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Rapoport CS, Choi AK, Kwakkenbos L, Carrier ME, Henry RS, Levis B, Bartlett SJ, Gietzen A, Gottesman K, Guillot G, Lawrie-Jones A, Mayes MD, Mouthon L, Richard M, Worron-Sauvé M, Benedetti A, Roesch SC, Thombs BD, Malcarne VL. Moderators of Loneliness Trajectories in People with Systemic Sclerosis During the COVID-19 Pandemic: A SPIN COVID-19 Cohort Longitudinal Study. Int J Behav Med 2024; 31:352-362. [PMID: 38238585 DOI: 10.1007/s12529-023-10248-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 05/21/2024]
Abstract
BACKGROUND Many individuals with systemic sclerosis (SSc) are at heightened risk for COVID-19 related morbidity and isolation due to interstitial lung disease, frailty, and immunosuppressant use. Minimal research has explored loneliness predictors in individuals with chronic illnesses during COVID-19. This study evaluated moderators of loneliness trajectories in individuals with SSc during COVID-19. METHODS Longitudinal data were analyzed across 30 timepoints from April 2020 to May 2022 from 775 adults in the Scleroderma Patient-centered Intervention Network (SPIN) COVID-19 Cohort. Hierarchical linear modeling evaluated cross-level moderators of loneliness trajectories, including marital status, baseline number of household members, number of virtual or telephone one-on-one or virtual group conversations, number of hours spent enjoying in-person household conversations or activities, and satisfaction with quality of in-person household conversations (all in the past week). Level-1 moderation analyses assessed effects of conversation, activity, and satisfaction means and slopes over time. RESULTS Baseline values were not statistically significant moderators of loneliness trajectories. Higher mean (averaged over time) virtual or telephone one-on-one and in-person household conversations, in-person household activity, and in-person household conversation satisfaction were associated with lower loneliness trajectories (ps < .05). The relationship between in-person household conversation satisfaction and loneliness trajectory was statistically significantly but minimally attenuated over time (p < .001). CONCLUSIONS For people with SSc, higher mean conversation, activity, and satisfaction variables were associated with lower levels of loneliness during the pandemic, but changes in these social variables were generally not predictive of changes in loneliness.
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Affiliation(s)
- Chelsea S Rapoport
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Alyssa K Choi
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen, the Netherlands
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Amy Gietzen
- National Scleroderma Foundation, Tri-State Chapter, Buffalo, NY, USA
| | | | | | - Amanda Lawrie-Jones
- Scleroderma Australia, Melbourne, VIC, Australia
- Scleroderma Victoria, Melbourne, VIC, Australia
| | - Maureen D Mayes
- Department of Internal Medicine, University of Texas McGovern School of Medicine, Houston, TX, USA
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
- APHP-CUP, Hôpital Cochin, Paris, France
| | | | - Maureen Worron-Sauvé
- Scleroderma Society of Ontario, Hamilton, ON, Canada
- Scleroderma Canada, Hamilton, ON, Canada
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Scott C Roesch
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Department of Psychology, San Diego State University, 6363 Alvarado Ct., Ste. 103, San Diego, CA, 92120, USA
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
| | - Vanessa L Malcarne
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
- Department of Psychology, San Diego State University, 6363 Alvarado Ct., Ste. 103, San Diego, CA, 92120, USA.
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Østbø N, Yakes Jimenez E, Carrier ME, Kwakkenbos L, Thombs B. Use and perceptions of nutrition information resources in systemic sclerosis: a Scleroderma Patient-centred Intervention Network (SPIN) cohort study. Clin Exp Rheumatol 2024:20366. [PMID: 38573100 DOI: 10.55563/clinexprheumatol/dt5hae] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/28/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES People with systemic sclerosis (SSc) may find it challenging to obtain high-quality nutrition and diet information. Objectives were to evaluate (i) how commonly different information resources are used and (ii) perceived trustworthiness, accessibility, comprehensibility, and individualisation of resources. METHODS We administered the Scleroderma Patient-centred Intervention Network Nutrition Information Resources Survey to participants in an international cohort. Participants were asked if they had used 26 informational resources in four categories, including (i) health care providers, (ii) websites or social media, (iii) print materials, and (iv) events, and to rate each resource on trustworthiness, accessibility, comprehensibility, and individualisation (0 = not at all to 10 = completely). RESULTS 727 participants completed the survey. Most (94%) had sought nutrition or diet information from at least one resource. The most-used category was health care providers (86%), followed by print materials (68%), websites or social media (66%), and events (43%). People who had used a resource generally rated it more favourably across all domains than those who had not. The highest-rated resources across domains were conventional health care providers (doctors, registered dieticians, nurses), SSc patient organisations, SSc support groups, and university or research institution websites. CONCLUSIONS Respondents used many different diet and nutrition information resources. They preferred resources from conventional health care providers, affiliated with credible institutions (e.g., SSc patient organisations), or with personal connections (e.g., SSc support groups). Future research should address the limited evidence base on nutrition in SSc and assess the quality of information provided by different information resources.
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Affiliation(s)
- Nora Østbø
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada, and Department of Health Management and Health Economics, University of Oslo, Norway
| | - Elizabeth Yakes Jimenez
- Departments of Paediatrics and Internal Medicine and College of Population Health, University of New Mexico Health Sciences Center, Albuquerque, NM; and Nutrition Research Network, Academy of Nutrition and Dietetics, Chicago, IL, USA
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen; Department of IQ Health care, Radboud University Medical Center, Nijmegen; and Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Brett Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec; Department of Psychiatry, McGill University, Montreal, Quebec; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec; Department of Medicine, McGill University, Montreal, Quebec; Department of Psychology, McGill University, Montreal, Quebec; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada.
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Neyer MA, Henry RS, Carrier ME, Kwakkenbos L, Virgili-Gervais G, Wojeck RK, Wurz A, Gietzen A, Gottesman K, Guillot G, Lawrie-Jones A, Mayes MD, Mouthon L, Nielson WR, Richard M, Sauvé M, Harel D, Malcarne VL, Bartlett SJ, Benedetti A, Thombs BD. The association of resilience and positive mental health in systemic sclerosis: A Scleroderma Patient-centered Intervention Network (SPIN) cohort cross-sectional study. J Psychosom Res 2024; 179:111648. [PMID: 38507968 DOI: 10.1016/j.jpsychores.2024.111648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/07/2024] [Accepted: 03/09/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE A previous study using Scleroderma Patient-centered Intervention Network (SPIN) Cohort data identified five classes of people with systemic sclerosis (also known as scleroderma) based on patient-reported somatic (fatigue, pain, sleep) and mental health (anxiety, depression) symptoms and compared indicators of disease severity between classes. Across four classes ("low", "normal", "high", "very high"), there were progressively worse somatic and mental health outcomes and greater disease severity. The fifth ("high/low") class, however, was characterized by high disease severity, fatigue, pain, and sleep but low mental health symptoms. We evaluated resilience across classes and compared resilience between classes. METHODS Cross-sectional study. SPIN Cohort participants completed the 10-item Connor-Davidson-Resilience Scale (CD-RISC) and PROMIS v2.0 domains between August 2022 and January 2023. We used latent profile modeling to identify five classes as in the previous study and multiple linear regression to compare resilience levels across classes, controlling for sociodemographic and disease variables. RESULTS Mean CD-RISC score (N = 1054 participants) was 27.7 (standard deviation = 7.3). Resilience decreased progressively across "low" to "normal" to "high" to "very high" classes (mean 4.7 points per step). Based on multiple regression, the "high/low" class exhibited higher resilience scores than the "high" class (6.0 points, 95% confidence interval [CI] 4.9 to 7.1 points; standardized mean difference = 0.83, 95% CI 0.67 to 0.98). CONCLUSIONS People with worse disease severity and patient-reported outcomes reported substantially lower resilience, except a class of people with high disease severity, fatigue, pain, and sleep disturbance but positive mental health and high resilience.
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Affiliation(s)
- Marieke A Neyer
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
| | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands; Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Psychiatry, Centre for Mindfulness, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | - Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, Canada.
| | - Amy Gietzen
- National Scleroderma Foundation, Tri-State Chapter, Binghamton, NY, USA
| | | | | | - Amanda Lawrie-Jones
- Scleroderma Australia, Melbourne, Victoria, Australia; Scleroderma Victoria, Melbourne, Victoria, Australia.
| | - Maureen D Mayes
- University of Texas McGovern School of Medicine, Houston, TX, USA.
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Paris, France; Assistance Publique Hôpitaux de Paris-Centre, Hôpital Cochin, Université Paris Cité, Paris, France.
| | - Warren R Nielson
- Department of Psychology, Western University, and Lawson Research Institute, London, Ontario, Canada
| | | | - Maureen Sauvé
- Scleroderma Society of Ontario, Hamilton, Ontario, Canada; Scleroderma Canada, Hamilton, Ontario, Canada
| | | | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA; San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada.
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada; Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada.
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Dal Santo T, Rice DB, Carrier ME, Virgili-Gervais G, Levis B, Kwakkenbos L, Golberg M, Bartlett SJ, Gietzen A, Gottesman K, Guillot G, Hudson M, Hummers LK, Malcarne VL, Mayes MD, Mouthon L, Richard M, Sauvé M, Wojeck RK, Geoffroy MC, Benedetti A, Thombs BD. Factors associated with physical function among people with systemic sclerosis: a SPIN cohort cross-sectional study. Rheumatology (Oxford) 2024:keae162. [PMID: 38471107 DOI: 10.1093/rheumatology/keae162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/12/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVES To compare physical function in systemic sclerosis (SSc, scleroderma) to general population normative data and identify associated factors. METHODS Scleroderma Patient-centered Intervention Network Cohort participants completed the Physical Function domain of the Patient-Reported Outcomes Measurement Information System Version 2 upon enrolment. Multivariable linear regression was used to assess associations of sociodemographic, lifestyle, and disease-related variables. RESULTS Among 2,385 participants, mean physical function T-score (43.7, SD = 8.9) was ∼2/3 of a standard deviation (SD) below the US general population (mean = 50, SD = 10). Factors associated in multivariable analysis included older age (-0.74 points per SD years, 95% CI -0.78 to -1.08), female sex (-1.35, -2.37 to -0.34), fewer years of education (-0.41 points per SD in years, -0.75 to -0.07), being single, divorced, or widowed (-0.76, -1.48 to -0.03), smoking (-3.14, -4.42 to -1.85), alcohol consumption (0.79 points per SD drinks per week, 0.45-1.14), BMI (-1.41 points per SD, -1.75 to -1.07), diffuse subtype (-1.43, -2.23 to -0.62), gastrointestinal involvement (-2.58, -3.53 to -1.62), digital ulcers (-1.96, -2.94 to -0.98), moderate (-1.94, -2.94 to -0.93) and severe (-1.76, -3.24 to -0.28) small joint contractures, moderate (-2.10, -3.44 to -0.76) and severe (-2.54, -4.64 to -0.44) large joint contractures, interstitial lung disease (-1.52, -2.27 to -0.77), pulmonary arterial hypertension (-3.72, -4.91 to -2.52), rheumatoid arthritis (-2.10, -3.64 to -0.56) and idiopathic inflammatory myositis (-2.10, -3.63 to -0.56). CONCLUSION Physical function is impaired for many individuals with SSc and associated with multiple disease factors.
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Affiliation(s)
- Tiffany Dal Santo
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Danielle B Rice
- Department of Psychology, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Meira Golberg
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Amy Gietzen
- National Scleroderma Foundation, Tri-State Chapter, Buffalo, New York, USA
| | - Karen Gottesman
- National Scleroderma Foundation, Los Angeles, California, USA
| | | | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Laura K Hummers
- Johns Hopkins University School of Medicine, Division of Rheumatology, Baltimore, Maryland, USA
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, California, USA
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
| | - Maureen D Mayes
- University of Texas McGovern School of Medicine, Houston, Texas, USA
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Paris, France
- Assistance Publique Hôpitaux de Paris-Centre, Hôpital Cochin, Université Paris Cité, Paris, France
| | - Michelle Richard
- Scleroderma Canada, Hamilton, Ontario, Canada
- Scleroderma Atlantic, Halifax, Nova Scotia, Canada
| | - Maureen Sauvé
- Scleroderma Canada, Hamilton, Ontario, Canada
- Scleroderma Society of Ontario, Hamilton, Ontario, Canada
| | | | - Marie-Claude Geoffroy
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- , McGill Group for Suicide Studies, Douglas Research Centre, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
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Choi AK, Rapoport CS, Kwakkenbos L, Carrier ME, Gottesman K, Roesch SC, Harel D, Thombs BD, Malcarne VL. Measurement equivalence of the English and French versions of the self-efficacy to manage chronic disease scale: a Scleroderma Patient-Centered Intervention Network (SPIN) study. Qual Life Res 2024; 33:843-851. [PMID: 38191792 DOI: 10.1007/s11136-023-03571-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE The Self-Efficacy to Manage Chronic Disease (SEMCD) scale is widely used, including in systemic sclerosis (SSc). The SEMCD has been validated in SSc, but the metric equivalence of the English and French versions has not been assessed (i.e., whether psychometric properties are equivalent across English and French). METHODS Participants were adults from the Scleroderma Patient-Centered Intervention Network (SPIN) Cohort (N = 2159) who completed baseline measures in English (n = 1473) or French (n = 686) between May 2014 to July 2020. Analyses assessed internal consistency reliability via Cronbach's alpha and McDonald's omega, convergent validity via Pearson's correlations, structural validity via confirmatory factor analysis (CFA), and differential item functioning via the Multiple-Indicator Multiple-Cause (MIMIC) model. RESULTS Internal consistency reliability was high in English (α = .93, ω = .93) and French (α = .92, ω = .93). All correlations between the SEMCD and measures of health outcomes were moderate to large, statistically significant, and in the hypothesized direction in both languages. The CFA demonstrated that the one-factor model of self-efficacy, overall, fit reasonably well (CFI = .96, TLI = .93, SRMR = .03, RMSEA = .14). Standardized factor loadings were large (.76 to .88). Three items displayed statistically significant uniform DIF and all six displayed nonuniform DIF; all DIF was of minimal magnitude. Comparison of unadjusted and DIF-adjusted models indicated that DIF did not meaningfully impact total score (ICC = 0.999, r = 0.999). CONCLUSION Scores from English- and French-speaking adults with SSc can be combined for analysis or compared.
