Rasch analysis of the Herth Hope Index in cancer patients

Rasch analysis and targeting assessment of the teach-CVI survey tool in a cohort of CVI patients

Purpose

Cerebral Visual Impairment (CVI) is the leading cause of pediatric visual impairment. Given the diversity of clinical presentations of CVI, we are interested in whether questionnaires appropriately target the spectrum CVI cases, specifically the Teach-CVI Screening Tool. Rasch analysis is a standard psychometric technique for assessing the targeting of questionnaire items, however this analysis technique has not yet been applied to this questionnaire.

Methods

We performed a retrospective review of clinical CVI cases from the NECO Center for Eye Care at Perkins School for the Blind from January 2016 to December 2022. Electronic medical records were reviewed to identify patients with an ICD-9 or ICD-10 code of CVI or other neurological visual impairment. Age, gender, diagnoses, visual acuity, contrast sensitivity, visual fields, ocular alignment, and Teach-CVI responses were collected. We applied the method of successive dichotomizations, a polytomous Rasch model, to estimate item measures and person measures from the survey. Targeting of questionnaire items to the sample population was explored by comparing estimated item measures to person measures. Multiple linear regression was used to determine which factors influence patient visual ability (i.e., Teach-CVI person measure).

Results

119 patient records were included, 54% of which were male. The mean age was 8.9 years (SD = 6.12) with a range of 0 to 33 years of age. Mean visual acuity was 0.46 logMAR (SD = 0.40), or 20/57. The majority of patients in the sample had a co-occurring visual disorder in addition to CVI (84%), the most frequent being strabismus (69.9%) or visual field loss (25.3%). Item measures ranged from -2.67 to 1.77 logits (SD = 0.76), with a mean of 0 logit by convention. Estimated person measures ranged from -2.19 to 3.08 logits (SD = 1.10) with a mean of -0.03 logit. The range of item measures covered 93.3% of the person measures, and all person measures, except one, were within one logit of an item measure. Visual measures were not statistically significantly associated with Teach-CVI person measures.

Conclusion

The findings from this study suggest that the Teach-CVI survey is well targeted and an appropriate patient reported outcome measure for CVI.

Pre-post feasibility trial of a telephone-delivered exercise intervention for patients during chemotherapy for recurrent ovarian cancer: the ECHO-R trial protocol

INTRODUCTION

The benefits of exercise in reducing treatment-related morbidity and improving quality of life following a primary diagnosis of cancer have been well documented and have led to exercise being recommended by oncology societies for all people with a cancer diagnosis. However, these recommendations are derived from research typically involving cohorts with more common cancers and relatively good prognosis, such as breast and prostate. Evidence from these cancers may not apply to women with recurrent ovarian cancer. Therefore, the primary objective of this trial is to evaluate the feasibility and safety of a home-based, telephone-delivered exercise intervention for women undergoing chemotherapy for recurrent ovarian cancer.

METHODS AND ANALYSIS

The Exercise During Chemotherapy for Recurrent Ovarian Cancer (ECHO-R) trial is a single-arm, phase II, pre/postintervention trial of a 6-month, telephone-delivered exercise intervention (consistent with recommended exercise oncology prescription). The target sample size is 80 women who are currently undergoing (or are scheduled to receive) chemotherapy for recurrent ovarian cancer. Recruitment is through participating hospital sites in Queensland, Australia, or via self-referral. The exercise intervention comprises 12 telephone sessions over a 6-month period delivered by trial-trained exercise professionals and supplemented (where feasible) by five sessions face to face. Exercise prescription is individualised and works towards an overall goal of achieving a weekly target of 150 min of moderate-intensity, mixed-mode exercise. Assessments via self-administered survey and physical fitness and function tests occur at baseline and then at 6 and 9 months postbaseline. Data to inform feasibility and safety are recorded as case notes by the exercise professional during each session.

ETHICS AND DISSEMINATION

Ethics approval for the ECHO-R trial was granted by the Metro North Human Research Ethics Committee (HREC/2020/QRBW/67223) on 6 November 2020. Findings from the trial are planned to be disseminated via peer-reviewed publications and both national and international exercise and oncology conferences.

