gay men with prostate cancer. METHODS Ninety-two gay and bisexual men who had received a diagnosis of prostate cancer in the past 4 years were recruited for the present study. Self-report questionnaires assessed demographic and medical variables, attachment, outness level and comfort, and illness intrusiveness. Bootstrapping procedures were used to assess for mediation. RESULTS Results suggested significant associations between anxious attachment, outness comfort, and illness intrusiveness. Less comfort with outness significantly mediated the association between greater anxious attachment and more illness intrusiveness. Avoidant attachment was not significantly associated with illness intrusiveness. CONCLUSIONS Findings support the mediating role of the subjective experience of being an out gay man in the association between anxious attachment and illness intrusiveness. These results suggest that facilitating greater comfort with outness would be beneficial for illness adjustment among gay men with prostate cancer whom have more anxious attachment styles. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - David M Latini
- Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Tae L Hart
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
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Aasprang A, Andersen JR, Våge V, Kolotkin RL, Natvig GK. Psychosocial functioning before and after surgical treatment for morbid obesity: reliability and validation of the Norwegian version of obesity-related problem scale. PeerJ 2015; 3:e1275. [PMID: 26468434 PMCID: PMC4592151 DOI: 10.7717/peerj.1275] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 09/06/2015] [Indexed: 01/12/2023] Open
Abstract
Background. The aims of this study were to translate the Obesity-Related Problem scale (OP scale) into the Norwegian language and test its reliability, validity and responsiveness in a Norwegian sample. Method. The questionnaire (OP scale) was translated from the original language (Swedish) into Norwegian. Patients completed the questionnaire prior to and one year after sleeve gastrectomy. Internal consistency was evaluated using Cronbach's α. Construct validity was tested by correlating the OP-scale with the SF-36 and the Cantril Ladder using the Pearson correlation coefficient. An exploratory and confirmatory factor analysis was used to test the unidimensionality of the OP scale. Responsiveness was tested by assessing changes in the OP scale from baseline to one year post-surgery using the paired sample t-test. Floor and ceiling effect were calculated as percentages. Results. A total of 181 patients (123 women) accepted for bariatric surgery was included in the study. The mean age was 43.1 ± 12.5 years, and mean body mass index (BMI) before surgery was 45 ± 6.9. The mean value of the OP scale at baseline was 63.30 ± 24.43 (severe impairment) and 21.01 ± 20.98 at one year follow-up (mild impairment). Internal consistency was high at baseline (Cronbach's α 0.91). The floor effect was small at baseline and high at one year. The ceiling effect was small at baseline and at one year. Exploratory and conformatory factor analysis showed one factor with a high percent of explained variance. Correlations between OP scale at baseline, SF-36, Cantril Ladder and BMI were statistically significant and in the predicted direction to support validity of the Norwegian OP scale. After one year correlations between the change in OP scale and the change in SF-36 scores, Cantril Ladder and BMI were also statistically significant, except for the change in the Role Physical-scale. The OP scale showed greater responsiveness than either the SF-36 or Cantril Ladder. Conclusion. These results confirm that the Norwegian version of the OP scale is a valid and reliable instrument for measuring psychosocial functioning in patients with clinically severe obesity.