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Affiliation(s)
- Alyssa K Choi
- San Diego State University/University of California San Diego, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120-4913, USA
| | - Chelsea S Rapoport
- San Diego State University/University of California San Diego, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120-4913, USA
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University Behavioural Science Institute, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | | | - Scott C Roesch
- San Diego State University/University of California San Diego, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120-4913, USA
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Daphna Harel
- Department of Applied Statistics, Social Science, and Humanities, New York University, New York, NY, USA
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Vanessa L Malcarne
- San Diego State University/University of California San Diego, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120-4913, USA.
- Department of Psychology, San Diego State University, San Diego, CA, USA.
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6
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Dal Santo T, Rice D, Carrier ME, Virgili-Gervais G, Levis B, Kwakkenbos L, Bartlett SJ, Gietzen A, Gottesman K, Guillot G, Hudson M, Hummers LK, Malcarne V, Mayes M, Mouthon L, Richard M, Sauve M, Wojeck R, Geoffroy MC, Benedetti A, Thombs B. Factors associated with satisfaction with social roles and activities among people with systemic sclerosis: a Scleroderma Patient-centered Intervention Network (SPIN) cohort cross-sectional study. RMD Open 2024; 10:e003876. [PMID: 38428973 PMCID: PMC10910418 DOI: 10.1136/rmdopen-2023-003876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/14/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVE The objectives were to (1) compare satisfaction with social roles and activities in a large multinational systemic sclerosis (SSc) cohort to general population normative data and (2) identify sociodemographic, lifestyle and SSc disease factors associated with satisfaction with social roles and activities. METHODS Participants in the Scleroderma Patient-centered Intervention Network Cohort completed the Patient Reported Outcomes Information System Version 2 satisfaction with social roles and activities domain questionnaire. Multivariable regression was used to assess associations with sociodemographic, lifestyle and disease factors. RESULTS Among 2385 participants, mean satisfaction with social roles and activities T-score (48.1, SD=9.9) was slightly lower than the US general population (mean=50, SD=10). Factors independently associated with satisfaction were years of education (0.54 per SD, 95% CI 0.14 to 0.93); non-White race or ethnicity (-1.13, 95% CI -2.18 to -0.08); living in Canada (-1.33, 95% CI -2.40 to -0.26 (reference USA)) or the UK (-2.49, 95% CI -3.92 to -1.06); body mass index (-1.08 per SD, 95% CI -1.47 to -0.69); gastrointestinal involvement (-3.16, 95% CI -4.27 to -2.05); digital ulcers (-1.90, 95% CI -3.05 to -0.76); moderate (-1.62, 95% CI -2.78 to -0.45) or severe (-2.26, 95% CI -3.99 to -0.52) small joint contractures; interstitial lung disease (-1.11, 95% CI -1.97 to -0.25); pulmonary arterial hypertension (-2.69, 95% CI -4.08 to -1.30); rheumatoid arthritis (-2.51, 95% CI -4.28 to -0.73); and Sjogren's syndrome (-2.42, 95% CI -3.96 to -0.88). CONCLUSION Mean satisfaction with social roles and activities is slightly lower in SSc than the general population and associated with multiple sociodemographic and disease factors.
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Affiliation(s)
- Tiffany Dal Santo
- Lady Davis Institute for Medical Research, Montreal, Québec, Canada
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
| | - Danielle Rice
- Department of Psychology, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Brooke Levis
- Lady Davis Institute for Medical Research, Montreal, Québec, Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud Universiteit, Nijmegen, The Netherlands
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Québec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
| | - Amy Gietzen
- National Scleroderma Foundation Tri-State Chapter, Buffalo, New York, USA
| | - Karen Gottesman
- National Scleroderma Foundation, Los Angeles, California, USA
| | | | - Marie Hudson
- Lady Davis Institute for Medical Research, Montreal, Québec, Canada
- Department of Medicine, McGill University, Montreal, Québec, Canada
| | - Laura K Hummers
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vanessa Malcarne
- Department of Psychology, San Diego State University, San Diego, California, USA
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/Univeristy of California, San Diego, California, USA
| | - Maureen Mayes
- University of Texas McGovern Medical School, Houston, Texas, USA
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Paris, France
- Assistance Publique Hôpitaux de Paris-Centre, Hôpital Cochin, Université Paris Cité, Paris, France
| | - Michelle Richard
- Scleroderma Atlantic, Halifax, Nova Scotia, Canada
- Slceroderma Canada, Hamilton, Ontario, Canada
| | - Maureen Sauve
- Slceroderma Canada, Hamilton, Ontario, Canada
- Scleroderma Society of Ontario, Hamilton, Ontario, Canada
| | - Robyn Wojeck
- University of Rhode Island, Kingston, Rhode Island, USA
| | - Marie-Claude Geoffroy
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
- McGill Group for Suicide Studies, Douglas Research Centre, Montreal, Québec, Canada
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, Québec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Brett Thombs
- Lady Davis Institute for Medical Research, Montreal, Québec, Canada
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
- Department of Medicine, McGill University, Montreal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, Canada
- Biomedical Ethics Unit, McGill University, Montreal, Québec, Canada
- Department of Psychology, McGill University, Montreal, Québec, Canada
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7
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Wurz A, Duchek D, Ellis K, Bansal M, Carrier ME, Tao L, Dyas L, Kwakkenbos L, Levis B, El-Baalbaki G, Rice DB, Wu Y, Henry RS, Bustamante L, Harb S, Hebblethwaite S, Patten SB, Bartlett SJ, Varga J, Mouthon L, Markham S, Thombs BD, Culos-Reed SN. A qualitative interview study exploring the psychological health impacts of the SPIN-CHAT program among people with systemic sclerosis at the onset of COVID-19: perceptions of trial participants and research team members. Disabil Rehabil 2024; 46:533-545. [PMID: 36708187 DOI: 10.1080/09638288.2023.2169775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 01/13/2023] [Indexed: 01/29/2023]
Abstract
PURPOSE Explore trial participants' and research team members' perceptions of the impact of the videoconference-based, supportive care program (SPIN-CHAT Program) during early COVID-19 for individuals with systemic sclerosis (SSc). METHODS Data were collected cross-sectionally. A social constructivist paradigm was adopted, and one-on-one videoconference-based, semi-structured interviews were conducted with SPIN-CHAT Trial participants and research team members. A hybrid inductive-deductive approach and reflexive thematic analysis were used. RESULTS Of the 40 SPIN-CHAT Trial participants and 28 research team members approached, 30 trial participants (Mean age = 54.9; SD = 13.0 years) and 22 research team members agreed to participate. Those who took part in interviews had similar characteristics to those who declined. Five themes were identified: (1) The SPIN-CHAT Program conferred a range of positive psychological health outcomes, (2) People who don't have SSc don't get it: The importance of SSc-specific programming, (3) The group-based format of the SPIN-CHAT Program created a safe space to connect and meet similar others, (4) The structure and schedule of the SPIN-CHAT Program reduced feelings of boredom and contributed to enhanced psychological health, (5) The necessity of knowledge, skills, and tools to self-manage SSc and navigate COVID-19. CONCLUSION Participants' and research team members' perspectives elucidated SPIN-CHAT Program benefits and how these benefits may have been realized. Results underscore the importance of social support from similar others, structure, and self-management to enhance psychological health during COVID-19. TRIAL REGISTRATION clinicaltrials.gov (NCT04335279)IMPLICATIONS FOR REHABILITATIONThe videoconference-based, supportive care SPIN-CHAT Program enhanced psychological health amongst individuals affected by systemic sclerosis.SPIN-CHAT Program participants and research team members shared that being around similar others, program structure, and self-management support were important and may have contributed to enhanced psychological health.Further efforts are required to explore experiences within supportive care programs to better understand if and how psychological health is impacted.
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Affiliation(s)
- Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Delaney Duchek
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Kelsey Ellis
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Mannat Bansal
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Laura Dyas
- National Scleroderma Foundation, Michigan Chapter, Southfield, MI, USA
| | - Linda Kwakkenbos
- Clinical Psychology, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboudumc Center for Mindfulness, Department of Psychiatry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, UK
| | | | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
| | - Yin Wu
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
| | - Laura Bustamante
- Department of Applied Human Sciences, Concordia University, Montreal, Canada
| | - Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | | | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Canada
- Research Institute, McGill University Health Centre, Montreal, Canada
| | - John Varga
- University of Michigan, Ann Arbor, MI, USA
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
- Department of Medicine, McGill University, Montreal, Canada
- Biomedical Ethics Unit, McGill University, Montreal, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, Canada
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8
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Wurz A, Ellis K, Nordlund J, Carrier ME, Cook V, Gietzen A, Adams C, Nassar EL, Rice DB, Fortune C, Guillot G, Mieszczak T, Richard M, Sauve M, Thombs BD. Researcher and patient experiences of co-presenting research to people living with systemic sclerosis at a patient conference: content analysis of interviews. Res Involv Engagem 2024; 10:13. [PMID: 38281049 PMCID: PMC10822162 DOI: 10.1186/s40900-024-00546-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/22/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Patient engagement in research is important to ensure research questions address problems important to patients, that research is designed in a way that can effectively answer those questions, and that findings are applicable, relevant, and credible. Yet, patients are rarely involved in the dissemination stage of research. This study explored one way to engage patients in dissemination, through co-presenting research. METHODS Semi-structured, one-on-one, audio-recorded interviews were conducted with researchers and patients who co-presented research at one patient conference (the 2022 Canadian National Scleroderma Conference) in Canada. A pragmatic orientation was adopted, and following verbatim transcription, data were analyzed using conventional content analysis. RESULTS Of 8 researchers who were paired with 7 patients, 5 researchers (mean age = 28 years, SD = 3.6 years) and 5 patients (mean age = 45 years, SD = 14.2 years) participated. Researcher and patient perspectives about their experiences co-presenting and how to improve the experience were captured across 4 main categories: (1) Reasons for accepting the invitation to co-present; (2) Degree that co-presenting expectations were met; (3) The process of co-presenting; and (4) Lessons learned: recommendations for co-presenting. CONCLUSIONS Findings from this study suggest that the co-presenting experience was a rewarding and enjoyable way to tailor research dissemination to patients. We identified a patient-centred approach and meaningful and prolonged patient engagement as essential elements underlying co-presenting success.
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Affiliation(s)
- Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, 45190 Caen Ave, Chilliwack, BC, V2R 0N3, Canada.