TRIAL REGISTRATION NUMBER

ACTRN12621000042842.

The Persian version of Herth Hope Index in Iranian patients with cancer: A psychometric study

OBJECTIVES

Hope is a contextual concept that has significant effects on human well-being. This study aimed to evaluate the psychometric properties of the Persian version of the Herth Hope Index (P-HHI) among Iranian patients with cancer.

METHOD

This cross-sectional study was conducted on 320 patients with cancer from September to December 2020. After translating the HHI into Persian, content, convergent and discriminant, construct validity (exploratory and confirmatory factor analysis), and reliability of the P-HHI were assessed.

RESULTS

The results of exploratory factor analysis showed that the P-HHI was composed of two factors: Life Expectancy and Thinking Positive, which explained 55.20% of the total variance.

SIGNIFICANCE OF RESULTS

The research revealed that the P-HHI has acceptable validity and reliability, which can be used to measure the hope concept among Iranian patients with cancer.

The Revised American Occupational Therapy Association Fieldwork Performance Evaluations: Evaluation of Internal Structure, Response Processes, and Precision-Part 2

IMPORTANCE

There is an evidence-based need to assess the validity and reliability/precision of the revised American Occupational Therapy Association's Fieldwork Performance Evaluation (FWPE) items for the occupational therapy student (OTS) and the occupational therapy assistant student (OTAS).

OBJECTIVE

To evaluate evidence of validity in relation to response processes, internal structure, and precision of the FWPEs.

DESIGN

Cross-sectional study design.

SETTING

OTS and OTAS fieldwork practice settings, United States.

PARTICIPANTS

Two hundred sixty-seven fieldwork educators participated in total, providing 228 OTS evaluations and 39 OTAS evaluations.

OUTCOMES AND MEASURES

A Rasch model was used to evaluate aspects of validity and precision.

RESULTS

The rating scales provided evidence of the tools' overall validity. Thirty-two of 37 items on the FWPE for the OTS, and 27 of 31 items on the FWPE for the OTAS demonstrated acceptable fit, but the evidence of unidimensionality in the subscales and in the total scales was not fully supported. The total/reduced FWPE scales were able to separate students into at least four distinct groups of fieldwork performance. The relationships between the current and revised FWPEs indicate that the new scales measure different but related constructs of student fieldwork performance, compared with the current version.

CONCLUSIONS AND RELEVANCE

The findings support that the revised FWPEs for the OTS and OTAS demonstrate preliminary evidence of internal structure, response processes, and precision, supporting evidence-based practice in fieldwork evaluations. What This Article Adds: This article highlights evidence demonstrating the validity and precision of the revised American Occupational Therapy Association's Fieldwork Performance Evaluation items and supports academic and fieldwork settings for occupational therapy students and occupational therapy assistant students.

Sound psychometric properties of a short new screening tool for patient safety climate: applying a Rasch model analysis

BACKGROUND

WHO recommends repeated measurement of patient safety climate in health care and to support monitoring an 11 item questionnaire on sustainable safety engagement (HSE) has been developed by the Swedish Association of Local Authorities and Regions. This study aimed to validate the psychometric properties of the HSE.

METHODS

Survey responses (n = 761) from a specialist care provider organization in Sweden was used to evaluate psychometric properties of the HSE 11-item questionnaire. A Rasch model analysis was applied in a stepwise process to evaluate evidence of validity and precision/reliability in relation to rating scale functioning, internal structure, response processes, and precision in estimates.

RESULTS

Rating scales met the criteria for monotonical advancement and fit. Local independence was demonstrated for all HSE items. The first latent variable explained 52.2% of the variance. The first ten items demonstrated good fit to the Rasch model and were included in the further analysis and calculation of an index measure based on the raw scores. Less than 5% of the respondents demonstrated low person goodness-of-fit. Person separation index > 2. The flooring effect was negligible and the ceiling effect 5.7%. No differential item functioning was shown regarding gender, time of employment, role within organization or employee net promotor scores. The correlation coefficient between the HSE mean value index and the Rasch-generated unidimensional measures of the HSE 10-item scale was r = .95 (p < .01).