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Affiliation(s)
- Anny Aasprang
- Faculty of Health Studies, Sogn og Fjordane University Collage, Førde, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - John Roger Andersen
- Faculty of Health Studies, Sogn og Fjordane University Collage, Førde, Norway
- Department of Surgery, Førde Central Hospital, Førde, Norway
| | - Villy Våge
- Department of Surgey, Voss Hospital, Helse Bergen Trust, Voss, Norway
- Centre for Health Research, Førde Hospital Trust, Førde, Norway
| | - Ronette L. Kolotkin
- Faculty of Health Studies, Sogn og Fjordane University Collage, Førde, Norway
- Department of Surgery, Førde Central Hospital, Førde, Norway
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC, USA
- Quality of Life Consulting, PLLC, Durham, NC, USA
| | - Gerd Karin Natvig
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Shahrbanian S, Duquette P, Ahmed S, Mayo NE. Pain acts through fatigue to affect participation in individuals with multiple sclerosis. Qual Life Res 2015; 25:477-491. [DOI: 10.1007/s11136-015-1098-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2015] [Indexed: 11/28/2022]
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Cross-cultural adaptation and validation of the osteoporosis assessment questionnaire short version (OPAQ-SV) for Chinese osteoporotic fracture females. Clin Rheumatol 2015; 35:1003-10. [PMID: 26175100 DOI: 10.1007/s10067-015-3010-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 06/10/2015] [Accepted: 07/04/2015] [Indexed: 10/23/2022]
Abstract
The Osteoporosis Assessment Questionnaire Short Version (OPAQ-SV) was cross-culturally adapted to measure health-related quality of life in Chinese osteoporotic fracture females and then validated in China for its psychometric properties. Cross-cultural adaptation, including translation of the original OPAQ-SV into Mandarin Chinese language, was performed according to published guidelines. Validation of the newly cross-culturally adapted OPAQ-SV was conducted by sampling 234 Chinese osteoporotic fracture females and also a control group of 235 Chinese osteoporotic females without fractures, producing robust content, construct, and discriminant validation results. Major categories of reliability were also met: the Cronbach alpha coefficient was 0.975, indicating good internal consistency; the test-retest reliability was 0.80; and principal component analysis resulted in a 6-factor structure explaining 75.847 % of the total variance. Further, the Comparative Fit Index result was 0.922 following the modified model confirmatory factor analysis, and the chi-squared test was 1.98. The root mean squared error of approximation was 0.078. Moreover, significant differences were revealed between females with fractures and those without fractures across all domains (p < 0.001). Overall, the newly cross-culturally adapted OPAQ-SV appears to possess adequate validity and reliability and may be utilized in clinical trials to assess the health-related quality of life in Chinese osteoporotic fracture females.
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Maunder RG, Nolan RP, Park JS, James R, Newton G. Social support and the consequences of heart failure compared with other cardiac diseases: The contribution of support received within an attachment relationship. Arch Cardiovasc Dis 2015; 108:437-45. [PMID: 26073228 DOI: 10.1016/j.acvd.2015.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 03/16/2015] [Accepted: 03/17/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Interpersonal support is protective in heart disease, but sources of support and the quality of support may change over time, especially with aging and disease progression. AIMS To determine if support received within an attachment relationship with a spouse is more protective than other types. METHODS Subjects were sex- and age-matched cardiac outpatients with (n=40) or without (n=43) heart failure; they were studied with an observer-rated measure of attachment and self-report measures of other variables. RESULTS Having heart failure was associated with more depressive symptoms and illness intrusiveness. Although perceived social support did not differ in people with or without heart failure, those with heart failure had a spouse as the primary source of attachment functions less frequently than those without heart failure (50% vs 79%; P=0.006). Not having a spouse as the main provider of attachment functions was a partial mediator of the relationship between disease type (heart failure or no heart failure) and depressive symptoms (β=-0.24, t=-2.2; P=0.03) and deficits in non-attachment support made a further independent contribution (β=-0.24, t=-2.4; P=0.02). Neither perceived social support nor having a spouse serving attachment needs made a significant contribution to illness intrusiveness. CONCLUSION Having someone other than a spouse to provide attachment support is more common in cardiac patients who have heart failure and is associated with an increased risk of depressive symptoms.
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Affiliation(s)
- Robert G Maunder
- Department of Psychiatry, Mount Sinai Hospital, Room 915, Mount Sinai Hospital, 600, University Avenue, M5G 1X5 Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Robert P Nolan
- Faculty of Medicine, University of Toronto, Toronto, Canada; Behavioural Cardiology Research Unit, University Health Network, Toronto, Canada
| | - Jamie S Park
- Department of Psychiatry, Mount Sinai Hospital, Room 915, Mount Sinai Hospital, 600, University Avenue, M5G 1X5 Toronto, Ontario, Canada
| | - Richard James
- Department of Cardiology, North York General Hospital, Toronto, Canada
| | - Gary Newton
- Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Cardiology, Mount Sinai Hospital, Toronto, Canada
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Depp CA, Ceglowski J, Wang VC, Yaghouti F, Mausbach BT, Thompson WK, Granholm EL. Augmenting psychoeducation with a mobile intervention for bipolar disorder: a randomized controlled trial. J Affect Disord 2015; 174:23-30. [PMID: 25479050 PMCID: PMC4339469 DOI: 10.1016/j.jad.2014.10.053] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 10/28/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Psychosocial interventions for bipolar disorder are frequently unavailable and resource intensive. Mobile technology may improve access to evidence-based interventions and may increase their efficacy. We evaluated the feasibility, acceptability and efficacy of an augmentative mobile ecological momentary intervention targeting self-management of mood symptoms. METHODS This was a randomized single-blind controlled trial with 82 consumers diagnosed with bipolar disorder who completed a four-session psychoeducational intervention and were assigned to 10 weeks of either: 1) mobile device delivered interactive intervention linking patient-reported mood states with personalized self-management strategies, or 2) paper-and-pencil mood monitoring. Participants were assessed at baseline, 6 weeks (mid-point), 12 weeks (post-treatment), and 24 weeks (follow up) with clinician-rated depression and mania scales and self-reported functioning. RESULTS Retention at 12 weeks was 93% and both conditions were associated with high satisfaction. Compared to the paper-and-pencil condition, participants in the augmented mobile intervention condition showed significantly greater reductions in depressive symptoms at 6 and 12 weeks (Cohen׳s d for both were d=0.48). However, these effects were not maintained at 24-weeks follow up. Conditions did not differ significantly in the impact on manic symptoms or functional impairment. LIMITATIONS This was not a definitive trial and was not powered to detect moderators and mediators. CONCLUSIONS Automated mobile-phone intervention is feasible, acceptable, and may enhance the impact of brief psychoeducation on depressive symptoms in bipolar disorder. However, sustainment of gains from symptom self-management mobile interventions, once stopped, may be limited.
