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Roose E, Huysmans E, Leysen L, Mostaqim K, Van Wilgen P, Beckwée D, De Couck M, Timmermans A, Bults R, Nijs J, Lahousse A. Effect of perceived injustice-targeted pain neuroscience education compared with biomedically focused education in breast cancer survivors: a study protocol for a multicentre randomised controlled trial (BCS-PI trial). BMJ Open 2024; 14:e075779. [PMID: 38233049 PMCID: PMC10806532 DOI: 10.1136/bmjopen-2023-075779] [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] [Received: 05/18/2023] [Accepted: 11/08/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Current treatments for pain in breast cancer survivors (BCSs) are mostly biomedically focused rather than biopsychosocially driven. However, 22% of BCSs with pain are experiencing perceived injustice, which is a known predictor for adverse pain outcomes and opioid prescription due to increased maladaptive pain behaviour. Educational interventions such as pain neuroscience education (PNE) are suggested to target perceived injustice. In addition, motivational interviewing can be an effective behavioural change technique. This trial aims to examine whether perceived injustice-targeted PNE with the integration of motivational interviewing is superior to biomedically focused pain education in reducing pain after 12 months in BCS with perceived injustice and pain. In addition, improvements in quality of life, perceived injustice and opioid use are evaluated, and a cost-effectiveness analysis will finally result in a recommendation concerning the use of perceived injustice-targeted PNE in BCSs with perceived injustice and pain. METHODS AND ANALYSIS This two-arm multicentre randomised controlled trial will recruit female BCS (n=156) with pain and perceived injustice. Participants will be randomly assigned to perceived injustice-targeted PNE or biomedically focused pain education in each centre. Both interventions include an online session, an information leaflet and three one-to-one sessions. The primary outcome (pain), secondary outcomes (quality of life, perceived injustice and outcomes for cost-effectiveness analysis) and explanatory outcomes (pain phenotyping, sleep, fatigue and cognitive-emotional factors) will be assessed at baseline and at 0, 6, 12 and 24 months postintervention using self-reported questionnaires online. Treatment effects over time will be evaluated using linear mixed model analyses. Additionally, a cost-utility analysis will be done from a healthcare payer and societal perspective. ETHICS AND DISSEMINATION The ethical agreement was obtained from the Main Ethics Committee (B.U.N.1432020000068) at the University Hospital Brussels and all other participating hospitals. Study results will be disseminated through presentations, conferences, social media, press and journals. TRIAL REGISTRATION NUMBER NCT04730154.
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Affiliation(s)
- Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- REVAL Research Group, Universiteit Hasselt, Diepenbeek, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Research Foundation-Flanders, (FWO), Brussels, Belgium
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Research Foundation-Flanders, (FWO), Brussels, Belgium
| | - Paul Van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Transcare Pain Transdisciplinary Pain Treatment Center, Groningen, Netherlands
| | - David Beckwée
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
| | - Marijke De Couck
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Rinske Bults
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gotenburg, Sweden
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Lyu MM, Chiew-Jiat RS, Cheng KKF. The effects of physical symptoms, self-efficacy and social constraints on fear of cancer recurrence in breast cancer survivors: Examining the mediating role of illness representations. Psychooncology 2024; 33:e6264. [PMID: 38047719 DOI: 10.1002/pon.6264] [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: 03/01/2023] [Revised: 07/24/2023] [Accepted: 11/22/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is common in breast cancer survivors (BCS). This study examined the mediating role of illness representations in the relationships between FCR and physical symptoms, social constraint and self-care self-efficacy. METHODS In this cross-sectional study, 385 women with breast cancer completed a series of questionnaires including the FCR Inventory, Social Constraints Scale-15, Cancer Survivors Self-Efficacy Scale, Illness Perception Questionnaire-Revised and European Organization for Research and Treatment Quality of Life Questionnaire-Breast Cancer. Structural equation modelling method was conduct by using a bootstrapping method. RESULTS Physical symptoms (β = 0.272, p < 0.01), social constraints (β = 0.130, p < 0.01), self-efficacy (β = -0.233, p < 0.01) and illness representation (β = 0.261, p < 0.01) have direct effects on FCR. The indirect effects of physical symptoms (β = 0.10, p < 0.01), social constraints (β = 0.076, p < 0.01) and self-efficacy (β = -0.025, p < 0.05) on FCR were partially mediated by illness representations. CONCLUSIONS In this study, the effects of physical symptoms, social constraints and self-efficacy on FCR were found to be mediated by illness representation. Reducing the impact of negative illness representations on FCR by reducing physical symptoms, increasing self-efficacy, and promoting open disclosure of cancer-related concerns may be effective in reducing FCR in BCS.