CONCLUSIONS

This study shows that an eleven-item questionnaire can be used to measure a common dimension of staff perceptions on patient safety. The responses can be used to calculate an index that enables benchmarking and identification of at least three different levels of patient safety climate. This study explores a single point in time, but further studies may support the use of the instrument to follow development of the patient safety climate over time by repeated measurement.

Psychometric evaluation of the Chinese version of the Herth Hope Index (HHI) in Chinese children with cancer

Hope plays an extremely important role in protecting childhood cancer patients from psychological distress caused by cancer. The availability of a valid and reliable instrument that can accurately assess hope is crucial for the development of interventions to enhance hope among childhood cancer patients. This study aimed to examine the psychometric properties of the Chinese version of the Herth Hope Index (HHI). Chinese childhood cancer patients aged 8-17 years (n = 412) were invited to participate in this cross-sectional study. Participants completed the Chinese translated version of the HHI, the Center for Epidemiology Studies Depression Scale for Children and the Paediatric Quality of Life Inventory 3.0 Cancer Module. Exploratory factor analysis and confirmatory factor analysis were conducted to assess the structural validity of the HHI. Content validity, convergent validity, internal consistency, and test-retest reliability at 2 weeks were also examined. The content validity index for items ranged from 0.8 to 1.0, and that for the scale was 0.9, demonstrating appropriate content validity. There was a positive correlation between HHI and Center for Epidemiology Studies Depression Scale for Children scores and a negative correlation between HHI and Paediatric Quality of Life Inventory 3.0 Cancer Module scores. The results indicated that the Chinese version of the HHI showed reasonable convergent validity and discriminant validity. Exploratory factor analysis yielded a three-factor model, which could explain 82.74% of the total variance. The confirmatory factor analysis results showed that χ²/df was 2.20, comparative fit index was 0.98, goodness of fit index was 0.94, and root-mean-square error of approximation was 0.07. Cronbach's alpha was 0.78, indicating good internal consistency. The findings of the study showed that the Chinese version of the HHI (11-item) is a reliable and valid instrument for assessing hope among Chinese childhood cancer patients. Evidence-based interventions can be provided to enhance hope in this population.

A Clinical Case Study of Solution-Focused Brief Therapy for Young Adult Cancer Patients’ Psychological Distress: Focusing on Positive Emotions

Psychological distress is highly prevalent among adolescent and young adult (AYA) cancer patients, an age-defined population (15–39) disproportionately impacted by their cancer diagnosis. Solution-focused brief therapy (SFBT) is a strength-based and evidence-supported approach for youth with medical conditions. The use of SFBT in young cancer patients, however, has been rarely described. Building on the broaden-and-build theory of positive emotions, this study describes how SFBT clinicians intentionally foster positive emotions, especially hope, in an AYA cancer patient to foster therapeutic change. We found improvements in the patient’s psychological distress as well as growth in levels of hope both in the immediate post-intervention assessment and in the 2-week follow-up. The findings of the study suggested that SFBT is a promising approach to the unique challenges confronting AYAs with cancer. It was not feasible for this case study to match the sex and racial identities for a therapist with the client’s preference, which is considered a main limitation of this study.

Disparities in awareness of and willingness to participate in cancer clinical trials between African American and White cancer survivors

BACKGROUND

Cancer clinical trials (CCTs) are essential for cancer care, yet the evidence is scarce when it comes to racial disparities in CCT participation among cancer survivors in the Midwest. This study aimed to 1) assess disparities in the awareness of and willingness to participate in CCTs between African American and White cancer survivors; and 2) compare perceptions about CCTs between the two racial groups.

METHODS

The study was based on cross-sectional data from the survey "Minority Patient Participation in Cancer Clinical Trials" that collected information from 147 Black and White cancer survivors from Nebraska between 2015 and 2016. Chi-square tests and logistic regressions were used to assess differences between Black and White cancer survivors regarding their awareness, willingness, and perceptions associated with CCT participation.