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Affiliation(s)
- Colin A Depp
- Department of Psychiatry, University of California, San Diego, CA, USA; VA San Diego Healthcare System, USA.
| | | | | | | | | | | | - Eric L Granholm
- Department of Psychiatry, UC San Diego,VA San Diego Healthcare System
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Zhang YP, Zhao XS, Zhang B, Zhang LL, Ni CP, Hao N, Shi CB, Porr C. Cross-cultural adaptation and psychometric assessment of the Chinese version of the comprehensive needs assessment tool for cancer caregivers (CNAT-C). Qual Life Res 2015; 24:1607-14. [PMID: 25702265 DOI: 10.1007/s11136-014-0891-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE The comprehensive needs assessment tool for cancer caregivers (CNAT-C) is a systematic and comprehensive needs assessment tool for the family caregivers. The purpose of this project was twofold: (1) to adapt the CNAT-C to Mainland China's cultural context and (2) to evaluate the psychometric properties of the newly adapted Chinese CNAT-C. METHODS Cross-cultural adaptation of the original CNAT-C was performed according to published guidelines. A pilot study was conducted in Mainland China with 30 Chinese family cancer caregivers. A subsequent validation study was conducted with 205 Chinese cancer caregivers from Mainland China. Construct validity was determined through exploratory and confirmatory factor analyses. Reliability was determined using internal consistency and test-retest reliability. RESULTS The split-half coefficient for the overall Chinese CNAT-C scale was 0.77. Principal component analysis resulted in an eight-factor structure explaining 68.11 % of the total variance. The comparative fit index (CFI) was 0.91 from the modified model confirmatory factor analysis. The Chi-square divided by degrees of freedom was 1.98, and the root mean squared error of approximation (RMSEA) was 0.079. In relation to the known-group validation, significant differences were found in the Chinese CNAT-C scale according to various caregiver characteristics. Internal consistency was high for the Chinese CNAT-C reaching a Cronbach α value of 0.94. Test-retest reliability was 0.85. CONCLUSIONS The newly adapted Chinese CNAT-C scale possesses adequate validity, test-retest reliability, and internal consistency and therefore may be used to ascertain holistic health and support needs of cancer patients' family caregivers in Mainland China.