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Affiliation(s)
- Meng-Meng Lyu
- National University of Singapore, Singapore, Singapore
| | | | - Karis Kin Fong Cheng
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Cai Y, Zhang Y, Cao W, Guo VY, Deng Y, Luo L, Shen J, Zhu Y, Chen X, Yang X, Hou F, Li J. Preliminary Validation of the Revised Illness Perception Questionnaire for Patients with Nasopharyngeal Carcinoma in China. Healthcare (Basel) 2023; 11:2469. [PMID: 37761666 PMCID: PMC10530590 DOI: 10.3390/healthcare11182469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/15/2023] [Accepted: 09/03/2023] [Indexed: 09/29/2023] Open
Abstract
Nasopharyngeal carcinoma is a common and highly malignant cancer in southern China. It is important to accurately assess the illness perception of nasopharyngeal carcinoma according to the common-sense model of self-regulation. The purpose was to validate the Chinese version of the Revised Illness Perception Questionnaire for patients with Nasopharyngeal carcinoma. A cross-sectional survey of 631 patients with Nasopharyngeal carcinoma was conducted in Guangzhou, China. The reliability of the scale was evaluated using Cronbach's alpha. The factor structure was assessed using exploratory factor analysis (EFA) of each dimension. The EFA revealed that the 29-item self-rated scale has a seven-factor structure consistent with the original scale and explained 67.3% of the variance after extraction and rotation. The scale showed satisfactory reliability. The item-total correlations ranged from -0.16 to 0.64 (p < 0.05). The item-subscale correlations ranged from 0.46 to 0.91 (p < 0.05). The item-other subscale correlations ranged from -0.38 to 0.51 and from -0.21 to 0.56 (p < 0.05). Significant correlations were found between the timeline (acute/chronic) (r = 0.224, r = 0.166), consequences (r = 0.415, r = 0.338), timeline cyclical (r = 0.366, r = 0.284), emotional representations (r = 0.497, r = 0.465), personal control (r = -0.122, r = -0.134), treatment control (r = -0.135, r = -0.148), and illness coherence (r = -0.261, r = -0.213) subscales, and depression, anxiety (p < 0.05). The scale revealed acceptable reliability, factorial validity, and construct validity. It could be used to assess the illness representations of Chinese patients with nasopharyngeal carcinoma.
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Affiliation(s)
- Yuqi Cai
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Yuan Zhang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510080, China
| | - Wangnan Cao
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100871, China
| | - Vivian Yawei Guo
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Yang Deng
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Liying Luo
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Jianling Shen
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Yang Zhu
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Xiaoting Chen
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Xiao Yang
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
| | - Fengsu Hou
- Shenzhen Kangning Hospital/Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Jinghua Li
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China (J.L.)