RESULTS

After adjusting for the effects of socio-demographic, health status, and psychosocial variables, Black cancer survivors were much less likely than White cancer survivors to be aware of CCTs (AOR 0.26; CI 0.08-0.81), to express willingness to participate in CCTs (AOR 0.03; CI 0.01, 0.32) and to actually participate in CCTs (AOR 0.13; CI 0.04-0.38). Black cancer survivors reported a lower level of trust in physicians and were less likely than White cancer survivors to believe that CCTs make a significant contribution to science.

CONCLUSIONS

Relative to White cancer survivors, Black cancer survivors had much lower awareness of and willingness to participate in CCTs. Part of these differences might be related to the differential perception of CCTs, psychosocial factors, and trust in physicians between the two groups.

Measurement invariance in gender and age of the Herth Hope Index to the general spanish population across the lifespan

The Herth Hope Index (HHI) is used to measure hope. Assessing the psychometric properties of HHI in Spanish population, exploring its structural validity, the different functionalities of the items and the invariability of this measure according to the gender and age of the population. Confirmatory factor analysis was conducted to explore the scale's dimensionality and test for strong measurement invariance across sex and age in a cross-sectional, multicenter, prospective study. A new scale was obtained with the structure of one factor with 9 items. Goodness-of-fit indices were excellent. The internal consistency of the one dimension proved high values. The configural invariance on gender shows that both men and women understand the new HHI items, also, this research also shows that there is no scalar invariance across age groups, revealing good levels of adjustment of the item. The Spanish version of the HHI proved to be a valid, reliable instrument to assess the hope in Spanish population.

Hope therapy in cancer patients: a systematic review

AIM

To identify the associated factors of hope therapy during treatment in cancer patients.

BACKGROUND

Hope is very important to cancer patients at all stages of the disease process. Several and different factors are associated with hope.

DESIGN

A systematic literature review of quantitative empirical studies on hope and quality of life in cancer patients.

DATA SOURCES

Search in MEDLINE, Psychinfo, and Cochrane (January 2010-December 2020).

REVIEW METHODS

A coherent search strategy was designed where MESH terms were combined with "free text" terms: hope (e.g., hope therapy, Herth Hope Index, quality of life) and cancer (e.g. neoplasm, tumor). Two authors independently screened all the studies and assessed their quality.

RESULTS

Twenty studies were included. The overall score of Herth Hope Index in cancer patients was 36.93, and the overall score of quality of life in cancer patients were 47.52. Also, the trend of quality of life and Herth Hope Index in cancer patients has been decreasing, from 2010 to 2020.

CONCLUSIONS

This systematic literature review of associated factors of hope in cancer patients receiving treatment shows that hope seems to be positively related mainly by intrinsic factors, such as perceived health, quality of life, and social support.

Expressive Arts Therapy Combined with Progressive Muscle Relaxation following Music for Perioperative Patients with Gynecological Malignancies: A Pilot Study

Objective

We aimed to assess the impact of an expressive arts therapy combined with progressive muscle relaxation following music on mental health (anxiety and hope) in patients with gynecological malignancies undergoing surgery.

Methods

This was a nonrandomized controlled trial. Eligible patients had a primary or recurrent gynecological malignancy scheduled to be treated with surgery. The intervention consisted of three sessions (preoperation, postoperation, and predischarge) during the perioperative period. Firstly, before starting the first session of intervention, all patients completed three questionnaires including a Hospital Anxiety and Depression Scale (HADS), a Herth Hope Index (HHI), and a State Anxiety Inventory (SAI), and the intervention group patients also had to complete the SAI questionnaire again after completing the intervention. Secondly, after the second session of intervention, all patients completed the SAI questionnaire, with the intervention group completed the SAI questionnaire before the intervention. Thirdly, after the third session of intervention, all patients completed HHI and SAI questionnaires, with the intervention group completed the SAI questionnaire before the intervention. Also, to subjectively rate the benefit of expressive arts therapy, the intervention group additionally completed a separate, supplemental questionnaire.