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Affiliation(s)
- Yin-Ping Zhang
- Department of Nursing, Xi'an Jiaotong University Health Science Center, No.76, West Yanta Road, Xi'an, 710061, People's Republic of China,
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Devins GM, Wong JC, Payne AYM, Lebel S, Lee RNF, Mah K, Irish J, Rodin G. Distancing, self-esteem, and subjective well-being in head and neck cancer. Psychooncology 2015; 24:1506-13. [DOI: 10.1002/pon.3760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 12/15/2014] [Accepted: 12/23/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Gerald M. Devins
- Princess Margaret Cancer Center and University of Toronto; Canada
| | | | | | | | - Ruth N. F. Lee
- McMaster University Medical Centre and McMaster University; Canada
| | | | - Jonathan Irish
- Princess Margaret Cancer Center and University of Toronto; Canada
| | - Gary Rodin
- Princess Margaret Cancer Center and University of Toronto; Canada
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Gros DF. Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders. Psychiatry Res 2014; 220:275-82. [PMID: 25193379 DOI: 10.1016/j.psychres.2014.08.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 08/05/2014] [Accepted: 08/10/2014] [Indexed: 11/25/2022]
Abstract
Considerable attention has focused on the growing need for evidence-based psychotherapy for veterans with affective disorders within the Department of Veteran Affairs. Despite, and possibly due to, the large number of evidence-based protocols available, several obstacles remain in their widespread delivery within Veterans Affairs Medical Centers. In part as an effort to address these concerns, newer transdiagnostic approaches to psychotherapy have been developed to provide a single treatment that is capable of addressing several, related disorders. The goal of the present investigation was to develop and evaluate a transdiagnostic psychotherapy, Transdiagnostic Behavior Therapy (TBT), in veterans with affective disorders. Study 1 provided initial support for transdiagnostic presentation of evidence-based psychotherapy components in veterans with principal diagnoses of affective disorders (n=15). These findings were used to inform the development of the TBT protocol. In Study 2, an initial evaluation of TBT was completed in a second sample of veterans with principal diagnoses of affective disorders (n=29). The findings of Study 2 demonstrated significant improvements in symptoms of depression, anxiety, stress, posttraumatic stress, and related impairment across participants with various principal diagnoses. Together, the investigation provided preliminary support for effectiveness of TBT in veterans with affective disorders.
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Affiliation(s)
- Daniel F Gros
- Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
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The Barriers to Seeking Treatment for Obsessive-Compulsive Disorder in an Australian Population. BEHAVIOUR CHANGE 2014. [DOI: 10.1017/bec.2014.20] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Individuals with obsessive-compulsive disorder (OCD) experience a significant deterioration in quality of life (Fontenelle et al., 2010; Kugler et al., 2013) and marked functional impairment (Markarian et al., 2010). Despite this, a large proportion of these individuals do not seek any type of help (Goodwin, Koenen, Hellman, Guardino, & Struening, 2002; Mayerovitch et al., 2003). The current study investigated the barriers to seeking OCD treatment using an online survey that was completed by 86 participants living in Australia who identified as having OCD. Results showed that the three main barriers to seeking OCD treatment were: (a) preference for handling problems alone; (b) cost of treatment; and (c) lack of knowledge about available mental health treatment. Individuals who reported receiving an OCD diagnosis (n = 57) demonstrated more severe symptoms, poorer quality of life and higher symptom intrusiveness than those who had not received a diagnosis (n = 29). Furthermore, significant associations were found between religious affiliation and barriers to treatment where greater religious attendance was correlated with a higher likelihood of identifying cultural factors as a barrier to OCD treatment. Additionally, higher levels of religious attendance were associated with a greater understanding of where to go for OCD treatment, not wanting to handle problems alone, and recognising that symptoms are a problem. This article considers approaches to overcoming barriers to accessing effective evidence-based treatment for people with OCD symptoms, and highlights future directions for research.
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Emotional adjustment over 1 year post-diagnosis in patients with cancer: understanding and predicting adjustment trajectories. Support Care Cancer 2014; 23:1391-9. [DOI: 10.1007/s00520-014-2492-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 10/23/2014] [Indexed: 11/25/2022]