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Chen J, Guo Z, Luo X, Zhang Y, Zhang X, Li M, Xiong C, Zhao M, Yan J. Longitudinal trajectories of illness perception regarding breast cancer-related lymphedema among women with breast cancer. J Psychosom Res 2023; 170:111344. [PMID: 37178472 DOI: 10.1016/j.jpsychores.2023.111344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 03/19/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To identify longitudinal trajectories of illness perception (IP) regarding breast cancer-related lymphedema (BCRL) in the first six months after surgery among women with breast cancer and to explore the predictive effects of demographics and clinical factors on IP trajectories. METHODS From August 2019 to August 2021, a total of 352 patients participated in this study, 328 of whom were included in the data analysis. Demographic and clinical characteristics were collected at baseline (1-3 days after surgery). The BCRL-specific revised illness perception questionnaire was used to measure IP regarding BCRL at baseline and 1 month, 3 months and 6 months post-surgery. A multilevel model was conducted to analyze the data. RESULTS Over the first six months post-surgery, the "timeline acute/chronic" and "illness coherence" dimensions showed positive growth trajectories; the "personal control" and "treatment control" dimensions presented negative growth trajectories; and the trajectories of identity, consequences, cyclicality and emotional influence perceptions regarding BCRL showed no significant changes. Age, education level, marital status, employment status, family monthly income per person, cancer stage and status of removed lymph nodes were indicated to be predictive factors of IP trajectories. CONCLUSIONS The present study determined significant changes over the first six months post-surgery in four IP dimensions and predictive effects of some demographics and clinical details on IP trajectories. These findings may help healthcare providers know more about the dynamic characteristics of IPs regarding BCRL in patients with breast cancer and assist them in identifying patients with a tendency toward improper IP regarding BCRL.
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Affiliation(s)
- Jing Chen
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Zijun Guo
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Xia Luo
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Yue Zhang
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Xiaomin Zhang
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Mingfang Li
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Chenxia Xiong
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Meng Zhao
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China
| | - Jun Yan
- School of Nursing, Sun Yat-Sen University, No. 74, Zhongshan II Road, Guangzhou, Guangdong Province, China.
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Luo X, Zhang L, Chen J, Zhang Y, Yan J. The Predictive Role of Illness Perception on Lymphedema Risk-Management Behaviors in Women After Breast Cancer Surgery: A Longitudinal Study. Cancer Nurs 2023; Publish Ahead of Print:00002820-990000000-00115. [PMID: 36881651 DOI: 10.1097/ncc.0000000000001225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND Illness perception affects lymphedema risk-management behaviors. However, little is known about these behavioral changes within 6 months after surgery and how illness perception predicts behavioral trajectories. OBJECTIVE The aim of this study was to explore the trajectories of lymphedema risk-management behaviors in breast cancer survivors within 6 months after surgery and the predictive role of illness perception. METHODS Participants were recruited from a cancer hospital in China and completed a baseline survey (Revised Illness Perception Questionnaire) and follow-up assessments (Lymphedema Risk-Management Behavior Questionnaire and the physical exercise compliance dimension of the Functional Exercise Adherence Scale) at the first, third, and sixth months postoperatively. RESULTS A total of 251 women were analyzed. Regarding the Lymphedema Risk-Management Behavior Questionnaire, the total scores were stable. The scores of the "lifestyle" and "skin care" dimensions showed upward trends; the scores of the "avoiding compression and injury" and "other matters needing attention" dimensions showed downward trends. For "physical exercise compliance," scores remained stable. Furthermore, key illness perceptions (especially "personal control" and "causes") at baseline could predict the starting levels of and changes in behavioral trajectories. CONCLUSION Different lymphedema risk-management behaviors exhibited different trajectories and could be predicted by illness perception. IMPLICATIONS FOR PRACTICE Oncology nurses should focus on the early development of behaviors related to "lifestyle" and "skin care" and the later maintenance of "avoiding compression and injury" and "other matters needing attention" during follow-up, as well as help women strengthen their personal control beliefs and correctly understand the causes of lymphedema during hospitalization.
