Psychometric properties of Quality-of-Life Index for Vietnamese women with breast cancer three weeks postmastectomy

Cross-cultural adaptation and psychometric properties of the Indonesian version for quality of life among breast cancer patients

Background

Breast cancer is one of the most important health problems worldwide. Quality of life (QoL) is an important indicator to evaluate symptoms in cancer patients, including those with breast cancer. Culturally suitable, valid, reliable, and appropriate instruments to measure the QoL of breast cancer patients are needed, which is still rare in Indonesia. This study aimed to translate the EORTC QLQ-BR45 instrument into Indonesian and evaluate its psychometrics.

Methods

A cross-sectional study was performed on 635 patients conveniently selected from the oncology department in referral hospital. The first phase of this study involved translation of the existing EORTC QLQ-BR45 into Indonesian, and in the second phase, we evaluated its psychometric properties. Construct validity was evaluated using confirmatory factor analysis (CFA). Criterion validity was examined according to the association between disease stage and Karnofsky Performance Scale (KPS).

Results

A total of 635 (99.00%) completed the EORTC QLQ-BR45 successfully. The instrument indicated good readability and high content validity. All Cronbach's alpha coefficients were satisfactory (overall value, 0.87). For construct validity, patients with KPS ≥80% did better than those with KPS ≤70% as did two multi-item scales in functional scales (body image and breast satisfaction) and five multi-item scales in symptom scales (systemic therapy side effects, endocrine therapy, and arm, breast, and endocrine sexual symptoms). Body image score of late-stage patients was significantly higher. CFA indicated that the nine-factor structure of the Indonesian EORTC QLQ-BR45 was a good fit for the data.

Conclusion

The Indonesian EORTC QLQ-BR45 questionnaire is reliable and valid with good psychometric properties, thus can be used for breast cancer patients in Indonesia.

The effect of Benson relaxation application ('Bens app') on reducing fatigue in patients with breast cancer undergoing chemotherapy: A quasi-experimental study

Background

Fatigue is the most common symptom in patients with breast cancer undergoing chemotherapy. Benson's relaxation technique is considered effective to reduce fatigue, but its effect in combination with smartphone technology is limited.

Objective

This study aimed to analyze and determine the effect of the Benson relaxation application (Bens app) on fatigue in patients with breast cancer undergoing chemotherapy.

Methods

A quasi-experimental design with a pretest-posttest comparison group was used. Fifty-six patients were included using consecutive sampling technique, of which 28 were assigned to the experimental group (received Benson relaxation technique using Bens app) and comparison group (obtained Benson relaxation technique using booklet). The Benson relaxation was done two times per day for seven days, and the Brief Fatigue Inventory questionnaire was used to measure the patients' fatigue levels. Data were analyzed using paired and independent t-tests.

Results

The experimental group (p = 0.001) and the comparison group (p = 0.015) showed a significant reduction in fatigue after receiving the Benson relaxation for seven days. However, there was a statistically significant difference in fatigue between the experiment and comparison groups after the intervention (t55 = 2.481, p = 0.016).

Conclusion

Benson relaxation could reduce fatigue in patients with breast cancer using the Bens app and booklet. However, the Bens app is considered more effective than a booklet. Therefore, the Bens app can be viewed as an alternative to help patients perform Benson relaxation and integrated into the nurse palliative care program for patients with cancer.

Persistent post-surgical pain and its relationship to health-related quality of life in Pakistani women after breast cancer surgery

Background

Breast cancer is the most commonly diagnosed cancer in women; it is also the second-leading cause of death from cancer. Persistent pain after breast cancer surgery is a serious clinical problem that negatively impacts the health-related quality of life of breast cancer survivors. Although persistent post-surgical pain following breast cancer surgery has long been under-reported; however, it is less explored in Pakistan's geographical background.

Objective

The study aimed to examine the persistent post-surgical pain after breast cancer surgery and its relationship to health-related quality of life among Pakistani women.

Methods

A descriptive correlational research design was employed in this study. The Brief Pain Inventory Short Form (BPI-SF) was used to assess the persistent post-surgical pain. The Functional Assessment of Cancer Therapy-Breast (FACT-B) was used to measure the health-related quality of life. Data were collected between February and May 2019 from Pakistani women who have undergone breast cancer surgery for at least three months and attended follow-up visits at two tertiary care hospitals in Pakistan. A Spearman's correlation coefficient was used for data analysis.

Results

The study included 91 Pakistani women. The participants were all females, with an average age of 45.6 years (SD = 6.53). The majority received radical mastectomy (n = 84, 92.3%) with adjuvant therapy (n = 91, 100%). The prevalence of breast surgery-related persistent pain was 100%, with 63 (69.2%) rating the pain as moderate to severe and reported neuropathic pain. The data analysis revealed a statistically significant negative correlation between BPI-SF items and FACT-B dimensions (r = -.43, p < 0.01). The participants appeared to show the highest score of the FACT-B in the social/family well-being (M = 16.58, SD = 3.44). The lowest score of the FACT-B was physical well-being (M = 6.98, SD = 6.38).

Conclusion

Persistent post-surgical pain has a negative impact on the health-related quality of life of Pakistani women breast cancer survivors, particularly on their physical well-being. Therefore, follow-up care of breast cancer survivors after treatment completion requires proper persistent pain-relief treatments and interventions to control pain and maintain health-related quality of life in oncology and research in this sphere. This basic knowledge from this study will enlighten the nurses and health care professionals to pay more attention to pain management and regular evaluation of persistent post-surgical pain after breast cancer surgery in order to improve their health-related quality of life.