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How does integrative oncology influence patients’ physical and psychosocial outcomes, and what are patients, carers and healthcare professionals’ experiences? An integrative review. Semin Oncol Nurs 2022; 38:151258. [DOI: 10.1016/j.soncn.2022.151258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/05/2022] [Indexed: 11/19/2022]
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Fernando SS, Paige EK, Dendle C, Weinkove R, Kong DCM, Omond P, Routledge DJ, Szer J, Blyth CC. Consensus guidelines for improving patients' understanding of invasive fungal disease and related risk prevention in the haematology/oncology setting, 2021. Intern Med J 2021; 51 Suppl 7:220-233. [PMID: 34937138 DOI: 10.1111/imj.15593] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Patients with invasive fungal disease (IFD) are at significant risk of morbidity and mortality. A productive partnership between patients, their carers/families, and the multidisciplinary team managing the infection and any underlying conditions, is essential. Sharing information and addressing knowledge gaps are required to ensure those at risk of IFD avoid infection, while those with suspected or confirmed infection optimise their therapy and avoid toxicities. This new addition to the Australian and New Zealand consensus guidelines for the management of IFD and antifungal use in the haematology/oncology setting outlines the key information needs of patients and their carers/families. It specifically addresses risk factor reduction, antifungal agents and adherence, and the risks and benefits of complementary and alternative therapies. Knowledge gaps are also identified to help inform the future research agenda.
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Affiliation(s)
| | - Emma K Paige
- Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia
| | - Claire Dendle
- Infection and Immunity Service, Monash Health, Melbourne, Victoria, Australia.,School of Clinical Sciences, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robert Weinkove
- Wellington Blood and Cancer Centre, Capital and Coast District Health Board, Wellington, New Zealand.,Cancer Immunotherapy Programme, Malaghan Institute of Medical Research, Wellington, New Zealand
| | - David C M Kong
- Pharmacy Department, Ballarat Health Service, Ballarat, Victoria, Australia.,Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.,National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Paul Omond
- National Centre for Infections in Cancer, Melbourne, Victoria, Australia.,Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - David J Routledge
- Department of Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jeff Szer
- Department of Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Faculty of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia.,School of Medicine, University of Western Australia, Perth, Western Australia, Australia.,Department of Paediatric Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia.,Department of Microbiology, PathWest Laboratory Medicine WA, QEII Medical Centre, Perth, Western Australia, Australia
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Nixon J, Chan R, McKinnell E, Ward E, Pinkham E, Wishart L, Miller E, Brown B. Rethinking the Meaning of "Wellness" for a Person with Cancer: A Qualitative Study to Explore What Elements Constitute "Wellness". Asia Pac J Oncol Nurs 2021; 8:360-368. [PMID: 34159228 PMCID: PMC8186391 DOI: 10.4103/apjon.apjon-212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/09/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE This study explored what people with cancer and their family members define as wellness, and what they perceive to be the needs to support wellness during the cancer experience. METHODS This study utilized qualitative focus groups underpinned by an interpretative descriptive design. Participants included people with a cancer diagnosis having completed/currently undergoing cancer treatment, and/or family/friends. Participants were invited to share their experience and perceptions of cancer wellness, which was then mapped in relation to Hettler's six dimensions of wellness. RESULTS Twenty-six participants (16 people with cancer, ten family/friends) were involved in the process. All six dimensions of wellness were reported by the groups with 19 descriptive content categories that related to these domains. The data revealed that people with cancer and family/friends have individual and diverse meanings of wellness. Participants offered suggestions for strategies to promote wellness relating to the environment and supportive care interventions. CONCLUSIONS People with cancer and their families experience wellness individually. Cancer wellness models should consider the personal nature of wellness in relation to the six domains of wellness when developing wellness programs, including health professional access, an environment that supports wellness, the provision and access to reliable information, and support the key needs of being physically active and financial security.