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
| | - Kelsey Ellis
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Julia Nordlund
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Vanessa Cook
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Amy Gietzen
- National Scleroderma Foundation, Tri-State Chapter, New York, USA
| | - Claire Adams
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Elsa-Lynn Nassar
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Danielle B Rice
- Mood Disorders Treatment and Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | | | | | - Tracy Mieszczak
- Rochester Scleroderma Support Group, National Scleroderma Foundation, New York, USA
| | | | - Maureen Sauve
- Scleroderma Society of Ontario, Hamilton, ON, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
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9
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Kwakkenbos L, Thombs BD, Khanna D, Carrier ME, Baron M, Furst DE, Gottesman K, van den Hoogen F, Malcarne VL, Mayes MD, Mouthon L, Nielson WR, Poiraudeau S, Riggs R, Sauvé M, Wigley F, Hudson M, Bartlett SJ. Performance of the Patient-Reported Outcomes Measurement Information System-29 in scleroderma: a Scleroderma Patient-centered Intervention Network Cohort Study. Rheumatology (Oxford) 2023; 62:3771. [PMID: 31168593 PMCID: PMC11009684 DOI: 10.1093/rheumatology/kez234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Linda Kwakkenbos
- Lady Davis Institute for Medical Research, Jewish General Hospital
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Department of Medicine, McGill UniversityMontréal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational HealthMcGill University, Montréal, Québec, Canada
- Department of Educational and Counselling PsychologyMcGill University, Montréal, Québec, Canada
- Department of PsychologyMcGill University, Montréal, Québec, Canada
- School of Nursing, McGill University, Montréal, Québec, Canada
| | - Dinesh Khanna
- University of Michigan Scleroderma Program, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Murray Baron
- Lady Davis Institute for Medical Research, Jewish General Hospital
- Department of Medicine, McGill UniversityMontréal, Québec, Canada
| | - Daniel E Furst
- Division of Rheumatology, Geffen School of Medicine, University of California, Los Angeles
| | | | - Frank van den Hoogen
- Department of Rheumatology, Radboud University Medical Center
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University and the University of California, San Diego, CA
| | - Maureen D Mayes
- Department of Internal Medicine, Division of Rheumatology, McGovern Medical School, University of Texas, Houston, TX, USA
| | - Luc Mouthon
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris
- Service de Médecine Interne, Hôpital Cochin, Paris, France
| | - Warren R Nielson
- Beryl & Richard Ivey Rheumatology Day Programs, St Joseph's Health Care
- Lawson Health Research Institute, London, Ontario, Canada
| | - Serge Poiraudeau
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris
- Service de Médecine Physique et Réadaptation, Hôpital Cochin
- IFR Handicap, INSERM, Paris, France
| | | | - Maureen Sauvé
- Scleroderma Society of Ontario, Hamilton
- Scleroderma Society of Canada, Ottawa, ON, Canada
| | - Fredrick Wigley
- Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University and the University of California, San Diego, CA
| | - Susan J Bartlett
- Department of Medicine, McGill UniversityMontréal, Québec, Canada
- Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- McGill University Health Center, Montréal, Québec, Canada
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10
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Neyer MA, Henry RS, Carrier ME, Kwakkenbos L, Wojeck RK, Gietzen A, Gottesman K, Guillot G, Lawrie-Jones A, Mayes MD, Mouthon L, Nielson WR, Richard M, Worron-Sauvé M, Harel D, Malcarne VL, Bartlett SJ, Thombs BD. Validity, Reliability, and Differential Item Functioning of English and French Versions of the 10-Item Connor-Davidson Resilience Scale in Systemic Sclerosis: A Scleroderma Patient-Centered Intervention Network Cohort Study. Arthritis Care Res (Hoboken) 2023; 75:2369-2378. [PMID: 37128826 DOI: 10.1002/acr.25139] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/04/2023] [Accepted: 04/25/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Some individuals with systemic sclerosis (SSc) report positive mental health, despite severe disease manifestations, which may be associated with resilience, but no resilience measure has been validated in SSc. This study was undertaken to assess the validity, reliability, and differential item functioning (DIF) between English- and French-language versions of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in SSc. METHODS Eligible participants were enrolled in the Scleroderma Patient-centered Intervention Network Cohort and completed the CD-RISC-10 between August 2022 and January 2023. We used confirmatory factor analysis (CFA) to evaluate the CD-RISC-10 factor structure and conducted DIF analysis across languages with Multiple Indicators Multiple Causes models. We tested convergent validity with another measure of resilience and measures of self-esteem and depression and anxiety symptoms. We assessed internal consistency and test-retest reliability using Cronbach's alpha and intraclass correlation coefficient (ICC). RESULTS A total of 962 participants were included in this analysis. CFA supported a single-factor structure (Tucker-Lewis index = 0.99, comparative fit index = 0.99, root mean square error of approximation = 0.08 [90% confidence interval (90% CI) 0.07, 0.09]). We found no meaningful DIF. Internal consistency was high (α = 0.93 [95% CI 0.92, 0.94]), and we found that correlations with other measures of psychological functioning were moderate to large (|r| = 0.57-0.78) and confirmed study hypotheses. The scale showed good 1-2-week test-retest reliability (ICC 0.80 [95% CI 0.75, 0.85]) in a subsample of 230 participants. CONCLUSION The CD-RISC-10 is a valid and reliable measure of resilience in SSc, with score comparability across English and French versions.
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Affiliation(s)
- Marieke A Neyer
- Lady Davis Institute of the Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | - Richard S Henry
- Lady Davis Institute of the Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | | | | | - Amy Gietzen
- National Scleroderma Foundation, Tri-State Chapter, Buffalo, New York
| | | | | | - Amanda Lawrie-Jones
- Scleroderma Australia and Scleroderma Victoria, Melbourne, Victoria, Australia
| | | | - Luc Mouthon
- Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Warren R Nielson
- Western University and Lawson Research Institute, London, Ontario, Canada
| | | | - Maureen Worron-Sauvé
- Scleroderma Society of Ontario and Scleroderma Canada, Hamilton, Ontario, Canada
| | | | | | | | - Brett D Thombs
- Jewish General Hospital and McGill University, Montreal, Quebec, Canada
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11
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Provencher S, Henry RS, Bacalao C, Carrier ME, Kwakkenbos L, Thombs BD. Support and information needs of people with systemic sclerosis by time since diagnosis: A cross-sectional study. J Scleroderma Relat Disord 2023; 8:247-252. [PMID: 37744044 PMCID: PMC10515994 DOI: 10.1177/23971983231181726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/27/2023] [Indexed: 09/26/2023]
Abstract
Background How support and informational needs of people with systemic sclerosis (SSc) may differ by time since diagnosis is not known. Our objective was to determine if informational and support needs of recently diagnosed individuals with systemic sclerosis differ from people diagnosed for longer periods of time. Methods The North American Scleroderma Support Group Members survey included 30 items on reasons for attending support groups. Respondents were classified by time since diagnosis of 0-3 years, 4-9 years or 10+ years. Survey item responses were dichotomized into Not Important or Somewhat Important versus Important or Very Important. We conducted Chi-square tests with Hochberg's Sequential Method to identify item differences by time since diagnosis. Results A total of 175 respondents completed the survey. Most support needs were rated as Important or Very Important by respondents, regardless of disease duration, particularly needs related to interpersonal and social support (10 items; median 81%) and learning about disease treatment and management strategies (11 items; median 82%). Discussing other aspects of living with systemic sclerosis (e.g. spirituality, discussing disease with family and friends) was rated lower (9 items; 44%). Respondents with 0-3 years since diagnosis were the highest on 29 of 30 items. Respondents with 0-3 years since diagnosis were significantly higher on items related to discussing medical care and 4 items on other aspects (spirituality, talking with family and friends, financial issues, sexual issues). Conclusion People with systemic sclerosis have a wide range of information and support needs, regardless of their disease duration, but people with recent diagnoses have greater needs.
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Affiliation(s)
- Sabrina Provencher
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Carolina Bacalao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen, the Netherlands
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Psychiatry, Center for Mindfulness, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
- Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
| | - the Scleroderma Patient-centered Intervention Network (SPIN) Support Group Project Advisory Team
- SPIN Support Group Project Advisory Team Members: Laura Dyas, National Scleroderma Foundation Michigan Chapter, Southfield, Michigan, USA; Stephen Elrod, National Scleroderma Foundation of Southern California Patient Support Group, Bakersfield, California, USA; Catherine Fortuné, Ottawa Scleroderma Support Group, Ottawa, Ontario, Canada; Amy Gietzen, National Scleroderma Foundation, Tri-State Chapter, Buffalo, NY, USA; Karen Gottesman, National Scleroderma Foundation, Los Angeles, California, USA; Karen Nielsen, Scleroderma Society of Ontario, Hamilton, Ontario, Canada; Michelle Richard, Scleroderma Atlantic, Halifax, Nova Scotia, Canada; Ken Rozee, Scleroderma Atlantic, Halifax, Nova Scotia, Canada; Maureen Sauvé, Scleroderma Society of Ontario and Scleroderma Canada, Hamilton, Ontario, Canada; Nancy Stephens, Michigan Patient Group, Detroit, Michigan, USA
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12
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S Rapoport C, Choi AK, Kwakkenbos L, Carrier ME, Henry RS, Mouthon L, Roesch SC, Thombs BD, Malcarne VL. Evaluation of Measurement Properties and Differential Item Functioning in the English and French Versions of the University of California, Los Angeles, Loneliness Scale-6: A Scleroderma Patient-Centered Intervention Network (SPIN) Study. Arthritis Care Res (Hoboken) 2023; 75:2158-2165. [PMID: 36938696 DOI: 10.1002/acr.25115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/06/2023] [Accepted: 03/16/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVE Loneliness has been associated with poorer health-related quality of life but has not been studied in patients with systemic sclerosis (SSc). The current study was undertaken to examine and compare the psychometric properties of the English and French versions of the University of California, Los Angeles, Loneliness Scale-6 (ULS-6) in patients with SSc during the COVID-19 pandemic. METHODS This study used baseline cross-sectional data from 775 adults enrolled in the Scleroderma Patient-Centered Intervention Network (SPIN) COVID-19 Cohort. Reliability and validity of ULS-6 scores overall and between languages were evaluated using confirmatory factor analysis (CFA), differential item functioning (DIF) through the multiple-indicator multiple-cause (MIMIC) model, omega/alpha calculation, and correlations of hypothesized convergent relationships. RESULTS CFA for the total sample supported the single-factor structure (comparative fit index [CFI] 0.96, standardized root mean residual [SRMR] 0.03), and all standardized factor loadings for items were large (0.60-0.86). The overall MIMIC model with language as a covariate fit well (CFI 0.94, SRMR 0.04, root mean square error of approximation 0.11). Statistically significant DIF was found for 3 items across language (βitem2 = 0.14, P < 0.001; βitem4 = -0.07, P = 0.01; βitem6 = 0.13, P < 0.001), but these small differences were without practical measurement implications. Analyses demonstrated high internal consistency with no language-based convergent validity differences. CONCLUSION Analyses demonstrated evidence of acceptable reliability and validity of ULS-6 scores in English- and French-speaking adults with SSc. DIF analysis supported use of the ULS-6 to examine comparative experiences of loneliness without adjusting for language.
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Affiliation(s)
- Chelsea S Rapoport
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Alyssa K Choi
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | | | | | - Richard S Henry
- Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | - Luc Mouthon
- Reference Center for Rare Systemic Autoimmune Diseases of Ile de France, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris, France
| | - Scott C Roesch
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology and San Diego State University, San Diego, California
| | - Brett D Thombs
- Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | - Vanessa L Malcarne
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology and San Diego State University, San Diego, California
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13
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Wojeck RK, Knisely MR, Bailey DE, Somers TJ, Kwakkenbos L, Carrier ME, Nielson WR, Bartlett SJ, Malcarne VL, Hudson M, Levis B, Benedetti A, Mouthon L, Thombs BD, Silva SG. Patterns of patient-reported symptoms and association with sociodemographic and systemic sclerosis disease characteristics: a scleroderma Patient-centered Intervention Network (SPIN) Cohort cross-sectional study. EClinicalMedicine 2023; 62:102104. [PMID: 37533421 PMCID: PMC10393558 DOI: 10.1016/j.eclinm.2023.102104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 08/04/2023] Open
Abstract
Background Systemic sclerosis is a heterogenous disease in which little is known about patterns of patient-reported symptom clusters. We aimed to identify classes of individuals with similar anxiety, depression, fatigue, sleep disturbance, and pain symptoms and to evaluate associated sociodemographic and disease-related characteristics. Methods This multi-centre cross-sectional study used baseline data from Scleroderma Patient-centered Intervention Network Cohort participants enrolled from 2014 to 2020. Eligible participants completed the PROMIS-29 v2.0 measure. Latent profile analysis was used to identify homogeneous classes of participants based on patterns of anxiety, depression, fatigue, sleep disturbance, and pain scores. Sociodemographic and disease-related characteristics were compared across classes. Findings Among 2212 participants, we identified five classes, including four classes with "Low" (565 participants, 26%), "Normal" (651 participants, 29%), "High" (569 participants, 26%), or "Very High" (193 participants, 9%) symptom levels across all symptoms. Participants in a fifth class, "High Fatigue/Sleep/Pain and Low Anxiety/Depression" (234 participants, 11%) had similar levels of fatigue, sleep disturbance, and pain as in the "High" class but low anxiety and depression symptoms. There were significant and substantive trends in sociodemographic characteristics (age, education, race or ethnicity, marital or partner status) and increasing disease severity (diffuse disease, tendon friction rubs, joint contractures, gastrointestinal symptoms) across severity-based classes. Disease severity and sociodemographic characteristics of "High Fatigue/Sleep/Pain and Low Anxiety/Depression" class participants were similar to the "High" severity class. Interpretation Most people with systemic sclerosis can be classified by levels of patient-reported symptoms, which are consistent across symptoms and highly associated with sociodemographic and disease-related variables, except for one group which reports low mental health symptoms despite high levels of other symptoms and substantial disease burden. Studies are needed to better understand resilience in systemic sclerosis and to identify and facilitate implementation of cognitive and behavioural strategies to improve coping and overall quality of life. Funding National Institute of Nursing Research (F31NR019007), Canadian Institutes of Health Research, Arthritis Society Canada, the Lady Davis Institute for Medical Research, the Jewish General Hospital Foundation, McGill University, Scleroderma Society of Ontario, Scleroderma Canada, Sclérodermie Québec, Scleroderma Manitoba, Scleroderma Atlantic, Scleroderma Association of BC, Scleroderma SASK, Scleroderma Australia, Scleroderma New South Wales, Scleroderma Victoria, and Scleroderma Queensland.
