Development and Content Validation of End of Treatment Questionnaires for Children With Cancer

We Are Done! Now What? Exploring End of Treatment Needs of Childhood Cancer Survivors and Their Parents

Background: Increased childhood cancer survival rates have spurred a new body of research pertaining to the cancer-survivorship continuum. Literature suggests a lack of research and guidelines for care at the end of treatment (EOT). To improve the transition to survivorship and determine any posttreatment challenges, this study explored the experiences of childhood cancer survivors (CCSs), parents/caregivers, and pediatric oncology health care professionals (HCPs) at EOT. Method: This study employed a mixed methods design. EOT Questionnaires were completed by CCSs and parents/caregivers within 6 months of completing treatment, and by pediatric oncology HCPs. Results: A total of 75 CCSs and parents/caregivers and 21 HCPs completed the study. The majority of parents/caregivers (78%) and older CCSs (94%) recalled having an EOT "meeting." Most were satisfied with the meeting, but described unexpected worries/problems following EOT. Family members stating they were "very satisfied" with the EOT meeting increased significantly relative to the number of EOT topics addressed. In contrast, the omission of certain psychosocial discussion topics negatively correlated with satisfaction. Oncologists provided the majority of EOT services, with infrequent provision by other HCPs. Less than 20% of HCPs characterized families as "very satisfied" with EOT services and suggested improvements to meet families' needs. Discussion: This study found unmet psychosocial and anticipatory guidance needs, indicating a lack of preparedness. The results suggest that end of cancer treatment requires a more standardized, comprehensive, and multidisciplinary approach. Enhanced education and support services are needed to promote the successful navigation of all families through this period of transition.

Development and content validity of an instrument for assessing the motivation for weight loss in adolescents with overweight and obesity

Objective

To develop and validate the content of an instrument for assessing the motivation for weight loss in adolescents with overweight and obesity.

Methods

The development and validation of the instrument were conducted in five stages, for which two systematic reviews were conducted. The first one, for the identification of questionnaires assessing the motivation for weight loss, included six studies and contributed to the selection of the domains for the instrument. The second one, conducted to identify the motivations for weight loss in adolescents with overweight and/or obesity, included six studies and contributed to the selection of 17 motivations included in the initial version of the instrument. The motivations most commonly identified were: having better health, improving my appearance, improving my self-esteem and avoiding bullying. The content validity was confirmed by a committee of 12 experts from the areas of nutrition, endocrinology, psychology, and physical education. Based on these evaluations, the content validity index was calculated. Only the items with a content validity index >0.80 for practical relevance were held in the instrument.

Results

Five of the 17 motivations included in the initial version of the instrument were excluded because they had content validity index <0.80 for practical relevance. Of the 12 items held in the instrument, five were revised by experts in order to standardize wording and make the language more appropriate for adolescents. Experts categorized the items into the health, personal satisfaction, appearance and social domains.

Conclusions

This is the first instrument assessing the motivation for weight loss in adolescents with overweight and obesity in Brazil. The content validity evaluation by the panel of experts provided more practical relevance, as well as contributed to a better presentation of the items. Further psychometric testing is needed to determine reliability and construct validity of the instrument.