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Affiliation(s)
- Jodie Nixon
- Department of Occupational Therapy, Princess Alexandra Hospital, Brisbane, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Raymond Chan
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Emma McKinnell
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia
| | - Elizabeth Ward
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Australia
| | - Elizabeth Pinkham
- Department of Physiotherapy, Princess Alexandra Hospital, Brisbane, Australia
| | - Laurelie Wishart
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Australia
| | - Elizabeth Miller
- Division of Cancer Services, Princess Alexandra Hospital, Brisbane, Australia
| | - Bena Brown
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Australia
- Department of Speech Pathology, Princess Alexandra Hospital, Brisbane, Australia
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Hunter J, Grant S, Delaney GP, Templeman K, Ussher J, Parton C, Kellett A, Smith C. Barriers and Facilitators to Integrative Oncology Services in Australia: A Changed Mind Set Required. J Altern Complement Med 2021; 27:S89-S98. [PMID: 33788601 DOI: 10.1089/acm.2020.0299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objectives: This study aimed to explore barriers and facilitators to integrative oncology (IO) service provision and access in Australia. Design: The study design was mixed method with two substudies: a cross-sectional national cancer service survey of public and private sectors; and focus group interviews and an online survey of cancer survivors. Triangulation analysis of qualitative and quantitative data was used to identify and interrogate meta-themes. Subjects: The cancer service response rate was 93.2% (n = 275/295); 71/275 (25.8%) provided IO. Thirty-three cancer survivors from Anglo-European, Arabic, Vietnamese, and Chinese backgrounds were interviewed, and 121 survivors answered the online survey. Results: IO gaps were substantial, with no services in many regions and cities; a lack of diversity and availability of therapeutic options, including culturally appropriate services; and a mismatch between the high use of natural health products by survivors and types of IO services provided. Two overlapping meta-themes were identified: "barriers and facilitators" and "peoples and institutions"; each with four subthemes, respectively, "access/provision, affordability/funding, information/evidence, and culture/values" and "cancer survivors, healthcare professionals, organizations, and policies." While affordability/funding was the greatest barrier to survivors and providers, solutions varied (e.g., building a stronger evidence-base, business model advice) and often conflicted (e.g., public verses private sector funding). The most insidious barrier was professional/corporate cultures and values that influenced hospital policies (or lack thereof), conceptions of evidence and the therapeutic alliance. Survivors called for a change of mindset in the culture of medicine and value-based health care. Conclusions: The barriers and facilitators to IO services were more complex than building the evidence-base and demonstrating value to justify funding. To achieve a better alignment of patients' preferences with service provision, providers require more guidance on clinical governance, business models, local service gaps, and interprofessional collaboration. National strategies and funding models are needed to ensure appropriate, equitable IO service provision.
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Affiliation(s)
- Jennifer Hunter
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Suzanne Grant
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Geoff P Delaney
- South-Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, Australia.,Cancer Services, South Western Sydney Local Health District, Liverpool, Australia
| | - Kate Templeman
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Jane Ussher
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Chloe Parton
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Andrew Kellett
- School of Medicine, Western Sydney University, Penrith, Australia
| | - Caroline Smith
- NICM Health Research Institute, Western Sydney University, Penrith, Australia.,Graduate Research School, Western Sydney University, Penrith, Australia
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Grant SJ, Hunter J, Seely D, Balneaves LG, Rossi E, Bao T. Integrative Oncology: International Perspectives. Integr Cancer Ther 2019; 18:1534735418823266. [PMID: 30791736 PMCID: PMC7240876 DOI: 10.1177/1534735418823266] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Interest in integrative oncology (IO) is growing globally. Patients with cancer are actively using traditional complementary and integrative medicine (TCIM) as part of their cancer and survivorship care. Published studies from around the world report increasing use of TCIM by people living with cancer. This article summarizes the presentations that took place during a symposium titled, "Integrative Oncology: International Perspectives" at the International Research Congress on Integrative Medicine and Health in Baltimore, 2018. The purpose of the presentations was to examine whether cancer services across a variety of geographical regions, including Australia, Canada, the United States, and the European Union, were actively responding to cancer survivors' demand for TCIM. The presenters highlighted utilization rates and both facilitators and barriers to the provision of IO services in their respective countries and regions. The audience discussion following the presentations drew out many noteworthy perspectives.