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Affiliation(s)
| | | | | | | | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen, the Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Radboudumc Center for Mindfulness, Department of Psychiatry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Susan J. Bartlett
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Vanessa L. Malcarne
- Department of Psychology, San Diego State University, California, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
| | - Susan G. Silva
- Duke University School of Nursing, Durham, North Carolina, USA
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14
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Xu M, Harel D, Carrier ME, Kwakkenbos L, Bartlett SJ, Gottesman K, Guillot G, Hummers L, Malcarne VL, Richard M, Thombs BD. Differential Item Functioning on the Cochin Hand Function Scale Among People With Systemic Sclerosis by Language, Sex, and Disease Subtype: A Scleroderma Patient-Centered Intervention Network (SPIN) Cohort Study. Arthritis Care Res (Hoboken) 2023. [PMID: 37489073 DOI: 10.1002/acr.25199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/27/2023] [Accepted: 07/18/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE To evaluate the degree that the Cochin Hand Function Scale (CHFS) generates scores that are comparable across language, sex, and disease subtype. METHODS We included participants enrolled in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort who completed the CHFS at their baseline assessment between April 2014 and September 2020. Confirmatory factor analysis (CFA) was used to test unidimensionality, and multiple indicator multiple cause (MIMIC) models were used for differential item functioning (DIF) analysis based on language, sex, and disease subtype. Both intraclass correlation coefficient (ICC) and Pearson's correlation were calculated using factor scores obtained from unadjusted and DIF-adjusted MIMIC models to evaluate agreement and correlation between scores. RESULTS A total of 2,155 participants were included. CFA with covarying error terms supported a good fit of the model (χ2 [127] = 1,754.671; P < 0.001; Tucker-Lewis index = 0.985; comparative fit index = 0.987; root mean square error of approximation = 0.077). Nine items displayed statistically significant DIF for language of administration, 10 items for sex, and 10 items for disease subtype. However, the overall impact of DIF was negligible when comparing factor scores that did and did not account for DIF (ICC = 0.999; r = 0.999). CONCLUSION The CHFS has score comparability in systemic sclerosis regardless of participants' language, sex, and disease subtype.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Brett D Thombs
- Jewish General Hospital and McGill University, Montreal, Quebec, Canada
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15
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Wurz A, Ellis K, Duchek D, Bansal M, Carrier ME, Tao L, Dyas L, Kwakkenbos L, Levis B, El-Baalbaki G, Rice DB, Wu Y, Henry RS, Bustamante L, Harb S, Hebblethwaite S, Patten SB, Bartlett SJ, Varga J, Mouthon L, Markham S, Thombs BD, Culos-Reed SN. Exploring research team members' and trial participants' perceptions of acceptability and implementation within one videoconference-based supportive care program for individuals affected by systemic sclerosis during COVID-19: a qualitative interview study. Transl Behav Med 2023; 13:442-452. [PMID: 36999812 PMCID: PMC10314727 DOI: 10.1093/tbm/ibac091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
The SPIN-CHAT Program was designed to support mental health among individuals with systemic sclerosis (SSc; commonly known as scleroderma) and at least mild anxiety symptoms at the onset of COVID-19. The program was formally evaluated in the SPIN-CHAT Trial. Little is known about program and trial acceptability, and factors impacting implementation from the perspectives of research team members and trial participants. Thus, the propose of this follow-up study was to explore research team members' and trial participants' experiences with the program and trial to identify factors impacting acceptability and successful implementation. Data were collected cross-sectionally through one-on-one, videoconference-based, semi-structured interviews with 22 research team members and 30 purposefully recruited trial participants (Mage = 54.9, SD = 13.0 years). A social constructivist paradigm was adopted, and data were analyzed thematically. Data were organized into seven themes: (i) getting started: the importance of prolonged engagement and exceeding expectations; (ii) designing the program and trial: including multiple features; (iii) training: research team members are critical to positive program and trial experiences; (iv) offering the program and trial: it needs to be flexible and patient-oriented; (v) maximizing engagement: navigating and managing group dynamics; (vi) delivering a videoconference-based supportive care intervention: necessary, appreciated, and associated with some barriers; and (vii) refining the program and trial: considering modification when offered beyond the period of COVID-19 restrictions. Trial participants were satisfied with and found the SPIN-CHAT Program and Trial to be acceptable. Results offer implementation data that can guide the design, development, and refinement of other supportive care programs seeking to promote psychological health during and beyond COVID-19.
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Affiliation(s)
- Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Kelsey Ellis
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Delaney Duchek
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Mannat Bansal
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Laura Dyas
- National Scleroderma Foundation, Michigan Chapter, Southfield, MI, USA
| | - Linda Kwakkenbos
- Clinical Psychology, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Radboudumc Center for Mindfulness, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, UK
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Yin Wu
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Laura Bustamante
- Department of Applied Human Sciences, Concordia University, Montreal, QC, Canada
| | - Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute and O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, QC, Canada
- Research Institute, McGill University Health Centre, Montreal, QC, Canada
| | - John Varga
- University of Michigan, Ann Arbor, MI, USA
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares d’Ile de France, Hôpital Cochin, Assistance Publique, Hôpitaux de Paris (APHP), Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King’s College London, London, UK
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, AB, Canada
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16
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Henry RS, Kwakkenbos L, Carrier ME, Patten S, Bartlett SJ, Mouthon L, Varga J, Benedetti A, Thombs BD. Mental health symptoms in scleroderma during COVID-19: a Scleroderma Patient-centred Intervention Network (SPIN) cohort longitudinal study. Clin Exp Rheumatol 2023:19565. [PMID: 37083160 DOI: 10.55563/clinexprheumatol/cca0xv] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/13/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVES People with systemic sclerosis (SSc) are vulnerable in COVID-19 and face challenges related to shifting COVID-19 risk and protective restrictions. We evaluated mental health symptom trajectories in people with SSc through March 2022. METHODS The longitudinal Scleroderma Patient-centred Intervention Network (SPIN) COVID-19 cohort was launched in April 2020 and included participants from the ongoing SPIN Cohort and external enrolees. Analyses included estimated means with 95% CIs for anxiety and depression symptoms pre-COVID-19 for ongoing SPIN Cohort participants and anxiety, depression, loneliness, and fear of COVID-19 for all participants across 28 COVID-19 assessments up to March 2022. We conducted sensitivity analyse including estimating trajectories using only responses from participants who completed >90% of items for ≥21 of 28 possible assessments ("completers") and stratified analyses for all outcomes by sex, age, country, and SSc subtype. RESULTS Anxiety symptoms increased in early 2020 but returned to pre-COVID-19 levels by mid-2020 and remained stable through March 2022. Depression symptoms did not initially change but were slightly lower by mid-2020 compared to pre-COVID-19 and were stable through March 2022. COVID-19 fear started high and decreased. Loneliness did not change across the pandemic. Results were similar for completers and for all subgroups. CONCLUSIONS People with SSc continue to face COVID-19 challenges related to ongoing risk, the opening of societies, and removal of protective restrictions. People with SSc, in aggregate, appear to be weathering the pandemic well, but health care providers should be mindful that some individuals may benefit from mental health support.
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Affiliation(s)
- Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, and Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen; Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen; and Radboudumc Center for Mindfulness, Department of Psychiatry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Scott Patten
- Department of Community Health Sciences, University of Calgary, Alberta; Hotchkiss Brain Institute, University of Calgary, Alberta; and O'Brien Institute for Public Health, University of Calgary, Alberta, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal; and Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris (AP-HP), and APHP-CUP, Hôpital Cochin, Paris, Université de Paris, France
| | - John Varga
- Department of Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal; and Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal; Department of Psychiatry, McGill University, Montreal; Department of Medicine, McGill University, Montreal; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal; Department of Psychology, McGill University, Montreal; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada.
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17
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Kirren Q, Daste C, Foissac F, Abdoul H, Alami S, Carrier ME, Kwakkenbos L, Lefèvre-Colau MM, Rannou F, Papelard A, Roren A, Thombs BD, Mouthon L, Nguyen C. Differences in Disability Perception in Systemic Sclerosis: A Mirror Survey of Patients and Health Care Providers. J Clin Med 2023; 12:jcm12041359. [PMID: 36835895 PMCID: PMC9959687 DOI: 10.3390/jcm12041359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Differences in disability perception between patients and care providers may impact outcomes. We aimed to explore differences in disability perception between patients and care providers in systemic sclerosis (SSc). We conducted a cross-sectional internet-based mirror survey. SSc patients participating in the online SPIN Cohort and care providers affiliated with 15 scientific societies were surveyed using the Cochin Scleroderma International Classification of Functioning, Disability and Health (ICF)-65 questionnaire, including 65 items (from 0 to 10), representing 9 domains of disability. Mean differences between patients and care providers were calculated. Care providers' characteristics associated with a mean difference ≥ 2 of 10 points were assessed in multivariate analysis. Answers were analyzed for 109 patients and 105 care providers. The mean age of patients was 55.9 (14.7) years and the disease duration was 10.1 (7.5) years. For all domains of the ICF-65, care providers' rates were higher than those of patients. The mean difference was 2.4 (1.0) of 10 points. Care providers' characteristics associated with this difference were organ-based specialty (OR = 7.0 [2.3-21.2]), younger age (OR = 2.7 [1.0-7.1]) and following patients with disease duration ≥5 years (OR = 3.0 [1.1-8.7]). We found systematic differences in disability perception between patients and care providers in SSc.
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Affiliation(s)
- Quentin Kirren
- UFR de Médecine, Faculté de Santé, Université Paris Cité, 75006 Paris, France
- Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, AP-HP, Centre-Université Paris Cité, 75014 Paris, France
| | - Camille Daste
- UFR de Médecine, Faculté de Santé, Université Paris Cité, 75006 Paris, France
- Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, AP-HP, Centre-Université Paris Cité, 75014 Paris, France
- INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Université Paris Cité, 75004 Paris, France
| | - Frantz Foissac
- Unité de Recherche Clinique—Centre d’Investigation Clinique Paris Descartes Necker/Cochin, Hôpital Tarnier, 75014 Paris, France
- EA 7323, Évaluation des Thérapeutiques et Pharmacologie Périnatale et Pédiatrique, Université Paris Cité, 75014 Paris, France
| | - Hendy Abdoul
- Unité de Recherche Clinique—Centre d’Investigation Clinique Paris Descartes Necker/Cochin, Hôpital Tarnier, 75014 Paris, France
| | - Sophie Alami
- Cabinet d’Études Sociologiques Interlis, 75006 Paris, France
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University Nijmegen, 6525 XZ Nijmegen, The Netherlands
| | - Marie-Martine Lefèvre-Colau
- UFR de Médecine, Faculté de Santé, Université Paris Cité, 75006 Paris, France
- Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, AP-HP, Centre-Université Paris Cité, 75014 Paris, France
- INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Université Paris Cité, 75004 Paris, France
| | - François Rannou
- UFR de Médecine, Faculté de Santé, Université Paris Cité, 75006 Paris, France
- Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, AP-HP, Centre-Université Paris Cité, 75014 Paris, France
- INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, Université Paris Cité, 75006 Paris, France
| | - Agathe Papelard
- Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, AP-HP, Centre-Université Paris Cité, 75014 Paris, France
| | - Alexandra Roren
- Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, AP-HP, Centre-Université Paris Cité, 75014 Paris, France
- INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, Université Paris Cité, 75004 Paris, France
- Département Universitaire des Sciences de la Rééducation et de la Réadaptation, Faculté de Santé, Université Paris Cité, 75006 Paris, France
| | - Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Departments of Psychiatry, McGill University, Montreal, QC H3A 1G1, Canada
- Departments of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC H3A 1G1, Canada
- Departments of Medicine, McGill University, Montreal, QC H3A 1G1, Canada
- Departments of Psychology, McGill University, Montreal, QC H3A 1G1, Canada
- Departments of Educational and Counselling Psychology, McGill University, Montreal, QC H3A 1G1, Canada
- Biomedical Ethics Unit, McGill University, Montreal, QC H3A 1G1, Canada
| | - Luc Mouthon
- UFR de Médecine, Faculté de Santé, Université Paris Cité, 75006 Paris, France
- Service de Médecine Interne, Hôpital Cochin, AP-HP, Centre-Université de Paris, 75014 Paris, France
| | - Christelle Nguyen
- UFR de Médecine, Faculté de Santé, Université Paris Cité, 75006 Paris, France
- Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, AP-HP, Centre-Université Paris Cité, 75014 Paris, France
- INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, Université Paris Cité, 75006 Paris, France
- Correspondence: ; Tel.: +33-158-412-945
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18
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Kwakkenbos L, Carrier ME, Welling J, Levis B, Levis AW, Sauve M, Turner KA, Tao L, Aguila K, Carboni-Jiménez A, Cañedo-Ayala M, Harb S, van den Ende C, Hudson M, van Breda W, Nguyen C, Boutron I, Rannou F, Thombs BD, Mouthon L. Randomized controlled trial of an internet-based self-guided hand exercise program to improve hand function in people with systemic sclerosis: the Scleroderma Patient-centered Intervention Network Hand Exercise Program (SPIN-HAND) trial. Trials 2022; 23:994. [PMID: 36510233 PMCID: PMC9742661 DOI: 10.1186/s13063-022-06923-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/12/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Systemic sclerosis (scleroderma; SSc) is a rare autoimmune connective tissue disease. Functional impairment of hands is common. The Scleroderma Patient-centered Intervention Network (SPIN)-HAND trial compared effects of offering access to an online self-guided hand exercise program to usual care on hand function (primary) and functional health outcomes (secondary) in people with SSc with at least mild hand function limitations. METHODS The pragmatic, two-arm, parallel-group cohort multiple randomized controlled trial was embedded in the SPIN Cohort. Cohort participants with Cochin Hand Function Scale (CHFS) scores ≥ 3 and who indicated interest in using the SPIN-HAND Program were randomized (3:2 ratio) to an offer of program access or to usual care (targeted N = 586). The SPIN-HAND program consists of 4 modules that address (1) thumb flexibility and strength; (2) finger bending; (3) finger extension; and (4) wrist flexibility and strength. The primary outcome analysis compared CHFS scores 3 months post-randomization between participants offered versus not offered the program. Secondary outcomes were CHFS scores 6 months post-randomization and functional health outcomes (Patient-Reported Outcomes Measurement Information System profile version 2.0 domain scores) 3 and 6 months post-randomization. RESULTS In total, 466 participants were randomized to intervention offer (N = 280) or usual care (N = 186). Of 280 participants offered the intervention, 170 (61%) consented to access the program. Of these, 117 (69%) viewed at least one hand exercise instruction video and 77 (45%) logged into the program website at least 3 times. In intent-to-treat analyses, CHFS scores were 1.2 points lower (95% CI - 2.8 to 0.3) for intervention compared to usual care 3 months post-randomization and 0.1 points lower (95% CI - 1.8 to 1.6 points) 6 months post-randomization. There were no statistically significant differences in other outcomes. CONCLUSION The offer to use the SPIN-HAND Program did not improve hand function. Low offer uptake, program access, and minimal usage among those who accessed the program limited our ability to determine if using the program would improve function. To improve engagement, the program could be tested in a group format or as a resource to support care provided by a physical or occupational therapist. TRIAL REGISTRATION NCT03419208 . Registered on February 1, 2018.