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Bidonde J, Busch AJ, Webber SC, Schachter CL, Danyliw A, Overend TJ, Richards RS, Rader T. Aquatic exercise training for fibromyalgia. Cochrane Database Syst Rev 2014; 2014:CD011336. [PMID: 25350761 PMCID: PMC10638613 DOI: 10.1002/14651858.cd011336] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Exercise training is commonly recommended for individuals with fibromyalgia. This review examined the effects of supervised group aquatic training programs (led by an instructor). We defined aquatic training as exercising in a pool while standing at waist, chest, or shoulder depth. This review is part of the update of the 'Exercise for treating fibromyalgia syndrome' review first published in 2002, and previously updated in 2007. OBJECTIVES The objective of this systematic review was to evaluate the benefits and harms of aquatic exercise training in adults with fibromyalgia. SEARCH METHODS We searched The Cochrane Library 2013, Issue 2 (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, NHS Economic Evaluation Database), MEDLINE, EMBASE, CINAHL, PEDro, Dissertation Abstracts, WHO international Clinical Trials Registry Platform, and AMED, as well as other sources (i.e., reference lists from key journals, identified articles, meta-analyses, and reviews of all types of treatment for fibromyalgia) from inception to October 2013. Using Cochrane methods, we screened citations, abstracts, and full-text articles. Subsequently, we identified aquatic exercise training studies. SELECTION CRITERIA Selection criteria were: a) full-text publication of a randomized controlled trial (RCT) in adults diagnosed with fibromyalgia based on published criteria, and b) between-group data for an aquatic intervention and a control or other intervention. We excluded studies if exercise in water was less than 50% of the full intervention. DATA COLLECTION AND ANALYSIS We independently assessed risk of bias and extracted data (24 outcomes), of which we designated seven as major outcomes: multidimensional function, self reported physical function, pain, stiffness, muscle strength, submaximal cardiorespiratory function, withdrawal rates and adverse effects. We resolved discordance through discussion. We evaluated interventions using mean differences (MD) or standardized mean differences (SMD) and 95% confidence intervals (95% CI). Where two or more studies provided data for an outcome, we carried out meta-analysis. In addition, we set and used a 15% threshold for calculation of clinically relevant differences. MAIN RESULTS We included 16 aquatic exercise training studies (N = 881; 866 women and 15 men). Nine studies compared aquatic exercise to control, five studies compared aquatic to land-based exercise, and two compared aquatic exercise to a different aquatic exercise program.We rated the risk of bias related to random sequence generation (selection bias), incomplete outcome data (attrition bias), selective reporting (reporting bias), blinding of outcome assessors (detection bias), and other bias as low. We rated blinding of participants and personnel (selection and performance bias) and allocation concealment (selection bias) as low risk and unclear. The assessment of the evidence showed limitations related to imprecision, high statistical heterogeneity, and wide confidence intervals. Aquatic versus controlWe found statistically significant improvements (P value < 0.05) in all of the major outcomes. Based on a 100-point scale, multidimensional function improved by six units (MD -5.97, 95% CI -9.06 to -2.88; number needed to treat (NNT) 5, 95% CI 3 to 9), self reported physical function by four units (MD -4.35, 95% CI -7.77 to -0.94; NNT 6, 95% CI 3 to 22), pain by seven units (MD -6.59, 95% CI -10.71 to -2.48; NNT 5, 95% CI 3 to 8), and stiffness by 18 units (MD -18.34, 95% CI -35.75 to -0.93; NNT 3, 95% CI 2 to 24) more in the aquatic than the control groups. The SMD for muscle strength as measured by knee extension and hand grip was 0.63 standard deviations higher compared to the control group (SMD 0.63, 95% CI 0.20 to 1.05; NNT 4, 95% CI 3 to 12) and cardiovascular submaximal function improved by 37 meters on six-minute walk test (95% CI 4.14 to 69.92). Only two major outcomes, stiffness and muscle strength, met the 15% threshold for clinical relevance (improved by 27% and 37% respectively). Withdrawals were similar in the aquatic and control groups and adverse effects were poorly reported, with no serious adverse effects reported. Aquatic versus land-basedThere were no statistically significant differences between interventions for multidimensional function, self reported physical function, pain or stiffness: 0.91 units (95% CI -4.01 to 5.83), -5.85 units (95% CI -12.33 to 0.63), -0.75 units (95% CI -10.72 to 9.23), and two units (95% CI -8.88 to 1.28) respectively (all based on a 100-point scale), or in submaximal cardiorespiratory function (three seconds on a 100-meter walk test, 95% CI -1.77 to 7.77). We found a statistically significant difference between interventions for strength, favoring land-based training (2.40 kilo pascals grip strength, 95% CI 4.52 to 0.28). None of the outcomes in the aquatic versus land comparison reached clinically relevant differences of 15%. Withdrawals were similar in the aquatic and land groups and adverse effects were poorly reported, with no serious adverse effects in either group. Aquatic versus aquatic (Ai Chi versus stretching in the water, exercise in pool water versus exercise in sea water)Among the major outcomes the only statistically significant difference between interventions was for stiffness, favoring Ai Chi (1.00 on a 100-point scale, 95% CI 0.31 to 1.69). AUTHORS' CONCLUSIONS Low to moderate quality evidence relative to control suggests that aquatic training is beneficial for improving wellness, symptoms, and fitness in adults with fibromyalgia. Very low to low quality evidence suggests that there are benefits of aquatic and land-based exercise, except in muscle strength (very low quality evidence favoring land). No serious adverse effects were reported.