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Affiliation(s)
- Xia Luo
- Author Affiliations: School of Nursing, Sun Yat-sen University (Mss Luo, Chen, and Y. Zhang, and Dr Yan); and Department of Breast Oncology, Sun Yat-sen University Cancer Center (Mrs L. Zhang), Guangzhou, China
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Truong DM, Mire SS, Day SX, Ni L, Keller-Margulis M. A cross-cultural comparison of a measure of parent perceptions among families of children with autism in Vietnam. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:997-1010. [PMID: 36510836 DOI: 10.1177/13623613221141262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
LAY ABSTRACT Raising an autistic child can affect many aspects of families' lives. Parents are responsible for many decisions, from initiating evaluation to selecting and implementing treatments. How parents conceptualize the course and nature of their child's diagnosis influences these processes and parents' own well-being. Parents' perceptions about their children's autism are also affected by cultural contexts and understanding of autism. The Illness Perception Questionnaire-Revised (IPQ-R) is widely used to study cognitions in chronic health research and has been adapted and validated to measure parents' perceptions and beliefs about their children's ASD (IPQ-R-ASD). However, such studies are mostly conducted in high-income countries (HICs) with western, individualistic cultural values (e.g. United States, Canada). Therefore, it is unclear whether the IPQ-R-ASD is a useful instrument in understanding parents' perceptions of autism in Vietnam, a lower- and middle-income country (LMIC) with collectivistic Asian cultural values. These differences suggest that parents in Vietnam may have cognitive representations of their children's autism that differ from those of parents living in HIC, western countries. The purpose of this study was to examine the usability of the translated Vietnamese IPQ-R-ASD that may, ultimately, help explore Vietnamese parents' autism perceptions. While the study's result indicated the usability of the translated measure in Vietnam, when interpreted with Vietnamese norms, results also highlighted notable differences between Vietnamese and North American parents' perceptions of autism that warrant further research.
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Affiliation(s)
| | | | | | - Lan Ni
- University of Houston, USA
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Fan Z, Chen H, Wu H, Zhang X. Patient Toward Physician Occupational Stigma Scale: Development of the Chinese Version. Psychol Res Behav Manag 2022; 15:2117-2127. [PMID: 35983020 PMCID: PMC9379113 DOI: 10.2147/prbm.s375032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/31/2022] [Indexed: 01/17/2023] Open
Abstract
Background/Objective Physicians’ occupational stigma could eradicate physician-patient trust, threatening physicians’ social status and occupational reputation. Hitherto, there has been no scale obtaining good psychometric properties to assess patients’ stigma toward physicians. The present study aimed to develop the Patient toward Physician Occupational Stigma Scale (PPOSS) and examine its reliability and validity. Methods The questionnaire comprising sociodemographic information and the PPOSS were employed to survey 645 Chinese patients in two phases. In Sample 2, the Wake Forest Physician Trust Scale (WFOTS), the Intolerance of Uncertainty Scale-12 (IUS-12), and the Brief Illness Perception Questionnaire (BIPQ) were tested. Results The PPOSS includes 19 items subsumed into three dimensions of stereotype, discrimination, and prejudice. According to the results of confirmatory factor analysis (CFA), the three-factor model fitted well (χ2/df=2.065, RMSEA=0.057, SRMR=0.045, RFI=0.904, CFI=0.956, IFI=0.956, PNFI=0.779, PCFI=0.811). The PPOSS was significantly negatively correlated with the WFOTS, and significantly positively correlated with the IUS-12 and the BIPQ. The Cronbach’s alpha coefficients for the total scale and each dimension were between 0.87 and 0.94, and the split-half reliability coefficients were between 0.84 and 0.93. Besides, the PPOSS had the measurement invariance across gender. Conclusion With its satisfactory psychometric properties, the PPOSS can be used as an effective instrument to assess patients’ stigma toward physicians.