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Affiliation(s)
- Linda Kwakkenbos
- grid.5590.90000000122931605Clinical Psychology, Radboud University, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- grid.414980.00000 0000 9401 2774Lady Davis Institute for Medical Research of the Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC H3T 1E2 Canada
| | - Joep Welling
- grid.491384.30000 0004 9361 2881NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Brooke Levis
- grid.414980.00000 0000 9401 2774Lady Davis Institute for Medical Research of the Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC H3T 1E2 Canada ,grid.9757.c0000 0004 0415 6205Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Alexander W. Levis
- grid.38142.3c000000041936754XDepartment of Biostatistics, Harvard T. H. Chan School of Public Health, Cambridge, MA USA
| | - Maureen Sauve
- Scleroderma Society of Ontario, Hamilton, ON Canada ,Scleroderma Canada, Hamilton, ON Canada
| | - Kimberly A. Turner
- grid.414980.00000 0000 9401 2774Lady Davis Institute for Medical Research of the Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC H3T 1E2 Canada
| | - Lydia Tao
- grid.414980.00000 0000 9401 2774Lady Davis Institute for Medical Research of the Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC H3T 1E2 Canada
| | - Kylene Aguila
- grid.414980.00000 0000 9401 2774Lady Davis Institute for Medical Research of the Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC H3T 1E2 Canada
| | - Andrea Carboni-Jiménez
- grid.414980.00000 0000 9401 2774Lady Davis Institute for Medical Research of the Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC H3T 1E2 Canada
| | - Mara Cañedo-Ayala
- grid.414980.00000 0000 9401 2774Lady Davis Institute for Medical Research of the Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC H3T 1E2 Canada
| | - Sami Harb
- grid.414980.00000 0000 9401 2774Lady Davis Institute for Medical Research of the Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC H3T 1E2 Canada
| | | | - Marie Hudson
- grid.414980.00000 0000 9401 2774Lady Davis Institute for Medical Research of the Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC H3T 1E2 Canada ,grid.14709.3b0000 0004 1936 8649Department of Medicine, McGill University, Montreal, QC Canada
| | - Ward van Breda
- grid.12380.380000 0004 1754 9227Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Christelle Nguyen
- Université Paris Descartes, Université de Paris, Paris, France ,grid.50550.350000 0001 2175 4109Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Isabelle Boutron
- Université Paris Descartes, Université de Paris, Paris, France ,grid.50550.350000 0001 2175 4109Assistance Publique - Hôpitaux de Paris, Paris, France
| | - François Rannou
- Université Paris Descartes, Université de Paris, Paris, France ,grid.50550.350000 0001 2175 4109Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Brett D. Thombs
- grid.414980.00000 0000 9401 2774Lady Davis Institute for Medical Research of the Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC H3T 1E2 Canada ,grid.14709.3b0000 0004 1936 8649Department of Medicine, McGill University, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649Department of Psychology, McGill University, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649Biomedical Ethics Unit, McGill University, Montreal, QC Canada
| | - Luc Mouthon
- Université Paris Descartes, Université de Paris, Paris, France ,grid.50550.350000 0001 2175 4109Assistance Publique - Hôpitaux de Paris, Paris, France ,grid.411784.f0000 0001 0274 3893Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d’Ile de France, Hôpital Cochin, Paris, France
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Thombs BD, Levis B, Carrier ME, Dyas L, Nordlund J, Tao L, Aguila K, Bourgeault A, Konrad V, Sauvé M, Connolly K, Henry RS, Østbø N, Levis AW, Kwakkenbos L, Malcarne VL, El-Baalbaki G, Hudson M, Wurz A, Culos-Reed SN, Platt RW, Benedetti A. Effects of a support group leader education program jointly developed by health professionals and patients on peer leader self-efficacy among leaders of scleroderma support groups: a two-arm parallel partially nested randomised controlled trial. Orphanet J Rare Dis 2022; 17:396. [PMID: 36307891 PMCID: PMC9616616 DOI: 10.1186/s13023-022-02552-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background More people with rare diseases likely receive disease education and emotional and practical support from peer-led support groups than any other way. Most rare-disease support groups are delivered outside of the health care system by untrained leaders. Potential benefits may not be achieved and harms, such as dissemination of inaccurate information, may occur. Our primary objective was to evaluate the effects of a rare-disease support group leader education program, which was developed collaboratively by researchers, peer support group leaders, and patient organization leaders, compared to waitlist control, on peer leader self-efficacy among scleroderma support group leaders.
Methods The trial was a pragmatic, two-arm partially nested randomised controlled trial with 1:1 allocation into intervention or waitlist control. Eligible participants were existing or candidate peer support group leaders affiliated with a scleroderma patient organization. Leader training was delivered in groups of 5–6 participants weekly for 13 weeks in 60–90 min sessions via the GoToMeeting® videoconferencing platform. The program included 12 general leader training modules and one module specific to scleroderma. Primary outcome was leader self-efficacy, measured by the Support Group Leader Self-efficacy Scale (SGLSS) immediately post-intervention. Secondary outcomes were leader self-efficacy 3 months post-intervention; emotional distress, leader burnout, and volunteer satisfaction post-intervention and 3 months post-intervention; and program satisfaction among intervention participants post-intervention.
Results One hundred forty-eight participants were randomised to intervention (N = 74) or waitlist (N = 74). Primary outcome data were provided by 146 (99%) participants. Mean number of sessions attended was 11.4 (standard deviation = 2.6). Mean program satisfaction score (CSQ-8) was 30.3 (standard deviation = 3.0; possible range 8–32). Compared to waitlist control, leader self-efficacy was higher post-intervention [SGLSS; 16.7 points, 95% CI 11.0–22.3; standardized mean difference (SMD) 0.84] and 3 months later (15.6 points, 95% CI 10.2–21.0; SMD 0.73); leader volunteer satisfaction was significantly higher at both assessments, emotional distress was lower post-intervention but not 3 months later, and leader burnout was not significantly different at either assessment.
Conclusions Peer support group leader education improved leader self-efficacy substantially. The program could be easily adapted for support group leaders in other rare diseases. Trial registration:NCT03965780; registered on May 29, 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02552-x.
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Affiliation(s)
- Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada. .,Department of Psychiatry, McGill University, Montreal, QC, Canada. .,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada. .,Department of Medicine, McGill University, Montreal, QC, Canada. .,Department of Psychology, McGill University, Montreal, QC, Canada. .,Biomedical Ethics Unit, McGill University, Montreal, QC, Canada.
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada.,Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Laura Dyas
- National Scleroderma Foundation, Michigan Chapter, Southfield, MI, USA
| | - Julia Nordlund
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Kylene Aguila
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Angelica Bourgeault
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | | | - Maureen Sauvé
- Scleroderma Society of Ontario and Scleroderma Canada, Hamilton, ON, Canada
| | | | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Nora Østbø
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Alexander W Levis
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen, The Netherlands.,Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Psychiatry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA.,San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
| | - Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Abbotsford, BC, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Department of Oncology, Cumming School of Medicine, Calgary, AB, Canada.,Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB, Canada
| | - Robert W Platt
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste Catherine Road, Montreal, QC, H3T 1E2, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada.,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC, Canada
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Kwakkenbos L, Carrier ME, Welling J, Turner KA, Cumin J, Pépin M, van den Ende C, Schouffoer AA, Hudson M, van Breda W, Sauve M, Mayes MD, Malcarne VL, Nielson WR, Nguyen C, Boutron I, Rannou F, Thombs BD, Mouthon L. Randomized feasibility trial of the Scleroderma Patient-centered Intervention Network hand exercise program (SPIN-HAND). PeerJ 2022; 10:e13471. [PMID: 35945943 PMCID: PMC9357372 DOI: 10.7717/peerj.13471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 04/29/2022] [Indexed: 01/20/2023] Open
Abstract
Purpose The Scleroderma Patient-centered Intervention Network (SPIN) online hand exercise program (SPIN-HAND), is an online self-help program of hand exercises designed to improve hand function for people with scleroderma. The objective of this feasibility trial was to evaluate aspects of feasibility for conducting a full-scale randomized controlled trial of the SPIN-HAND program. Materials and Methods The feasibility trial was embedded in the SPIN cohort and utilized the cohort multiple randomized controlled trial (cmRCT) design. In the cmRCT design, at the time of cohort enrollment, cohort participants consent to be assessed for trial eligibility and randomized prior to being informed about trials conducted using the cohort. When trials were conducted in the cohort, participants randomized to the intervention were informed and consented to access the intervention. Participants randomized to control were not informed that they have not received an intervention. All participants eligible and randomized to participate in the trial were included in analyses on an intent-to-treat basis. Cohort participants with a Cochin Hand Function Scale score ≥ 3/90 and an interest in using an online hand-exercise intervention were randomized (1:1 ratio) to be offered as usual care plus the SPIN-HAND Program or usual care for 3 months. User satisfaction was assessed with semi-structured interviews. Results Of the 40 randomized participants, 24 were allocated to SPIN-HAND and 16 to usual care. Of 24 participants randomized to be offered SPIN-HAND, 15 (63%) consented to use the program. Usage of SPIN-HAND content among the 15 participants who consented to use the program was low; only five (33%) logged in more than twice. Participants found the content relevant and easy to understand (satisfaction rating 8.5/10, N = 6). Automated eligibility and randomization procedures via the SPIN Cohort platform functioned properly. The required technical support was minimal. Conclusions Trial methodology functioned as designed, and the SPIN-HAND Program was feasibly delivered; however, the acceptance of the offer and use of program content among accepters were low. Adjustments to information provided to potential participants will be implemented in the full-scale SPIN-HAND trial to attempt to increase offer acceptance.