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Affiliation(s)
- Julia Bidonde
- University of SaskatchewanCommunity Health & Epidemiology107 Wiggins RdSaskatoonSKCanadaS7N 5E5
| | - Angela J Busch
- University of SaskatchewanSchool of Physical Therapy1121 College DriveSaskatoonSKCanadaS7N 0W3
| | - Sandra C Webber
- University of ManitobaCollege of Rehabilitation Sciences, Faculty of Health SciencesR106‐771 McDermot AvenueWinnipegMBCanadaR3E 0T6
| | | | | | - Tom J Overend
- University of Western OntarioSchool of Physical TherapyElborn College, Room 1588,School of Physical Therapy, University of Western OntarioLondonONCanadaN6G 1H1
| | | | - Tamara Rader
- Cochrane Musculoskeletal GroupOttawa Hospital Research Institute501 Smyth RoadOttawaONCanadaK1H 8L6
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Contribution of symptom clusters to multiple sclerosis consequences. Qual Life Res 2014; 24:617-29. [DOI: 10.1007/s11136-014-0804-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2014] [Indexed: 10/24/2022]
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Jacoby A, Ring A, Whitehead M, Marson A, Baker GA. Exploring loss and replacement of loss for understanding the impacts of epilepsy onset: a qualitative investigation. Epilepsy Behav 2014; 33:59-68. [PMID: 24632355 DOI: 10.1016/j.yebeh.2014.02.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/11/2014] [Accepted: 02/13/2014] [Indexed: 11/27/2022]
Abstract
Previous research identifies loss as a key concept for our understanding of the impact of chronic illness. In this in-depth qualitative study, we explored the utility of the concept of loss and loss replacement as a means of gaining a fuller understanding of the implications of a diagnosis of epilepsy for overall quality of life (QOL). Potential participants were identified from the database of a large UK-based randomized controlled trial of antiepileptic drug treatment for new-onset epilepsy and selected using purposive sampling methods. In-depth interviews were conducted with 67 people; interview material was analyzed thematically. Our findings confirm 'loss' as a key concept in understanding epilepsy impact. Participants cited profound physical and social losses, and the links between these and psychological loss were clearly articulated. Informants described two main processes via which the linked losses they experienced occurred: personal withdrawal processes and externally enforced processes. Seizure control was integral to restoring psychological well-being and a sense of normality but was only one of a number of influences moderating the degree of loss experienced following seizure onset. Our work emphasizes that people with epilepsy (PWE) require active support for their continued engagement or reengagement in roles and activities identified as central to their psychological well-being and overall QOL. Achieving this requires a multiagency approach to drive forward key strategies for reduction of the negative impacts of epilepsy and to engender a sense of normality in the context of a condition often experienced as placing the individual outside the socially determined parameters of the 'normal'.
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Affiliation(s)
- Ann Jacoby
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK.
| | - Adele Ring
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK
| | - Margaret Whitehead
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK
| | - Anthony Marson
- Department of Molecular & Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Gus A Baker
- Department of Molecular & Clinical Pharmacology, University of Liverpool, Liverpool, UK
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Streiner DL, Kottner J. Recommendations for reporting the results of studies of instrument and scale development and testing. J Adv Nurs 2014; 70:1970-1979. [PMID: 24684713 DOI: 10.1111/jan.12402] [Citation(s) in RCA: 196] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2014] [Indexed: 01/28/2023]
Abstract
Scales and instruments play an important role in health research and practice. It is important that studies that report on their psychometric properties do so in a way such that readers can understand what was done and what was found. This paper is a guide to writing articles about the development and assessment of these tools. It covers what should be in the abstract and how key words should be chosen. The article then discusses what should be in the main parts of the paper: the introduction, methods, results and discussion. In each of these parts, it suggests the statistical tests that should be used and how to report them. The emphasis throughout the paper is that reliability and validity are not fixed properties of a scale, but depend on an interaction among it, the population being evaluated and the circumstances under which the instrument is administered.