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Affiliation(s)
- Suzanne J Grant
- 1 Western Sydney University, Penrith, NSW, Australia.,2 Chris O'Brien Lifehouse Comprehensive Cancer Centre, Camperdown, NSW, Australia
| | - Jennifer Hunter
- 1 Western Sydney University, Penrith, NSW, Australia.,3 The University of Sydney, Australia
| | - Dugald Seely
- 4 Ottawa Integrative Cancer Centre, Ottawa, ON, Canada.,5 Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | | | - Elio Rossi
- 7 Coordinating Center of Complementary Medicine-Local Health Unit Tuscany North West, Lucca, Italy
| | - Ting Bao
- 8 Memorial Sloan Kettering Cancer Center, NY, USA
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Haynes K, Ugalde A, Pittman L, Linde D, Shields M, Livingston P. The contribution of wellness centres to cancer care: Patient and carer perspectives. Collegian 2019. [DOI: 10.1016/j.colegn.2018.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ugalde A, Haynes K, White V, Russell L, Livingston PM. "An Ambition to Make People Feel at Home" or "The Emperor's New Clothes"? Professional stakeholder views of wellness centres in cancer care. Eur J Cancer Care (Engl) 2019; 28:e13096. [PMID: 31094044 DOI: 10.1111/ecc.13096] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/04/2019] [Accepted: 03/26/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Wellness centres offer people affected by cancer to access to information and services in a supportive environment. This study aimed to understand stakeholder opinions and perspectives about the potential of wellness centres to contribute to cancer care. METHODS This study adopted a qualitative approach with health professionals, leaders of key cancer organisations and cancer policy stakeholders interviewed. Results were analysed with thematic analysis. RESULTS Twenty-three stakeholders representing 13 organisations participated. The following three key themes were identified: (a) The promise and ambition of wellness centres; (b) The hesitations and questions; and (c) Optimising wellness. While many recognised the ambition of wellness centres to offer non-clinical spaces and support for patients and family, there were several concerns raised about the drivers, evidence, throughput, access and equity of services, in the context of other cancer care priorities. Participants made recommendations that focused on use of data; models of community or clinical integration; accessibility and scope; approaches to engaging minority or disadvantaged groups and contribution to cancer care and psycho-oncology. CONCLUSION Professional stakeholders hold varied views about the potential of wellness centres in contributing to cancer care. Research opportunities include understanding models of community clinical engagement and how to engage minority or disadvantaged populations to ensure equity of access.
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Affiliation(s)
- Anna Ugalde
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Kerry Haynes
- Australian Institute of Family Studies, Melbourne, Victoria, Australia
| | - Vicki White
- School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Lahiru Russell
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Patricia M Livingston
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Whyand T, de Lima YC, Davies P. Complementary and alternative medicine use during chemotherapy for neuroendocrine tumours. ACTA ACUST UNITED AC 2019; 28:387-393. [PMID: 30925244 DOI: 10.12968/bjon.2019.28.6.387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Exploring the patient experience of complementary and alternative medicine (CAM) can provide insight into the needs, preferences and values of patients with an neuroendocrine tumour (NET). Use and interest in CAM after a NET diagnosis has not been investigated until now. The authors aimed to identify the types of CAM being used by patients undergoing chemotherapy and what types of CAM patients considered most beneficial. Patients were identified for clinical audit from one hospital's NET nurse chemotherapy database. A questionnaire was given to 79 patients who had completed intravenous chemotherapy during the previous 3 years. CAM use by NET patients was found to be popular and included practices to support both physical and emotional health. Massage and taking vitamin and mineral supplements were most widely used. The antioxidant effects of some high-dose supplements may impact on chemotherapy outcomes. Massage, despite its irregular use, was perceived by patients to be the most useful CAM.
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Affiliation(s)
- Tara Whyand
- Neuroendocrine Tumour Research and Development Dietitian, Neuroendocrine Tumour Unit, Royal Free Hospital, London
| | - Yasmin Chotai de Lima
- Clinical Lead Dietitian, NET/Oncology, Department of Nutrition and Dietetics, Royal Free Hospital, London
| | - Philippa Davies
- Macmillan Senior Nurse Cancer Services, Cancer Services, Northwick Park Hospital, London
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Chan EA, Ching S, Li M. An ethnographic inquiry into the psychosocial care for oncology patients in the community: Healing from the 4Es. Eur J Oncol Nurs 2018; 36:40-47. [PMID: 30322508 DOI: 10.1016/j.ejon.2018.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 07/31/2018] [Accepted: 08/17/2018] [Indexed: 01/18/2023]
Abstract
PURPOSE The aim of this study was to explore how the provision of community care in a cancer support center can help cancer patients and survivors cope with the demands of cancer and its treatment. METHODS A focused ethnographic approach was adopted. Data were collected through participant observations and focus groups with various stakeholders. The data from the focus groups were transcribed verbatim and analyzed using constant comparative analysis. RESULTS Four main themes emerged: 1. Enabling users to achieve mental well-being on their coping journey, 2. Empowering users to deal with their uncertainties, 3. Enhancing meaningful nurturing interactions through the design of spaces and colors in the Centre, and 4. Evolving through seeing more value in themselves. These 4Es occurred through intimate human interaction in the Centre, which resulted in psychological renewal and the rebuilding of a sense of self among the users. CONCLUSIONS This study provides insights on the provision of community support services for cancer patients/users, specifically on how to help them to regain control over their lives, not only through providing services for psychosocial renewal by engaging in intimate human interactions, but also by contributing to an understanding of the effect of the physical environment and space on healing. The results also reveal a virtuous circle of the 4Es as the synergies from the services, activities and the environment in the Centre, which provide a harmonious context for the users in coping with their cancer journey.