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Affiliation(s)
| | - Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | - Joep Welling
- NVLE Dutch patient organization for systemic autoimmune diseases, Utrecht, The Netherlands
| | | | - Julie Cumin
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | - Mia Pépin
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | | | - Anne A. Schouffoer
- Leiden University Medical Center, Leiden, The Netherlands,Haga Teaching Hospital, The Hague, The Netherlands
| | - Marie Hudson
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada,Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Ward van Breda
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maureen Sauve
- Scleroderma Society of Ontario, Hamilton, Ontario, Canada,Scleroderma Canada, Ottawa, Ontario, Canada
| | - Maureen D. Mayes
- University of Texas McGovern School of Medicine, Houston, Texas, United States of America
| | | | | | | | - Isabelle Boutron
- Centre d’Épidémiologie Clinique, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Paris, France,Centre of Research Epidemiology and Statistics (CRESS), Inserm, INRA, Université de Paris, Paris, France
| | - François Rannou
- Université de Paris, Paris, France,Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Brett D. Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada,Department of Medicine, McGill University, Montreal, Quebec, Canada,Department of Psychiatry, McGill University, Montreal, Quebec, Canada,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada,Department of Psychology, McGill University, Montreal, Quebec, Canada,Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d’Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France,APHP-CUP, Hôpital Cochin, Paris, France
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Le Ralle MF, Daste C, Rannou F, Kwakkenbos L, Carrier ME, Lefèvre-Colau MM, Roren A, Thombs BD, Mouthon L, Nguyen C. Patient acceptable symptom state for burden from appearance changes in people with systemic sclerosis: a cross-sectional survey. J Rheumatol Suppl 2022; 49:903-907. [PMID: 35649549 DOI: 10.3899/jrheum.210889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE People with systemic sclerosis (SSc) often report substantial burden from appearance changes. We aimed to estimate the patient acceptable symptom state (PASS) for burden from appearance changes in people with SSc. METHODS We conducted a secondary analysis of the SCISCIF II study, a cross-sectional survey of 113 patients with SSc from France enrolled in the Scleroderma Patient-centered Intervention Network Cohort. Burden from appearance changes was assessed with a self-administered numeric rating scale (0, no burden to 10, maximal burden). Acceptability of the symptom state was assessed with a specific anchoring question. Participants who answered "yes" were in the group of patients who considered their symptom state as acceptable. The PASS for the burden from appearance changes was estimated with the 75th percentile method. RESULTS Assessments of burden from appearance changes and answers to the anchoring question were available in 82/113 (73%) participants from the SCISCIF II study. Mean age was 55.9 (14.3) years, disease duration 9.6 (6.5) years and 32/82 (40%) participants had diffuse cutaneous SSc. The PASS estimate for the burden from appearance changes was 4.8 (95% CI from 1.0 to 7.0) of 10 points. CONCLUSION Our study provides a PASS estimate for burden from appearance changes. Our estimate could serve as a binary response criterion to assess the efficacy of treatments targeting burden from appearance changes.
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Affiliation(s)
- Myrianne-Fleur Le Ralle
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Camille Daste
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - François Rannou
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Linda Kwakkenbos
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Marie-Eve Carrier
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Marie-Martine Lefèvre-Colau
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Alexandra Roren
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Brett D Thombs
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Luc Mouthon
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
| | - Christelle Nguyen
- Centre-Université Paris Cité, Department of Rehabilitation and Rehabilitation of the Musculoskeletal System and Pathologies of the Spine, Hôpital Cochin, 75014 Paris, France; University Paris City, Faculty de Santé, UFR de Médecine, 75006 Paris, France; INSERM UMR-S 1153, Epidemiology and Statistics Research Center Paris Sorbonne 75004 Cité, Paris, France; 4INSERM UMR-S 1124, Toxicity Environmental, Therapeutic Targets, Cellular Signaling and Biomarkers (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France; Clinical Psychology, Radboud University Nijmegen, The Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Federated Institute for Disability Research, 75013 Paris, France; Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medical; psychology; and Educational and Counseling Psychology; and Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada; AP-HP. Centre-Université Paris Cité, Department of Internal Medicine, Reference Center for Rare Autoimmune Systemic Diseases of le-de-France, Hôpital Cochin, 75014 Paris, France. Corresponding author: Prof. Christelle NGUYEN, MD, PhD. Assistance Publique-Hôpitaux de Paris.Centre-Université Paris City. Rehabilitation and Rehabilitation Rehabilitation Musculoskeletal System and Pathologies of the Spine. 27, Rue du Faubourg Saint-Jacques, 75014 Paris, FRANCE.
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Becetti K, Nguyen JT, Kwakkenbos L, Carrier ME, Tao L, Gordon JK, Mancuso CA, Welling J, Mouthon L, Bartlett SJ, Malcarne VL, Thombs BD, Spiera RF. Mental Health Care Use and Associated Factors in Systemic Sclerosis: A Scleroderma Patient-Centered Intervention Network Cohort Study. ACR Open Rheumatol 2022; 4:647-657. [PMID: 35603782 PMCID: PMC9374049 DOI: 10.1002/acr2.11439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Systemic sclerosis (SSc) has significant psychosocial implications. We aimed to evaluate the proportion of participants in a large international SSc cohort who used mental health services in a 3‐month period and to evaluate demographic, psychological, and disease‐specific factors associated with use. Methods Baseline data of participants enrolled in the Scleroderma Patient‐Centered Intervention Network Cohort were analyzed. We determined the proportion that used mental health services and the source of services in the 3 months prior to enrollment. Multivariable logistic regression was used to identify variables associated with service use. Results Of the 2319 participants included in the analysis, 417 (18%) used mental health services in the 3 months prior to enrollment. General practitioners were the most common mental health service providers (59%), followed by psychologists (25%) and psychiatrists (19%). In multivariable analysis, mental health service use was independently associated with higher education (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.03‐1.11), smoking (OR 1.06, 95% CI 1.02‐1.11), being retired (OR 0.60, 95% CI 0.38‐0.93), having limited SSc (OR 1.39, 95% CI 1.02‐1.89), and having higher anxiety symptom scores (OR 1.04, 95% CI 1.03‐1.06) and lower self‐efficacy scores (OR 0.90, 95% CI 0.83‐0.97). Variables not significantly associated included age, race, disease manifestations, depression symptom scores, and body image distress. Conclusion About 18% of participants in a large international cohort received mental health services in a 3‐month period, of whom the majority received these services from a general practitioner.
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Affiliation(s)
| | | | - Linda Kwakkenbos
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | | | | | - Joep Welling
- Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, the Netherlands, and Federation of European Scleroderma Associations, Brussels, Belgium
| | - Luc Mouthon
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, and Hôpital Cochin, Paris, France
| | - Susan J Bartlett
- McGill University and McGill University Health Center Research Institute, Montreal, Quebec, Canada
| | | | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital and McGill University, Montreal, Quebec, Canada
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Gordon JK, Showalter K, Wu Y, Kwakkenbos L, Carrier ME, Henry RS, Østbø N, Nordlund J, Bourgeault A, Cañedo-Ayala M, Carboni-Jiménez A, Denton CP, Mouthon L, Thombs BD, Spiera RF. Systemic sclerosis and COVID-19 vaccines: a SPIN Cohort study. The Lancet Rheumatology 2022; 4:e243-e246. [PMID: 35072109 PMCID: PMC8765760 DOI: 10.1016/s2665-9913(21)00416-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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24
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Kwakkenbos L, Østbø N, Carrier ME, Nielson WR, Fedoruk C, Levis B, Henry RS, Pope J, Frech T, Gholizadeh S, Johnson SR, Piotrowski P, Jewett LR, Gordon J, Chung L, Bilsker D, Tao L, Turner KA, Cumin J, Welling J, Fortuné C, Leite C, Gottesman K, Sauvé M, Reyna TSR, Hudson M, Larche M, van Breda W, Suarez-Almazor ME, Bartlett SJ, Malcarne VL, Mayes MD, Boutron I, Mouthon L, Benedetti A, Thombs BD. Randomized feasibility trial of the Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program. Pilot Feasibility Stud 2022; 8:45. [PMID: 35219340 PMCID: PMC8881754 DOI: 10.1186/s40814-022-00994-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 01/27/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The Scleroderma Patient-centered Intervention Network (SPIN) developed an online self-management program (SPIN-SELF) designed to improve disease-management self-efficacy in people with systemic sclerosis (SSc, or scleroderma). The aim of this study was to evaluate feasibility aspects for conducting a full-scale randomized controlled trial (RCT) of the SPIN-SELF Program. METHODS This feasibility trial was embedded in the SPIN Cohort and utilized the cohort multiple RCT design. In this design, at the time of cohort enrollment, cohort participants consent to be assessed for trial eligibility and randomized prior to being informed about the trial. Participants in the intervention arm are informed and provide consent, but not the control group. Forty English-speaking SPIN Cohort participants from Canada, the USA, or the UK with low disease-management self-efficacy (Self-Efficacy for Managing Chronic Disease Scale [SEMCD] score ≤ 7) who were interested in using an online self-management program were randomized (3:2 ratio) to be offered the SPIN-SELF Program or usual care for 3 months. Program usage was examined via automated usage logs. User satisfaction was assessed with semi-structured interviews. Trial personnel time requirements and implementation challenges were logged. RESULTS Of 40 SPIN Cohort participants randomized, 26 were allocated to SPIN-SELF and 14 to usual care. Automated eligibility and randomization procedures via the SPIN Cohort platform functioned properly, except that two participants with SEMCD scores > 7 (scores of 7.2 and 7.3, respectively) were included, which was caused by a system programming error that rounded SEMCD scores. Of 26 SPIN Cohort participants offered the SPIN-SELF Program, only 9 (35%) consented to use the program. Usage logs showed that use of the SPIN-SELF Program was low: 2 of 9 users (22%) logged into the program only once (median = 3), and 4 of 9 (44%) accessed none or only 1 of the 9 program's modules (median = 2). CONCLUSIONS The results of this study will lead to substantial changes for the planned full-scale RCT of the SPIN-SELF Program that we will incorporate into a planned additional feasibility trial with progression to a full-scale trial. These changes include transitioning to a conventional RCT design with pre-randomization consent and supplementing the online self-help with peer-facilitated videoconference-based groups to enhance engagement. TRIAL REGISTRATION clinicaltrials.gov , NCT03914781 . Registered 16 April 2019.
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Affiliation(s)
- Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Montessorilaan 3, 6525, HR, Nijmegen, The Netherlands.