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Affiliation(s)
- David L Streiner
- University of Toronto - Psychiatry, Toronto, Ontario, Canada.,McMaster University - Psychiatry & Behavioural Neurosciences, Hamilton, Ontario, Canada
| | - Jan Kottner
- Charité-Universitätsmedizin Berlin - Clinical Research Center for Hair and Skin Science, Germany
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Arès I, Lebel S, Bielajew C. The impact of motherhood on perceived stress, illness intrusiveness and fear of cancer recurrence in young breast cancer survivors over time. Psychol Health 2014; 29:651-70. [PMID: 24410202 DOI: 10.1080/08870446.2014.881998] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Parenting while coping with breast cancer can be challenging for many young women, yet little is known about the impact of motherhood on their well-being over time. DESIGN The first part of this study examined differences in perceived stress, illness intrusiveness and fear of cancer recurrence between young breast cancer survivors with and without children in two separate time frames (0-5 and 5-15 years since diagnosis). The second part identified determinants for these elements of well-being in young mothers exclusively. MAIN OUTCOME MEASURES Seven hundred and forty two young North American women previously diagnosed with breast cancer completed measures of perceived stress, illness intrusiveness, fear of cancer recurrence and parenting stress (mothers only) via a web-based survey. RESULTS Compared to young survivors without children, young mothers reported higher levels of fear of cancer recurrence and illness intrusiveness in intimate life domains during both time frames. Part 2 revealed how maternal age, age of children, time since diagnosis and parenting stress impacted on well-being in this group. CONCLUSIONS Young mothers with breast cancer need support to manage their fears of having a recurrence and to cope with problems in intimacy well into remission. This study identifies the most vulnerable groups of mothers.
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Affiliation(s)
- Isabelle Arès
- a School of Psychology , University of Ottawa , Ottawa , Canada
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Gros DF, Milanak ME, Hershenberg R. CONVERGENCE OF DEPRESSION AND ANXIETY SYMPTOMS IN FRIENDSHIP DYADS. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2013; 32:1061-1074. [PMID: 25089072 DOI: 10.1521/jscp.2013.32.10.1061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Despite psychometric rationale to include multiple informants, psychological assessment typically involves data collected from the patient (target) only, particularly with regard to depressive and anxious symptomatology. This study addressed this gap in the literature by assessing convergence between targets and their close friends (informants) in an ethnically diverse sample of young adults. One hundred and thirty-nine friendship dyads completed a packet of questionnaires including different versions administered to the targets and informants, with targets completing the standard questionnaire battery focused on their own symptoms and informants completing questionnaires on their view of the target participants' symptoms, rather than their own characteristics. Measures were included to assess a wide range of symptomatology, including behavioral, cognitive, and physiological symptoms of anxiety and depression. The target-informant correlations were largely significant and of small-to-medium magnitude. In addition, target-informant agreement was higher in more visible symptoms (e.g., behavioral) than in less visible symptoms (e.g., physiological) of anxiety and depression. Interestingly, level of closeness in the relationship did not influence the magnitude of correlations. Implications for future research and integration into clinical assessment practices are discussed.
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Affiliation(s)
- Daniel F Gros
- Ralph H. Johnson VA Medical Center and Medical University of South Carolina
| | - Melissa E Milanak
- Ralph H. Johnson VA Medical Center and Medical University of South Carolina
| | - Rachel Hershenberg
- Ralph H. Johnson VA Medical Center and Medical University of South Carolina
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45
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Wong Sarver N, Gros DF. A Modern Behavioral Treatment to Address Fetishism and Associated Functional Impairment. Clin Case Stud 2013. [DOI: 10.1177/1534650113512020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The clinical research and treatment options for sexual paraphilias are scant and have generally been limited to psychodynamic and early behavioral approaches. This article highlights the application of two existing evidence-based modern behavioral interventions, specifically behavioral activation and sensate focused therapy, to treat foot fetishism/sexual impulses and co-occurring mood/anxiety symptoms in a 57-year-old male Vietnam War veteran. This brief 6-week treatment addressed the patient’s complicating psychosocial factors and medical conditions, and focused on targeting behavioral avoidance symptoms associated with fetishism and depression (e.g., increasing socially and sexually appropriate and positive reinforcing behaviors in his environment). The patient no longer met diagnostic criteria for fetishism and endorsed significant reductions in depressed mood, anxiety, and stress at post-treatment and 1-month follow-up. This case illustrated how current behavioral treatments may be used to successfully treat patients with rare symptom presentations who may otherwise be neglected within a medical system.