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Affiliation(s)
- Zhiguang Fan
- Department of Education, Jilin International Studies University, Changchun City, Jilin Province, People's Republic of China.,Department of Marxism, Changchun University of Chinese Medicine, Changchun City, Jilin Province, People's Republic of China
| | - Hongyan Chen
- Department of Chinese Medicine, Changchun University of Chinese Medicine, Changchun City, Jilin Province, People's Republic of China
| | - Hanwei Wu
- Department of English, Jilin International Studies University, Changchun City, Jilin Province, People's Republic of China
| | - Xinghai Zhang
- Department of Marxism, Changchun University of Chinese Medicine, Changchun City, Jilin Province, People's Republic of China
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Illness perceptions and adherence to breast cancer-related lymphedema risk management behaviours among breast cancer survivors. Eur J Oncol Nurs 2022; 58:102144. [DOI: 10.1016/j.ejon.2022.102144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/29/2022] [Accepted: 04/14/2022] [Indexed: 11/18/2022]
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Laranjeira C, Querido AI, Valentim O. Psychometric properties of the revised illness perception questionnaire for people with alcohol use disorder in Portugal. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1916848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Research in Education and Community Intervention (RECI), Viseu, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic Institute of Leiria, Leiria, Portugal
| | - Ana Isabel Querido
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic Institute of Leiria, Leiria, Portugal
- Center for Research in Health and Information Systems (CINTESIS, NursID, University of Porto, Porto, Portugal
| | - Olga Valentim
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Center for Research in Health and Information Systems (CINTESIS, NursID, University of Porto, Porto, Portugal
- Regional Health Administration of Lisbon and Tagus Valley, Taipas Center Withdrawal Unit, Lisboa, Portugal
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Paramanandam VS, Lee MJ, Kilbreath SL, Dylke ES. Self-reported questionnaires for lymphoedema: a systematic review of measurement properties using COSMIN framework. Acta Oncol 2021; 60:379-391. [PMID: 33475033 DOI: 10.1080/0284186x.2020.1862422] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Lymphoedema may develop as a result of numerous genetic and traumatic causes; however, treatment for cancer is the most common cause of its development in more economically developed nations. This systematic review critically appraised, compared and summarised the measurement properties of lymphoedema-specific self-reported questionnaires (SRQs) measuring various patient-reported outcomes including quality of life (QOL), function, morbidity, and symptoms. METHODS Seven databases were searched to identify studies of the measurement properties of SRQs. Two review teams independently evaluated the quality of the individual studies using the risk of bias tool from the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). Measurement properties of the SRQs presented in the studies were then rated. Study level ratings were summarised for an SRQ if they were reported in multiple studies, and their overall quality of the evidence were then graded. RESULTS Forty articles, reporting on 19 SRQs were identified from 8615 records. The focus of the 19 SRQs included eight on QOL, four on symptoms, two on function, and two on impairment. The other three SRQs were on illness perception, self-efficacy, and patient-relevant treatment benefit, respectively. Eight and three SRQs were upper limb and lower limb-specific, respectively, whereas seven questionnaires were for both upper and lower limb lymphoedema. One SRQ was developed for head and neck lymphoedema. According to the COSMIN framework, none of the SRQs reviewed had sufficient evidence to support all nine measurement properties. In lower limb questionnaires, the LYMQOL-leg has sufficient content, structural, and construct validity as well as internal consistency and reliability. For upper limb lymphoedema questionnaires, the Lymph-ICF-UL had sufficient content and construct validity as well as reliability. CONCLUSION LYMQOL-leg SRQ is recommended with confidence for evaluation of QOL of people with lower limb lymphoedema while the Lymph-ICF-UL is recommended for evaluation of the QOL of the breast cancer-related lymphoedema with some confidence. In view of the high level of the indeterminate ratings of the measurement properties of the existing SRQs, further research is desirable.
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Affiliation(s)
- Vincent Singh Paramanandam
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
- Physiotherapy Department, Tata Memorial Hospital, Mumbai, India
| | - Mi-Joung Lee
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Sharon L. Kilbreath
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Elizabeth S. Dylke
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
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