| | - Nora Østbø
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Claire Fedoruk
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Brooke Levis
- Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Richard S Henry
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Janet Pope
- Department of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Tracy Frech
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Shadi Gholizadeh
- California School of Professional Psychology/Alliant, Los Angeles, CA, USA
| | - Sindhu R Johnson
- Toronto Scleroderma Program, Mount Sinai Hospital & Toronto Western Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Lisa R Jewett
- Department of Psychology, Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Jessica Gordon
- Department of Medicine, Hospital for Special Surgery, New York City, NY, USA
| | - Lorinda Chung
- Department of Medicine, Stanford University, Palo Alto, CA, USA.,Department of Medicine Palo Alto VA Health Care System, Palo Alto, CA, USA
| | - Dan Bilsker
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.,Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lydia Tao
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Kimberly A Turner
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Julie Cumin
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
| | - Joep Welling
- NVLE Dutch patient organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | | | | | | | - Maureen Sauvé
- Scleroderma Canada, Hamilton, Ontario, Canada.,Scleroderma Society of Ontario, Hamilton, Ontario, Canada
| | | | - Marie Hudson
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Maggie Larche
- Department of Medicine, McMaster University and St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Ward van Breda
- Faculty of Behavioural and Movement Sciences, Vrije University, Amsterdam, The Netherlands
| | - Maria E Suarez-Almazor
- Department of General Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA.,Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California San Diego, San Diego, CA, USA
| | - Maureen D Mayes
- Department of Internal Medicine, University of Texas McGovern School of Medicine, Houston, TX, USA
| | - Isabelle Boutron
- Université de Paris, Centre of Research Epidemiology and Statistics (CRESS), Inserm, INRA, Paris, France.,Centre d'Épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Paris, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,APHP-CUP, Hôpital Cochin, Université de Paris, F-75014, Paris, France
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Brett D Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.,Department of Psychology, McGill University, Montreal, Quebec, Canada.,Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.,Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
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Henry RS, Kwakkenbos L, Carrier ME, Negeri Z, Bourgeault A, Patten S, Bartlett SJ, Mouthon L, Varga J, Benedetti A, Thombs BD. Mental health before and during the pandemic in people with systemic sclerosis. The Lancet Rheumatology 2022; 4:e82-e85. [PMID: 34901884 PMCID: PMC8641958 DOI: 10.1016/s2665-9913(21)00363-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E4, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen, Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E4, Canada
| | - Zelalem Negeri
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E4, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | - Angelica Bourgeault
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E4, Canada
| | - Scott Patten
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - John Varga
- Department of Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA
| | - Andrea Benedetti
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E4, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
- Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
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26
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Lee YC, Fox RS, Kwakkenbos L, Levis B, Carrier ME, Welling J, Sauvé M, Mouthon L, Benedetti A, Bartlett SJ, Varga J, Thombs BD. Pain levels and associated factors in the Scleroderma Patient-centered Intervention Network (SPIN) cohort: a multicentre cross-sectional study. Lancet Rheumatol 2021; 3:e844-e854. [PMID: 38287631 DOI: 10.1016/s2665-9913(21)00318-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Pain is an important and detrimental feature of systemic sclerosis but is often overlooked or deprioritised in research and clinical care. Raynaud's phenomenon, arthritis, and cutaneous ulcers are among the commonly reported disease manifestations of systemic sclerosis that could be associated with pain. We aimed to assess levels of pain intensity and interference and to evaluate disease factors associated with pain intensity and interference. METHODS In this multicentre cross-sectional study, participants from the Scleroderma Patient-centered Intervention Network cohort who completed pain intensity and interference measures (Patient Reported Outcomes Information System-29 profile, version 2·0) as part of baseline assessments were included. Patients were recruited from 46 centres in Australia, Canada, France, Mexico, Spain, the UK, and the USA between April 15, 2014, and Jan 7, 2020. Eligible patients included those aged 18 years or older who met the criteria for systemic sclerosis devised by the American College of Rheumatology and the European League Against Rheumatism. Associations of pain intensity and pain interference with systemic sclerosis-related variables and overlap syndromes, controlling for sociodemographic variables, were assessed with multiple linear regression. Continuous independent variables were standardised. FINDINGS Among 2157 participants with systemic sclerosis (268 [12%] males and 1889 [88%] females), 1870 (87%) reported mild, moderate, or severe pain (defined as ≥1 on a 0 to 10 scale), and 815 (38%) reported moderate or severe pain (defined as ≥5). Moreover, 757 (35%) participants reported moderate or severe pain interference. Greater pain intensity was independently associated with female sex (0·58 points [95% CI 0·26-0·90]), non-White race or ethnicity (0·50 points [0·21-0·79]), fewer years in formal education (0·30 points per SD [0·19-0·41]), country (reference: USA; Canada: 0·29 points [0·01-0·57] and UK: 0·58 points [0·21-0·95]), greater body-mass index (0·35 points per SD [0·24-0·45]); joint contractures (0·67 points [0·39-0·94]), digital ulcers (0·33 points [0·10-0·55]), gastrointestinal involvement (0·66 points [0·33-0·98]), skin involvement (measured using modified Rodnan skin score; 0·22 points per SD [0·10-0·35]), rheumatoid arthritis (0·96 points [0·50-1·43]), and Sjögren's syndrome (0·42 points [0·01-0·83]). Pain interference results were similar. INTERPRETATION Pain is common among people with systemic sclerosis. Controlling for sociodemographic variables, greater pain was associated with multiple systemic sclerosis-related manifestations, including joint contractures, digital ulcers, gastrointestinal involvement, skin involvement, and the presence of overlap syndromes. Health-care providers should work with patients to address pain, including identifying and addressing systemic sclerosis manifestations associated with their pain, and supporting behavioural approaches to minimise impact on function and quality of life. FUNDING Canadian Institutes of Health Research, Arthritis Society, The Lady Davis Institute for Medical Research of the Jewish General Hospital, Jewish General Hospital Foundation, McGill University, Scleroderma Society of Ontario, Scleroderma Canada, Sclérodermie Québec, Scleroderma Manitoba, Scleroderma Atlantic, Scleroderma Association of BC, Scleroderma SASK, Scleroderma Australia, Scleroderma New South Wales, Scleroderma Victoria, and Scleroderma Queensland.
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Affiliation(s)
- Yvonne C Lee
- Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands; Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Brooke Levis
- Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Joep Welling
- Dutch patient organization for systemic autoimmune diseases, Utrecht, Netherlands; Federation of European Scleroderma Associations, Brussels, Belgium
| | - Maureen Sauvé
- Scleroderma Society of Ontario and Scleroderma Canada, Hamilton, ON, Canada
| | - Luc Mouthon
- Service de Medecine Interne, Centre de Reference Maladies Autoimmunes et Systemiques Rares d'Ile de France, Hopital Cochin, Assistance-Publique Hopitaux de Paris, Centre, Universite de Paris, Paris, France
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, QC, Canada; Research Institute of the McGill University Health Centre, McGill University Health Centre, Montreal, QC, Canada
| | - John Varga
- University of Michigan, Ann Arbor, MI, USA
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada; Department of Medicine, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada; Department of Psychiatry, McGill University, Montreal, QC, Canada; Department of Psychology, McGill University, Montreal, QC, Canada; Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada; Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
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27
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Nordlund J, Henry RS, Kwakkenbos L, Carrier ME, Levis B, Nielson WR, Bartlett SJ, Dyas L, Tao L, Fedoruk C, Nielsen K, Hudson M, Pope J, Frech T, Gholizadeh S, Johnson SR, Piotrowski P, Jewett LR, Gordon J, Chung L, Bilsker D, Levis AW, Turner KA, Cumin J, Welling J, Fortuné C, Leite C, Gottesman K, Sauve M, Rodríguez-Reyna TS, Larche M, van Breda W, Suarez-Almazor ME, Wurz A, Culos-Reed N, Malcarne VL, Mayes MD, Boutron I, Mouthon L, Benedetti A, Thombs BD. The Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program: protocol for a two-arm parallel partially nested randomized controlled feasibility trial with progression to full-scale trial. Trials 2021; 22:856. [PMID: 34838105 PMCID: PMC8626736 DOI: 10.1186/s13063-021-05827-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 11/13/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Systemic sclerosis (scleroderma; SSc) is a rare autoimmune connective tissue disease. We completed an initial feasibility trial of an online self-administered version of the Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program using the cohort multiple randomized controlled trial (RCT) design. Due to low intervention offer uptake, we will conduct a new feasibility trial with progression to full-scale trial, using a two-arm parallel, partially nested RCT design. The SPIN-SELF Program has also been revised to include facilitator-led videoconference group sessions in addition to online material. We will test the group-based intervention delivery format, then evaluate the effect of the SPIN-SELF Program on disease management self-efficacy (primary) and patient activation, social appearance anxiety, and functional health outcomes (secondary). METHODS This study is a feasibility trial with progression to full-scale RCT, pending meeting pre-defined criteria, of the SPIN-SELF Program. Participants will be recruited from the ongoing SPIN Cohort ( http://www.spinsclero.com/en/cohort ) and via social media and partner patient organizations. Eligible participants must have SSc and low to moderate disease management self-efficacy (Self-Efficacy for Managing Chronic Disease (SEMCD) Scale score ≤ 7.0). Participants will be randomized (1:1 allocation) to the group-based SPIN-SELF Program or usual care for 3 months. The primary outcome in the full-scale trial will be disease management self-efficacy based on SEMCD Scale scores at 3 months post-randomization. Secondary outcomes include SEMCD scores 6 months post-randomization plus patient activation, social appearance anxiety, and functional health outcomes at 3 and 6 months post-randomization. We will include 40 participants to assess feasibility. At the end of the feasibility portion, stoppage criteria will be used to determine if the trial procedures or SPIN-SELF Program need important modifications, thereby requiring a re-set for the full-scale trial. Otherwise, the full-scale RCT will proceed, and outcome data from the feasibility portion will be utilized in the full-scale trial. In the full-scale RCT, 524 participants will be recruited. DISCUSSION The SPIN-SELF Program may improve disease management self-efficacy, patient activation, social appearance anxiety, and functional health outcomes in people with SSc. SPIN works with partner patient organizations around the world to disseminate its programs free-of-charge. TRIAL REGISTRATION ClinicalTrials.gov NCT04246528 . Registered on 27 January 2020.
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Affiliation(s)
- Julia Nordlund
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Richard S. Henry
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
- Department of Psychiatry, McGill University, Montreal, Quebec Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Brooke Levis
- Centre for Prognosis Research, School of Medicine, Keele University, Keele, Staffordshire UK
| | | | - Susan J. Bartlett
- Department of Medicine, McGill University, Montreal, Quebec Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec Canada
| | - Laura Dyas
- Scleroderma Foundation, Michigan Chapter, Southfield, MI USA
| | - Lydia Tao
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Claire Fedoruk
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Karen Nielsen
- Scleroderma Society of Ontario, Hamilton, Ontario Canada
| | - Marie Hudson
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
- Department of Medicine, McGill University, Montreal, Quebec Canada
| | - Janet Pope
- Department of Medicine, University of Western Ontario, London, Ontario Canada
| | - Tracy Frech
- Department of Internal Medicine, University of Utah, Salt Lake City, UT USA
| | - Shadi Gholizadeh
- California School of Professional Psychology/Alliant, Los Angeles, CA USA
| | - Sindhu R. Johnson
- Toronto Scleroderma Program, Mount Sinai Hospital & Toronto Western Hospital, Toronto, Ontario Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario Canada
| | | | - Lisa R. Jewett
- Department of Psychology, Jewish General Hospital, Montreal, Quebec Canada
| | - Jessica Gordon
- Department of Medicine, Hospital for Special Surgery, New York City, NY USA
| | - Lorinda Chung
- Department of Medicine, Stanford University, Palo Alto, CA USA
- Department of Medicine, Palo Alto VA Health Care System, Palo Alto, CA USA
| | - Dan Bilsker
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia Canada
| | - Alexander W. Levis
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA USA
| | - Kimberly A. Turner
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Julie Cumin
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Joep Welling
- NVLE Dutch patient organization for systemic autoimmune diseases, Utrecht, The Netherlands
| | | | | | | | - Maureen Sauve
- Scleroderma Society of Ontario, Hamilton, Ontario Canada
- Scleroderma Canada, Hamilton, Ontario Canada
| | | | - Maggie Larche
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario Canada
| | - Ward van Breda
- Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands
| | - Maria E. Suarez-Almazor
- Department of General Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, British Columbia Canada
| | - Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta Canada
- Department of Oncology, Cumming School of Medicine, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta Canada
| | - Vanessa L. Malcarne
- Department of Psychology, San Diego State University, San Diego, CA USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California San Diego, San Diego, CA USA
| | - Maureen D. Mayes
- Department of Internal Medicine, University of Texas McGovern School of Medicine, Houston, TX USA
| | - Isabelle Boutron
- Université de Paris, Centre of Research Epidemiology and Statistics (CRESS), Inserm, INRA, Paris, France
- Centre d’Épidémiologie Clinique, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Paris, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d’Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, Quebec Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec Canada
| | - Brett D. Thombs
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
- Department of Psychiatry, McGill University, Montreal, Quebec Canada
- Department of Medicine, McGill University, Montreal, Quebec Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec Canada
- Department of Psychology, McGill University, Montreal, Quebec Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec Canada
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Østbø N, Jimenez EY, Harb S, Bourgeault A, Carrier ME, Thombs BD. Nutrition Information Resources Used by People With Systemic Sclerosis and Perceived Advantages and Disadvantages: A Nominal Group Technique Study. ACR Open Rheumatol 2021; 3:540-549. [PMID: 34196508 PMCID: PMC8363851 DOI: 10.1002/acr2.11293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/10/2021] [Indexed: 11/22/2022] Open
Abstract
Objective Where people with systemic sclerosis (SSc) (or scleroderma) obtain diet and nutrition information to manage their disease is not known. Objectives were to identify 1) resources used by people with SSc for nutrition and diet information and 2) perceived advantages and disadvantages of resources. Methods We conducted nominal group technique (NGT) sessions in which people with SSc reported nutrition and diet information resources they have used and perceived advantages and disadvantages of accessing and using resources. Participants indicated whether they had tried each resource. They rated helpfulness and importance of possible advantages and disadvantages. Items elicited across sessions were merged to eliminate overlap. Results We conducted four NGT sessions (three English language, one French language; 15 total participants) and identified 33 unique information resources, 147 resource‐specific advantages, and 118 resource‐specific disadvantages. Resource categories included health care providers, alternative and complementary practitioners, websites and other media platforms, events, and print materials. The most common themes for advantages and disadvantages included quality and individualization of information and accessibility of resources in terms of cost, location, and comprehensibility. Information provided by medical professionals was regarded as most credible and can be obtained through books, articles, and websites if individual consultation is not easily accessible. Web‐based information was considered highly accessible, although of variable credibility. In‐person events may be an important source of health information for people with SSc. Conclusion People with SSc obtain nutrition and diet information from multiple resources. They seek credible and accessible resources that provide SSc‐specific and individualized information.