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Affiliation(s)
- Engle Angela Chan
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong.
| | - Shirley Ching
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong.
| | - Michael Li
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong.
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The effect of self-selected complementary therapies on cancer patients’ quality of life and symptom distress: A prospective cohort study in an integrative oncology setting. Complement Ther Med 2018; 37:1-5. [DOI: 10.1016/j.ctim.2018.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 01/06/2018] [Accepted: 01/08/2018] [Indexed: 01/22/2023] Open
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Blignault I, McDonnell L, Aspinall D, Yates R, Reath J. Beyond diagnosis and survivorship: findings from a mixed-methods study of a community-based cancer support service. Aust J Prim Health 2017; 23:391-396. [PMID: 28514993 DOI: 10.1071/py16067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 02/06/2017] [Indexed: 11/23/2022]
Abstract
This consumer-led research investigated the client experiences and the individual and community benefits of a community-based cancer support service operating in a regional setting. The study included cross-sectional surveys, focus group discussions and key-informant interviews. In total, 114 clients, 28 carers and 20 therapists were surveyed; three client focus groups were conducted and five directors and staff were interviewed. For many clients and carers, the warm welcome experienced at first contact sets the tone for a long-term association with the organisation. The feeling of being cared for extends to the broader community and living with cancer becomes more than survivorship. Integral to the organisational model are opportunity (second-hand) shops that enable subsidised complementary therapies and other services, offer a way of giving back and assist disadvantaged community members. The organisational model has benefits, not only for people living with cancer and their families, but also for the wider community.
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Affiliation(s)
- Ilse Blignault
- Centre for Health Research, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Louise McDonnell
- Department of General Practice, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Diana Aspinall
- Nepean Blue Mountains PHN, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Robyn Yates
- Blue Mountains Cancer Help, PO Box 18, Katoomba, NSW 2780, Australia
| | - Jennifer Reath
- Department of General Practice, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
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Williams AM, Lester L, Bulsara C, Petterson A, Bennett K, Allen E, Joske D. Patient Evaluation of Emotional Comfort Experienced (PEECE): developing and testing a measurement instrument. BMJ Open 2017; 7:e012999. [PMID: 28122833 PMCID: PMC5278251 DOI: 10.1136/bmjopen-2016-012999] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/19/2016] [Accepted: 12/14/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The Patient Evaluation of Emotional Comfort Experienced (PEECE) is a 12-item questionnaire which measures the mental well-being state of emotional comfort in patients. The instrument was developed using previous qualitative work and published literature. DESIGN Instrument development. SETTING Acute Care Public Hospital, Western Australia. PARTICIPANTS Sample of 374 patients. INTERVENTIONS A multidisciplinary expert panel assessed the face and content validity of the instrument and following a pilot study, the psychometric properties of the instrument were explored. MAIN OUTCOME MEASURES Exploratory and confirmatory factor analysis assessed the underlying dimensions of the PEECE instrument; Cronbach's α was used to determine the reliability; κ was used for test-retest reliability of the ordinal items. RESULTS 2 factors were identified in the instrument and named 'positive emotions' and 'perceived meaning'. A greater proportion of male patients were found to report positive emotions compared with female patients. The instrument was found to be feasible, reliable and valid for use with inpatients and outpatients. CONCLUSIONS PEECE was found to be a feasible instrument for use with inpatient and outpatients, being easily understood and completed. Further psychometric testing is recommended.
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Affiliation(s)
- A M Williams
- School of Health Professions, Murdoch University, Murdoch, Western Australia, Australia
- Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - L Lester
- Health Promotion Evaluation Unit, School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - C Bulsara
- School of Nursing and Midwifery, Institute of Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - A Petterson
- SolarisCare Foundation, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - K Bennett
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - E Allen
- School of Health Professions, Murdoch University, Murdoch, Western Australia, Australia
- University of Technology Sydney, Ultimo, New South Wales, Australia
| | - D Joske
- Department of Haematology, Sir Charles Gairdner Hospital, The University of Western Australia, Crawley, Western Australia, Australia
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