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Affiliation(s)
| | - Daniel F. Gros
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
- Medical University of South Carolina, Charleston, USA
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Snyder S, Foley FW, Farrell E, Beier M, Zemon V. Psychological and physical predictors of illness intrusiveness in patients with multiple sclerosis. J Neurol Sci 2013; 332:41-4. [DOI: 10.1016/j.jns.2013.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 06/10/2013] [Accepted: 06/12/2013] [Indexed: 10/26/2022]
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Validity and reliability of the Spanish version of the Involvement Evaluation Questionnaire among caregivers of patients with eating disorders. Psychiatry Res 2012; 200:896-903. [PMID: 22884308 DOI: 10.1016/j.psychres.2012.07.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 07/13/2012] [Accepted: 07/23/2012] [Indexed: 12/22/2022]
Abstract
The Involvement Evaluation Questionnaire (IEQ) was developed to evaluate burden among caregivers of patients with schizophrenia. We aimed to examine its psychometric properties among caregivers of patients with eating disorders (ED). A prospective study was carried out, recruiting caregivers of patients with an ED attending two outpatient clinics in Bizkaia, Spain. Caregivers provided sociodemographic information and completed the Involvement Evaluation Questionnaire (IEQ), the Hospital Anxiety and Depression Scale (HADS), the Short-Form 12 (SF-12) and the Anorectic Behaviour Observation Scale (ABOS). The same information was requested one year later. The confirmatory factor analysis (CFA) provided satisfactory fit indexes. Almost all of the factor loadings were above 0.40. Cronbach's alpha coefficients were mostly superior to 0.70. The correlation coefficients between the IEQ domains and the other questionnaires were lower than the Cronbach's alpha coefficients. Known-groups validity was supported by significant differences in the IEQ mean scores according to certain variables, as contact hours, living with the patient, type of caregiver and gender. The indexes employed for the evaluation of responsiveness were between 0.13 and 0.99. The IEQ has good psychometric properties and can be used to evaluate burden among caregivers of patients with ED.
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Vergara I, Bilbao A, Orive M, Garcia-Gutierrez S, Navarro G, Quintana JM. Validation of the Spanish version of the Lawton IADL Scale for its application in elderly people. Health Qual Life Outcomes 2012; 10:130. [PMID: 23110491 PMCID: PMC3541128 DOI: 10.1186/1477-7525-10-130] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 10/15/2012] [Indexed: 12/02/2022] Open
Abstract
Background The adequate information about the functional capacity of elderly populations is a key for the comprehensive assessment of their health status and autonomy. The Lawton IADL (instrumental activities of daily living) Scale is a very often used scale to assess independent living skills, but has never been validated for its use in Spanish-speaking populations. The purpose of this study was to assess the validity, the reliability, and responsiveness of this widely used scale. Methods The validation was based on a prospective cohort of 1,965 patients aged 65 or over who suffered an accidental fall with a hip or wrist fracture as a result. These patients were followed up six months after the production of the fracture. Cronbach’s alpha was used to assess reliability, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) for the construct validity. Convergent and discriminant validity were examined by the correlation of the IADL Scale with the Barthel Index, SF-12, WOMAC short form, and QuickDASH questionnaires. Known-groups validity was also studied comparing IADL Scale according to different groups, and responsiveness was assessed by means of effect sizes. Results The mean age was 80.04 years (SD 8.04). The Cronbach alpha coefficient was 0.94. In the EFA, factor loadings ranged from 0.67 to 0.90, and CFA confirmed the homogeneity of the construct. Regarding the convergent validity, all correlation coefficients were higher than 0.40. Significant differences were found according to different groups, supporting known-groups validity. Responsiveness parameters showed moderate to large changes (effect sizes, 0.79 and 0.84 among patients classified as worsened). Conclusions These results confirm that the Spanish version of the Lawton IADL Scale has excellent reliability and validity and a moderate to large sensitivity to change. This study provides a proper validation, not only of the Spanish version of the Lawton IADL Scale, but also of the original instrument.
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Affiliation(s)
- Itziar Vergara
- Primary Care Research Unit-Gipuzkoa, Osakidetza, Spain-Red de investigación en servicios de salud en enfermedades crónicas (REDISSEC), P, Dr Beguiristain s/n, San Sebastian, Spain.
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Sisler JJ, Taylor-Brown J, Nugent Z, Bell D, Khawaja M, Czaykowski P, Wirtzfeld D, Park J, Ahmed S. Continuity of care of colorectal cancer survivors at the end of treatment: the oncology–primary care interface. J Cancer Surviv 2012; 6:468-75. [DOI: 10.1007/s11764-012-0235-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Accepted: 07/15/2012] [Indexed: 12/31/2022]
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Eskander A, Devins GM, Freeman J, Wei AC, Rotstein L, Chauhan N, Sawka AM, Brown D, Irish J, Gilbert R, Gullane P, Higgins K, Enepekides D, Goldstein D. Waiting for thyroid surgery: A study of psychological morbidity and determinants of health associated with long wait times for thyroid surgery. Laryngoscope 2012; 123:541-7. [DOI: 10.1002/lary.23503] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2012] [Indexed: 11/11/2022]
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