Validation of the Adherence Determinants Questionnaire scale among women with breast and cervical cancer

Validation of a scale to assess adherence to oral chemotherapy based on the experiences of patients and healthcare professionals (EXPAD-ANEO)

Background: Lack of adherence to Oral antineoplastic agents (OAAs) treatment has important clinical, social and economic consequences.

Objective: To develop and validate a novel instrument for assessing adherence to OAAs, based on the reported experiences of people with cancer in relation to their treatment and the opinions of the healthcare professionals who care for them.

Methods: We performed a multicenter validation study of a scale designed to assess adherence to OAAs. First, a steering committee developed the items for an initial scale, based on the results of a qualitative study that evaluated patients’ and professionals’ experiences with this treatment. We then assessed the validity and reliability of the initial scale in a sample of 268 outpatients with cancer who received their OAAs from four Spanish hospitals.

Results: The mean age of the sample of 268 outpatients was 64.1 (standard deviation [SD] 12.4) years, and 47% of participants were women. With the results of this analysis, we developed the EXPAD-ANEO scale, which has 2 factors, one for beliefs and expectations and another for behavior. Both factors explain 52% of the explained common variance. Good reliability was obtained, with a McDonald’s omega of 0.7 for the first factor and 0.6 for the second factor. The fit indices were optimal (Root Mean Square Error of Approximation = 0.02, Comparative Fit Index = 0.99, Tucker Lexis Index = 0.99 and Standardized Root Mean Squared Residual = 0.03), which verifies the appropriateness of the items to the model. We measured EXPAD-ANEO criterion validity against pill count, obtaining a specificity of 80%. We measured convergent validity with the Morisky-Green test and found a significant association (p < 0.001). We measured divergent validity with questions on health literacy from the 16-item European Health Literacy Survey and found no correlation (p = 0.153).

Conclusion: EXPAD-ANEO is the first validated instrument for evaluating patients’ experiences with and adherence to OAAs, providing valuable information that can help health professionals to establish individual strategies or collective programs for improving therapeutic results and reducing healthcare costs.

HEALTH-RELATED QUALITY OF LIFE AND THERAPEUTIC ADHERENCE IN BREAST AND PROSTATE CANCER

ABSTRACT Objective to correlate health-related quality of life and adherence to treatment of patients with breast and prostate cancer. Method an exploratory, descriptive and cross-sectional study, with a quantitative approach, conducted with 305 patients with breast and prostate cancer, in a state oncology hospital in Paraíba, Brazil, between June and November 2019. For data collection, a semi-structured instrument was used to obtain data regarding the sociodemographic and clinical profile, from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire “core” 30 items, from the specific module Quality of Life Questionnaire-Breast Cancer, and from the Adherence Determinants Questionnaire. Data analysis was performed using descriptive and inferential statistics. Results the correlation between health-related quality of life and adherence of patients with prostate cancer showed statistical significance (p≤0.05) between the Global health Scale and the Functional Scale, Intentions domain; emotional function and intentions; insomnia and subjective norms; financial difficulty and subjective norms. In women, there was statistical significance (p≤0.05) between role performance and subjective norms; fatigue and intentions; financial difficulty and total adherence; sexual desire, sexual satisfaction and perceived support/severity; breast symptoms and intentions. Conclusion health-related quality of life directly impacts on treatment adherence of patients with breast and prostate cancer.

Motivation and Continuance Intention towards Online Instruction among Teachers during the COVID-19 Pandemic: The Mediating Effect of Burnout and Technostress

In-service teachers have various emotional and motivational experiences that can influence their continuance intention towards online-only instruction during the COVID-19 pandemic, as a significant stress factor for their workplace. Derived from the Self-Determination Theory (SDT), Job Demands–Resources Model (JD–R), and Technology Acceptance Model (TAM), the present research model includes technological pedagogical knowledge (TPK) self-efficacy (SE), intrinsic (IM) and extrinsic (EM) work motivation, and occupational stress (OS) (i.e., burnout and technostress which have been examined in tandem) as key dimensions to explain the better continuance intention among in-service teachers to use online-only instruction (CI). Data for the research model were collected from 980 in-service teachers during the COVID-19 outbreak between April and May 2020. Overall, the structural model explained 70% of the variance in teachers’ CI. Motivational practices were directly and indirectly linked through OS with CI. The findings showed that IM has the most directly significant effect on teachers’ CI, followed by TPK-SE, and OS as significant, but lower predictors. IM was positively associated with TPK-SE and negatively associated with EM. The results offered valuable insights into how motivation constructs were related to OS and to a better understanding online instruction in an unstable work context, in order to support teachers in coping during working remotely.

A questionnaire on factors affecting the precaution adoption process model for cervical cancer - Psychometric properties

BACKGROUND

Implementing a cervical cancer prevention program requires an exploration of certain behaviors concerning this disease. This study is aimed to evaluate the psychometrics of a questionnaire that enquired about the factors involved in Precaution Adoption Process Model (PAPM) for cervical cancer among suburban women in Bandar Abbas, south of Iran.

MATERIALS AND METHODS

The primary draft of the questionnaire was developed with a review of the related literature on cervical cancer and the constructs affecting PAPM, with 68 items. The face validity, content validity ratio (CVR), and content validity index (CVI) of the questionnaire were approved by a panel of 10 experts. The internal consistency and test-retest reliability of the questionnaire were estimated too. Field testing sample included 300 women recruited from a women's healthcare center in suburban areas of Bandar Abbas in the south of Iran. Exploratory factor analysis was used to evaluate validity, and Cronbach's alpha coefficient was estimated for reliability.