Results

A total of 116 patients were enrolled and 110 included in the final analysis. No group differences were found for HHI scores between the intervention and control participants (Cohen's d = 0.19, P=0.31), although there was a substantial improvement in intervention participants' HHI scores compared to the standard care control participants. There was a statistically significant improvement in intervention participants' SAI from preintervention to postintervention of preoperation (Cohen's d = −0.23, P=0.002) and postoperation (Cohen's d = −0.34, P ≤ 0.001). However, no differences were observed for the predischarge period (Cohen's d = −0.09, P=0.118). Besides, a supplemental questionnaire indicated that 52 (98%) patients felt that expressive arts therapy was beneficial.

Conclusions

Expressive art therapy combined with progressive muscle relaxation under music may be of some effect on alleviating perioperative anxiety in patients with gynecologic malignancies. Therefore, further relevant studies with large samples and multicenters are urgently needed to provide a reliable evidence-based basis for perioperative psychological care of patients with gynecologic malignancies and to promote rapid recovery of patients. It is recommended that further art therapy studies to examine the impact of patient-tailored arts therapy interventions on spiritual well-being in patients with gynecological malignancies, especially in the perioperative period.

Factor Structure and Longitudinal Measurement Invariance of the Tangney's Brief Self-Control Scale in Chinese Adolescents

Self-control is an important trait for humans to perceive inner and outer perceptions while maintaining harmony with others in society. People with lower self-control are more likely to engage in undesired or irresponsible behavior. The Brief Self-Control Scale (BSCS) is an effective scale with a brief set of items which can effectively measure the level of an individual's control abilities. So far, it has been widely used in many longitudinal studies. However, the factor structure of the scale remains controversial, and far fewer studies have examined the longitudinal measurement invariance of the BSCS. This study aimed to revise the BSCS and test its factor structure for use in Chinese adolescents. Three samples of adolescents (N = 1,330/1,000/600, 11-19 years of age) were used. The item-total correlation and inter-item correlation coefficients were used to evaluate the quality of items. The exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and the principle component analysis (PCA) of the residuals were performed to test the factor structure of the BSCS. Three nested models were used to test the longitudinal measurement invariance (LMI) of the BSCS. Pearson correlation coefficient and Cronbach's alpha coefficient were conducted to test the criterion validity and internal consistency reliability, respectively. According to the CFA of different dimensional models of the BSCS, the results did not support the two-dimensional model, and poor factor loading was found for Item 12. Based on this, combined with lower item-total correlation and item-item correlations, Item 12 was eliminated. Based on results of the EFA with both Kaiser eigenvalues and minimum average partial correlations, only one factor of the revised 12-item BSCS was extracted to make the fit indices of the confirmatory factor analysis acceptable. Meanwhile, the results of principle component analysis of the residuals supported the unidimensional assumption. The fit indices of three nested models supported the longitudinal measurement invariance, indicating that this scale has the same meaning over time. The internal consistency coefficient of the BSCS-12 was 0.81 and the test-retest reliability was 0.70. Good concurrent validity was also demonstrated. Overall, these findings suggest that the revised 12-item Tangney's Brief Self-Control Scale has a one-dimensional structure and has good reliability and validity in Chinese adolescents.

Herth Hope Index: A Psychometric Evaluation Study within a Sample of Greek Patients with Cancer

Objectives:

This study aims to develop the Greek version of the Herth Hope Index (HHI) and assess its psychometric properties to a palliative care patient sample, using a cross-sectional design.

Materials and Methods:

The HHI was translated into Greek (HHI-Gr) using the ‘forward-backward’ procedure. It was administered to 130 eligible cancer patients, while for the stability of patients’ responses, 40 of these patients completed the HHI-Gr 3 days later. Along with the HHI-Gr, patients also completed the Hospital Anxiety and Depression Scale (HADS) and the Beck Hopelessness Scale (BHS). The HHI-Gr internal consistency reliability (Cronbach’s a), stability (intraclass correlation coefficient [ICC]), factor structure (factor analysis) and convergent validity (correlation with the HADS and the BHS questionnaires) were examined using the Eastern Cooperative Oncology Group (ECOG) performance status.

Results:

The HHI-Gr yielded a one-factor model and a Cronbach alpha (0.860) with excellent internal consistency reliability and stability ICC (>0.90). Satisfactory convergent validity was supported by the correlation analysis between the HHI-Gr and BHS (r = 0.718, P < 0.001). Overall test-retest reliability was satisfactory with a range between 0.77 and 0.96 (P < 0.001).

Conclusion:

These results demonstrate that the HHI-Gr is an instrument with satisfactory psychometric properties and is a valid research tool for the measurement of the levels of hope among Greek oncology patients.

The Factor Structure and Rasch Analysis of the Fear of COVID-19 Scale (FCV-19S) Among Chinese Students

The Fear of COVID-19 Scale (FCV-19S) is a new one-dimensional scale used to measure fear of an individual about the COVID-19. Given the seriousness of the COVID-19 situation in China when our study was taking place, our aim was to translate and examine the applicability of the FCV-19S in Chinese students. The sample used for validation comprised 2,445 Chinese students. The psychometrical characteristics of the Chinese FCV-19S (FCV-19S-C) were tested using Rasch analysis. Principal component analysis (PCA) proved the unidimensional structure of the model. Both infit and outfit mean square (MNSQ) values (0.69-1.31) and point-measure correlations (0.82-0.86) indicated a good model fit. Person-item separation and reliability values indicated good reliability of the scale. The person-item map revealed an acceptable level of match between the persons and the items. Differential item functioning of the FCV-19S-C showed no differences with respect to age or gender. FCV-19S-C scores were significantly associated with anxiety, stress, depression, ego-resilience, and general health. The FCV-19S-C was proven to be effective in measuring fear of Chinese students about the COVID-19.

Effect of high-quality nursing on negative emotions and hope levels of patients undergoing oral and maxillofacial surgery

OBJECTIVE

To investigate the effect of high-quality nursing on negative emotions and hope levels after oral and maxillofacial surgery (OMS).

METHODS

A prospective study involving 120 patients who underwent OMS from December 2018 to January 2020 was conducted. The study subjects were classified into a study group and control group with 60 in each, using a random number table. Routine nursing was applied in the control group, while the study group was given high-quality nursing. Psychological status, hope levels, quality of life (QOL), complications and satisfaction rate were compared between patients in the two groups before and after intervention.

RESULTS

After intervention, the scores of HAMA (Hamilton Anxiety Rating Scale) and HAMD (Hamilton Depression Rating Scale) of the two groups were both significantly reduced, and the decrease was significantly greater in the study group (all P<0.05). After intervention, the scores of Herth Hope Index (HHI) and Generic quality of life Inventory-74 (GQOLI-74) in the two groups were both elevated, and the increase was significantly greater in the study group (all P<0.01). As compared with the control group, the total incidence of complications in study group was significantly lower (P=0.04), while the satisfaction rate with nursing was higher (P=0.032).

CONCLUSION

High-quality nursing, with low incidence of complications and high overall satisfaction rate, can significantly relieve adverse emotions and promote QOL after OMS.

Hope and Distress Are Not Associated With the Brain Tumor Stage

Objective

Hopelessness and depression are strongly associated with suicidality. Given that physical and psychological outcomes can be altered with hope, hope is a therapeutic goal of increasing importance in the treatment of brain tumor patients. Moreover, it is not yet understood which factors affect the perception of hope in brain tumor patients. In addition, it remains uncertain whether lower-grade brain tumor patients suffer less from psycho-oncological distress than higher-grade brain tumor patients.

Methods

Neuro-oncological patients were examined perioperatively with the Distress Thermometer (DT) and the Herth Hope Index (HHI). In addition, psychological comorbidities (anxiety GAD-2, depression PHQ-2) and an assessment of general psycho-oncological distress were recorded.