RESULTS

After the face validation, 11 items were eliminated. Once CVR was estimated, two items were discarded. The remaining items had a CVR >0.79. All had a CVI >0.79. Six items were eliminated in the factor analysis. The final questionnaire included 49 items organized in 8 factors including awareness, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, social norms, fear, and self-efficacy. Principal component analysis with varimax rotation indicated eight main components that explained 56.25% of the variance. Reliability assessment showed a good internal consistency for all subscales and the Cronbach's alpha score ranged between 0.82 and 0.90. The test-retest reliability showed that the correlation coefficients (between 0.81 and 0.89) were significant at the 0.01 level for all sub-scales.

CONCLUSIONS

The final questionnaire was a new instrument comprised the effective constructs of PAPM and had a high reliability and validity. Thus, this questionnaire is recommended to be used to explore and enhance preventive behaviors of cervical cancer.

Development and validation of an instrument to assess Brazilian healthcare professional providers' knowledge on sickle cell disease

Objective

To develop and validate DFConhecimento, an instrument to assess Brazilian healthcare professional providers’ knowledge on sickle cell disease.

Method

Study carried out in four stages: (1) instrument development; (2) content validation by an Expert Committee; (3) cultural adequacy check at pre-test; (4) instrument reliability analysis by healthcare professional providers supported by Intraclass Correlation Coefficient calculation. The data for content validation and reliability analyses were collected through the web tool eSurv and analyzed within the statistical software and environment R.

Results

The instrument, consisting of 13 multiple-choice questions, showed acceptability, with an average Content Validity Index of 0.88. The reliability analysis showed moderate agreement (0.67) indicating that test-retest reproducibility is acceptable.

Conclusion

The instrument DFConhecimento showed reliability and internal consistency, proving suitable for measuring Brazilian healthcare professional providers’ acquisition of knowledge on sickle cell disease.

Adherence to oral pharmacological treatment in cancer patients: Systematic review

The objective was to identify the best-validated scale for assessing oral pharmacological adherence in oncology patients.

A bibliographic search was performed in MEDLINE via Ovid, EMBASE, CENTRAL and LILACS. We included all studies in which a validation of adherence scales to oral pharmacological treatment was performed in oncology patients older than 18 years without gender distinction. We excluded studies that included newly diagnosed patients. No statistical analysis was performed due to the nature of the study. A total of 4609 studies were found. After screening, six studies were selected for qualitative analysis. In the analysis of the six included studies, a total of 855 patients older than 18 years with oncological diagnoses were found. Two of the studies, Bagcivan et al. and Amorim et al., used scales that show acceptable validity and reliability to adequately measure adherence to pharmacological treatment in each of the patients. In this way, the quality of patient care and success in pharmacological treatments can be guaranteed. According to the results obtained in the evaluation of biases and analysis of psychometric properties, the best-validated scales are as follows: Adherence Determinants Questionnaire (ADQ) (Brazilian version) and the Oral Chemotherapy Adherence Scale (OCAS). These are valid, reliable and useful scales that can be adapted to any cultural context.

Translation and adaptation of the Competencias Esenciales en Salud Pública para los recursos humanos en salud

Objective:

to perform the translation and cultural adaptation of the document named Marco Regional de Competencias Esenciales en Salud Pública para los Recursos Humanos en Salud de la Región de las Américas (Regional Framework of Core Competencies in Public Health for Health Human Resources in the Region of Americas) from Spanish to Brazilian Portuguese.

Method:

a methodological study comprising the following phases: authorization for translation; initial translation; synthesis of translations and consensus; back-translation and formation of an expert committee.

Result:

in the translation of domain names, there was no difference in 66.7% (N = 4); in the translation of domain description and competencies there were divergences in 100% of them (N = 6, N = 56). A consensus of more than 80% was obtained in the translation and improvement in the expert committee by the change of words and expressions for approximation of meanings to the Brazilian context.

Conclusion:

the translated and adapted document has the potential of application in research, and use in the practice of collective/public health care in Brazil.

Objetivo:

realizar a tradução e adaptação cultural do Marco Regional de Competencias Esenciales en Salud Pública para los Recursos Humanos en Salud de la Región de las Américas, do espanhol para a língua portuguesa do Brasil.

Método:

pesquisa metodológica, que seguiu as fases: autorização para tradução; tradução inicial; síntese das traduções e consenso; retrotradução e composição de um comitê de especialistas.

Resultado:

na tradução dos nomes dos domínios, não houve diferença em 66,7 % (N=4); na tradução da descrição dos domínios e das competências ocorreram divergências em 100 % destes (N=6, N=56), obteve-se consenso acima de 80% ainda na tradução, e aprimoramento no comitê de especialistas pela alteração de palavras e expressões para aproximar os significados ao contexto brasileiro.

Conclusão:

o documento traduzido e adaptado possui potencial de aplicação em pesquisas e utilização na prática da atenção à saúde pública/coletiva no Brasil.

Objetivo:

realizar la traducción y adaptación cultural del Marco Regional de Competencias Esenciales en Salud Pública para los Recursos Humanos en Salud de la Región de las Américas, del español para el idioma portugués de Brasil.

Método:

investigación metodológica, que siguió las fases: autorización para traducción; traducción inicial; síntesis de las traducciones y consenso; y, retrotraducción y composición de un comité de especialistas.

Resultado:

en la traducción de los nombres de los dominios, no hubo diferencia en 66,7 % (N=4); en la traducción de la descripción de los dominios y de las competencias ocurrieron divergencias en 100 % de estos (N=6, N=56), se obtuvo consenso arriba de 80%, durante la traducción y perfeccionamiento, en el comité de especialistas, en la alteración de palabras y expresiones para aproximar los significados al contexto brasileño.

Conclusión:

el documento traducido y adaptado posee potencial de aplicación en investigaciones y de utilización en la práctica de la atención a la salud pública/colectiva en Brasil.