Results

Sixty-six brain tumor patients were included (median age 53 years, 35% higher-grade brain tumors, i.e., WHO grade III/IV). No differences between higher- and lower-grade brain tumor patients were observed for general psycho-oncological distress and hope. However, higher-grade brain tumor patients showed a significantly higher level of depression (p ≤ 0.001) and more negative expectations regarding therapeutic success (H = 4.873, p ≤ 0.050). The extent of depression correlated negatively with hope.

Conclusion

Unexpectedly, higher-grade brain tumor patients remained as hopeful as lower-grade brain tumor patients despite the devastating diagnosis, higher levels of depression, and a worse expectation of therapeutic success. Conversely, lower-grade brain tumor patients experience as much psycho-oncological distress as patients with a higher-grade brain tumor, underpinning the imperative need for comprehensive psycho-oncological screening. For all brain tumor patients, considering hope is important to avoid suicides resulting from hopelessness and depression.

Rasch Analysis of Work-Family Conflict Scale Among Chinese Prison Police

As a special group of police officer, prison police have to endure more work stress and have significant work-family conflict, which may lead to more physical and mental health problems and need to be noticed by the society. The Work-Family Conflict Scale (WFCS) is a brief self-report scale that measures the conflict that an individual experiences between their work and family roles and the extent they interfere with one another. However, there is limited data on the scale's psychometric properties. The aim of this study was to examine the dimensionality and reliability of the Chinese version of the WFCS. The study sample was made up of a total of 717 Chinese prison police (64.7% male, M = 41.73 years, SD = 8.30 years). The Rasch Rating Scale Model (RSM) was used to determine the latent structure and estimate the quality of items and reliability of scale. The principle component analysis (PCA) showed that the assumption of unidimensionality was fulfilled. The infit and outfit mean square (MNSQ) statistics (0.84-1.47) were of a reasonable range, and point-measure correlations (0.64-0.79) indicted good model fit of each item. The item-person separation and reliability indices both met psychometric standards, illustrating good reliability. The person-item map indicated acceptable fit of items and persons, suggesting an alignment between persons and items. In addition, no evidence emerged of differential item functioning across different gender groups. Overall, the WFCS has good reliability and validity, and can be used to accurately evaluate the level of work-family conflict in Chinese prison police.

Discussing Prognosis with Empathy to Cancer Patients

PURPOSE OF REVIEW

Our goal was to provide healthcare professionals (HCPs) with evidence-based data about what can be done to handle prognostic discussions with empathy.

RECENT FINDINGS

First, disclosing prognosis involves a good reason to do so and making sure that the patient will be able to process the discussion. Second, communication tips are given for the three dimensions of empathy: "establishing rapport with the patient," which should not be overlooked; the emotional dimension, which involves an accurate understanding of the patient and communication skills; and the "active/positive" dimension which is about giving hope, explaining things clearly and helping patients take control with shared decision-making and a planned future. Although communication tips are helpful, empathy training should be based more on the development of HCPs' emotional skills, in order to help them regulate their emotions and thus be more comfortable with those of patients and families. Furthermore, research into empathy toward minorities and relatives is needed.

The science of hope

Hope is a contextual term that has different connotations depending on the setting. We analyse the concept of hope with respect to its applicability for oncology. We review studies that present hope as a direct or secondary mediator of outcome. We posit that an individual's level of hope is often determined by innate personality characteristics and environmental factors, but can also be physiologically influenced by immune modulators, neurotransmitters, affective states, and even the underlying disease process of cancer. We argue that hope can be a therapeutic target and review evidence showing the effects of hope-enhancing therapies. Given the potential for hope to alter oncological outcomes in patients with cancer and the opportunity for improvement in quality of life, we suggest further research directions in this area.

Cross-cultural adaptation and psychometric properties of the Herth Hope Index in Kinyarwanda: adapting a positive psychosocial tool for healthcare recipients and providers in the Rwandan setting

Background

The lack of culturally appropriate instruments to measure hope across cultural settings is a barrier to assessing and addressing the relationship between hope and health outcomes. The study aim was to adapt and evaluate the psychometric properties of the Herth Hope Index (HHI) in Kinyarwanda in a population of healthcare recipients and healthcare workers in Rwanda.

Methods

A transcultural translation and adaptation of the HHI was conducted using qualitative methods (n = 43) to achieve semantic, content, and technical equivalence. The adapted instrument was administered to a purposive sample (n = 206) of Rwandan healthcare patients and providers. Temporal reliability, internal reliability using Cronbach’s alpha, and construct validity using confirmatory factor analysis (CFA) were assessed.

Results

The Herth Hope Index-Kinyarwanda (HHI-K) was found to have strong internal consistency (α = 0.85) and test-retest reliability (r = 0.85). The original HHI three-factor structure fit the data well in CFA (normed chi-square = 1.53; root mean square error of approximation = 0.05; standardized root mean square residual = 0.05; comparative fit index = 0.96; Tucker-Lewis Index = 0.95).

Conclusion

This article presents the first rigorous cultural adaptation of the HHI in a low-income country. The HHI-K has acceptable psychometric properties, resulting in a new useful tool for research, program development, and evaluation in Rwandan healthcare settings. The HHI-K instrument can be used to assess the effectiveness of programs that aim to promote hope and health outcomes across health system- and individual-levels. The process also provides a feasible model for adaptation of a positive psychosocial tool for both patients and providers in low-resource settings.

The factors associated with depression in schizophrenia patients: the role of self-efficacy, self-esteem, hope and resilience

Previous studies have shown a significant correlation between depression, resilience, self-efficacy, self-esteem and hope among schizophrenia patients, but few studies have examined the mechanisms among these factors. This study aimed to analyse the relationships among resilience, self-efficacy, self-esteem and hope as influencing factors of depression in schizophrenia patients. A cross-sectional study was conducted, and 361 schizophrenia patients were recruited. They were interviewed about their self-efficacy, self-esteem, hope, resilience and depressive symptoms. A structural equation model was used to examine the direct and indirect associations between them. The global model showed good model fit and the structural equation model revealed that the direct pathway of resilience on depression was significant, and the indirect pathway of self-efficacy, self-esteem and hope on depression via resilience was also significant. Notably, self-efficacy, self-esteem and hope did not directly affect depressive symptoms. These findings support the mediating model of self-efficacy, self-esteem and hope relevant to the depressive symptoms of schizophrenia patients in China, in which resilience plays a pivotal role. These findings elucidate the factors which may be associated with depressive symptoms and imply that enhancing resilience in people with schizophrenia could be beneficial. Moreover, studies with detailed longitudinal assessments are necessary to confirm these findings.

The perceived severity of a disease and the impact of the vocabulary used to convey information: using Rasch scaling in a simulated oncological scenario

BACKGROUND

Healthcare staff should be aware of the importance that patients may attach to the words that are used to convey information. This is relevant in terms of the patients' understanding. Modeling how people understand the information conveyed in a medical context may help health practitioners to better appreciate the patients' approach.

PURPOSE

1) Analyze the participants' self-reported perception of the type of information provided in an oncological scenario in terms of three dimensions: impairment to their health, risks associated with the disease itself and commitment required to undergo the treatment; and 2) show the benefits of using Rasch scaling for the analysis of the data. Starting from a survey, Rasch scaling produces a unidimensional logit-interval scale relating to the extent to which each item conveys a latent dimension. These were related to structure, in particular concerning communication by means of opposite vs. unipolar language.

SUBJECTS AND METHODS

The participants rated 82 items of information in a questionnaire regarding their perception of impairment to their health (H) and the risks (R) and commitment relating to the treatment prescribed (T).

RESULTS

The scaling produced an item bank for healthcare staff to consult in order to estimate the importance the recipient would be likely to attach to the vocabulary used and the likely impact of the information in terms of the patient's condition. Furthermore, the use of opposites was generally associated with a clearer impression of whether the information given was generally only very negative or slightly negative, whereas 'neutral' information was often perceived as being very negative.

ACTUAL FINDINGS

Is possible to estimate people's understanding more precisely (in terms of H, R and T) which can help healthcare practitioners to modulate the way they convey information.

LIMITATIONS

The participants in the study were healthy volunteers and the context was simulated.