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Affiliation(s)
- Nora Østbø
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Elizabeth Y Jimenez
- College of Population Health, University of New Mexico Health Sciences Center, Albuquerque, and Nutrition Research Network, Academy of Nutrition and Dietetics, Chicago, Illinois
| | - Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | - Angelica Bourgeault
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital and McGill University, Montreal, Quebec, Canada
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Thombs BD, Kwakkenbos L, Levis B, Bourgeault A, Henry RS, Levis AW, Harb S, Tao L, Carrier ME, Bustamante L, Duchek D, Dyas L, El-Baalbaki G, Ellis K, Rice DB, Wurz A, Nordlund J, Gagarine M, Turner KA, Østbø N, Culos-Reed N, Hebblethwaite S, Patten S, Bartlett SJ, Varga J, Mouthon L, Markham S, Martin MS, Benedetti A. Effects of a multi-faceted education and support programme on anxiety symptoms among people with systemic sclerosis and anxiety during COVID-19 (SPIN-CHAT): a two-arm parallel, partially nested, randomised, controlled trial. Lancet Rheumatol 2021; 3:e427-e437. [PMID: 33899008 PMCID: PMC8051930 DOI: 10.1016/s2665-9913(21)00060-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background No trials have tested multifaceted mental health interventions recommended by public health organisations during COVID-19. The objective of this trial was to evaluate the effect of the Scleroderma Patient-centered Intervention Network COVID-19 Home-isolation Activities Together (SPIN-CHAT) Program on anxiety symptoms and other mental health outcomes among people vulnerable during COVID-19 owing to a pre-existing medical condition. Methods The SPIN-CHAT Trial was a pragmatic, two-arm, parallel, partially nested, randomised, controlled trial (1:1 allocation to intervention or waitlist). Eligible participants with systemic sclerosis were recruited from the international SPIN COVID-19 Cohort. SPIN COVID-19 Cohort participants were eligible for the trial if they completed baseline measures and had at least mild anxiety symptoms, had not tested positive for COVID-19, and were not currently receiving mental health counselling. SPIN-CHAT is a 4-week (3 sessions per week) videoconference-based group intervention that provided education and practice with mental health coping strategies, and provided social support to reduce isolation. Groups included 6-10 participants. The primary outcome analysed in the intention-to-treat population was anxiety symptoms (PROMIS Anxiety 4a version 1.0) immediately post-intervention. This trial is registered with ClinicalTrials.gov, NCT04335279 and is complete. Findings Of participants who completed baseline measures between April 9, 2020, and April 27, 2020, 560 participants were eligible and 172 participants were randomly assigned to intervention (n=86) or waitlist (n=86). Mean age was 55·0 years (SD 11·4 years), 162 (94%) were women, and 136 (79%) identified as White. In intention-to-treat analyses, the intervention did not significantly reduce anxiety symptoms post-intervention (-1·57 points, 95% CI -3·59 to 0·45; standardised mean difference [SMD] -0·22 points) but reduced symptoms 6 weeks later (-2·36 points, 95% CI -4·56 to -0·16; SMD -0·31). Depression symptoms were significantly lower 6 weeks post-intervention (-1·64 points, 95% CI -2·91 to -0·37; SMD -0·31); no other secondary outcomes were significant. No adverse events were reported. Interpretation The intervention did not significantly improve anxiety symptoms or other mental health outcomes post-intervention. However, anxiety and depression symptoms were significantly lower 6 weeks later, potentially capturing the time it took for new skills and social support between intervention participants to affect mental health. Multi-faceted interventions such as SPIN-CHAT have potential to address mental health needs in vulnerable groups during COVID-19, yet uncertainty remains about effectiveness. Funding Canadian Institutes of Health Research (CIHR; VR4-172745, MS1-173066); McGill Interdisciplinary Initiative in Infection and Immunity Emergency COVID-19 Research Fund; Scleroderma Canada, made possible by an educational grant for patient support programming from Boehringer Ingelheim; the Scleroderma Society of Ontario; Scleroderma Manitoba; Scleroderma Atlantic; Scleroderma Australia; Scleroderma New South Wales; Scleroderma Victoria; Scleroderma Queensland; Scleroderma SASK; the Scleroderma Association of BC; and Sclérodermie Québec.
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Affiliation(s)
- Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada.,Department of Psychology, McGill University, Montreal, QC, Canada.,Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada.,Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Brooke Levis
- Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Angelica Bourgeault
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Alexander W Levis
- Department of Biostatistics, Harvard T H Chan School of Public Health, Cambridge, MA, USA
| | - Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Laura Bustamante
- Department of Applied Human Sciences, Concordia University, Montreal, QC, Canada
| | - Delaney Duchek
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Laura Dyas
- Scleroderma Foundation, Michigan Chapter, Southfield, MI, USA
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Kelsey Ellis
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychology, McGill University, Montreal, QC, Canada
| | - Amanda Wurz
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Julia Nordlund
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Maria Gagarine
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
| | | | - Nora Østbø
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Department of Oncology, Cumming School of Medicine, Calgary, Canada.,Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB, Canada
| | | | - Scott Patten
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, QC, Canada.,Research Institute, McGill University Health Centre, Montreal, QC, Canada
| | - John Varga
- University of Michigan, Ann Arbor, MI, USA
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares d'Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.,APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London, London, UK
| | - Michael S Martin
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.,Correctional Service of Canada, Ottawa, ON, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada.,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, QC, Canada
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Harb S, Peláez S, Carrier ME, Kwakkenbos L, Bartlett SJ, Hudson M, Mouthon L, Sauvé M, Welling J, Shrier I, Thombs BD. Barriers and facilitators to physical activity for people with scleroderma: a Scleroderma Patient-centered Intervention Network (SPIN) Cohort study. Arthritis Care Res (Hoboken) 2021; 74:1300-1310. [PMID: 33527717 DOI: 10.1002/acr.24567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 12/22/2020] [Accepted: 01/28/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To support physical activity among people with systemic sclerosis (SSc; scleroderma), we sought to determine the (1) prevalence and importance of barriers and (2) likelihood of using possible facilitators. METHODS We invited 1,707 participants from an international SSc cohort to rate the (1) importance of 20 barriers (14 medical; 4 social or personal; 1 lifestyle; 1 environmental); and (2) likelihood of using 91 corresponding barrier-specific and 12 general facilitators. RESULTS Among 721 respondents, 13 barriers were experienced by ≥25% of participants, including 2 (fatigue, Raynaud's) rated 'important' or 'very important' by ≥50% of participants, 7 (joint stiffness and contractures, shortness of breath, gastrointestinal problems, difficulty grasping, pain, muscle weakness and mobility limitations, low motivation) by 26-50%, and 4 by <26%. Overall, 23 (18 medical-related) of 103 facilitators were rated by ≥75% as 'likely' or 'very likely' to use among those who experienced corresponding barriers; these facilitators focused on adapting exercise (e.g., using controlled, slow movement), taking care of one's body (e.g., stretching), keeping warm (e.g., wearing gloves), and protecting skin (e.g., covering ulcers). Among those who had previously tried the facilitator, all facilitators were rated by ≥50% as 'likely' or 'very likely' to use; among those with the barrier who had not tried the facilitator, only 12 of 103 were rated by >50% as 'likely' or 'very likely'. CONCLUSION Medical-related physical activity barriers were common and considered important. Facilitators considered as most likely to be used involved adapting exercise, taking care of one's body, keeping warm, and protecting skin.
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Affiliation(s)
- Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada, Quebec.,Department of Psychiatry, McGill University, Montreal, Canada, Quebec
| | - Sandra Peláez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada, Quebec.,Research Centre, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada, Quebec
| | - Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, the Netherlands
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Canada, Quebec
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada, Quebec.,Department of Medicine, McGill University, Montreal, Canada, Quebec
| | - Luc Mouthon
- Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, Paris, France.,Service de Médecine Interne, Hôpital Cohin, Paris, France
| | - Maureen Sauvé
- Scleroderma Canada and Scleroderma Society of Ontario, Hamilton, Canada, Ontario
| | - Joep Welling
- Federation of European Scleroderma Associations, Brussels, Belgium
| | - Ian Shrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada, Quebec
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada, Quebec.,Department of Psychiatry, McGill University, Montreal, Canada, Quebec.,Department of Medicine, McGill University, Montreal, Canada, Quebec.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada, Quebec.,Department of Psychology, McGill University, Montreal, Canada, Quebec.,Department of Educational and Counselling Psychology, McGill University, Montreal, Canada.,Biomedical Ethics Unit, McGill University, Montreal, Canada
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31
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Wu Y, Kwakkenbos L, Henry RS, Carrier ME, Gagarine M, Harb S, Bourgeault A, Tao L, Carboni-Jiménez A, Negeri Z, Patten S, Bartlett SJ, Mouthon L, Varga J, Benedetti A, Thombs BD. Factors associated with fears due to COVID-19: A Scleroderma Patient-centered Intervention Network (SPIN) COVID-19 cohort study. J Psychosom Res 2021; 140:110314. [PMID: 33271402 PMCID: PMC7685938 DOI: 10.1016/j.jpsychores.2020.110314] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/18/2020] [Accepted: 11/21/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION No studies have examined factors associated with fear in any group of people vulnerable during COVID-19 due to pre-existing medical conditions. OBJECTIVE To investigate factors associated with fear of consequences of COVID-19 among people living with a pre-existing medical condition, the autoimmune disease systemic sclerosis (SSc; scleroderma), including country. METHODS Pre-COVID-19 data from the Scleroderma Patient-centered Intervention Network (SPIN) Cohort were linked to COVID-19 data collected in April 2020. Multivariable linear regression was used to assess factors associated with continuous scores of the 10-item COVID-19 Fears Questionnaire for Chronic Medical Conditions, controlling for pre-COVID-19 anxiety symptoms. RESULTS Compared to France (N = 156), COVID-19 Fear scores among participants from the United Kingdom (N = 50) were 0.12 SD (95% CI 0.03 to 0.21) higher; scores for Canada (N = 97) and the United States (N = 128) were higher, but not statistically significant. Greater interference of breathing problems was associated with higher fears due to COVID-19 (Standardized regression coefficient = 0.12, 95% CI 0.01 to 0.23). Participants with higher financial resources adequacy scores had lower COVID-19 Fear scores (Standardized coefficient = -0.18, 95% CI -0.28 to -0.09). CONCLUSIONS Fears due to COVID-19 were associated with clinical and functional vulnerabilities in this chronically ill population. This suggests that interventions may benefit from addressing specific clinical issues that apply to specific populations. Financial resources, health policies and political influences may also be important. The needs of people living with chronic illness during a pandemic may differ depending on the social and political context in which they live.
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Affiliation(s)
- Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Maria Gagarine
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Angelica Bourgeault
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Andrea Carboni-Jiménez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Zelalem Negeri
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Scott Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Luc Mouthon
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Paris, France; Service de Médecine Interne, Centre de Reference Maladies Systémiques Autoimmunes Rares d'Ile de France, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - John Varga
- Northwestern Scleroderma Program. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada; Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada; Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada.
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Thombs BD, Kwakkenbos L, Henry RS, Carrier ME, Patten S, Harb S, Bourgeault A, Tao L, Bartlett SJ, Mouthon L, Varga J, Benedetti A. Changes in mental health symptoms from pre-COVID-19 to COVID-19 among participants with systemic sclerosis from four countries: A Scleroderma Patient-centered Intervention Network (SPIN) Cohort study. J Psychosom Res 2020; 139:110262. [PMID: 33070043 PMCID: PMC7532799 DOI: 10.1016/j.jpsychores.2020.110262] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/21/2020] [Accepted: 09/30/2020] [Indexed: 01/17/2023]
Abstract
INTRODUCTION No studies have reported mental health symptom comparisons prior to and during COVID-19 in vulnerable medical populations. OBJECTIVE To compare anxiety and depression symptoms among people with a pre-existing medical condition and factors associated with changes. METHODS Pre-COVID-19 Scleroderma Patient-centered Intervention Network Cohort data were linked to COVID-19 data from April 2020. Multiple linear and logistic regression were used to assess factors associated with continuous change and ≥ 1 minimal clinically important difference (MCID) change for anxiety (PROMIS Anxiety 4a v1.0; MCID = 4.0) and depression (Patient Health Questionnaire-8; MCID = 3.0) symptoms, controlling for pre-COVID-19 levels. RESULTS Mean anxiety symptoms increased 4.9 points (95% confidence interval [CI] 4.0 to 5.7). Depression symptom change was negligible (0.3 points; 95% CI -0.7 to 0.2). Compared to France (N = 159), adjusted anxiety symptom change scores were significantly higher in the United Kingdom (N = 50; 3.3 points, 95% CI 0.9 to 5.6), United States (N = 128; 2.5 points, 95% CI 0.7 to 4.2), and Canada (N = 98; 1.9 points, 95% CI 0.1 to 3.8). Odds of ≥1 MCID increase were 2.6 for the United Kingdom (95% CI 1.2 to 5.7) but not significant for the United States (1.6, 95% CI 0.9 to 2.9) or Canada (1.4, 95% CI 0.7 to 2.5). Older age and adequate financial resources were associated with less continuous anxiety increase. Employment and shorter time since diagnosis were associated with lower odds of a ≥ 1 MCID increase. CONCLUSIONS Anxiety symptoms, but not depression symptoms, increased dramatically during COVID-19 among people with a pre-existing medical condition.
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Affiliation(s)
- Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1E4, Canada,Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec H3A 1A1, Canada,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada,Department of Medicine, McGill University, 1001 Decarie Boulevard, Montreal, Quebec H4A 3J1, Canada,Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, Quebec H3A 1G1, Canada,Department of Educational and Counselling Psychology, McGill University, 3700 McTavish Street, Montreal, Quebec H3A 1Y2, Canada,Biomedical Ethics Unit, McGill University, 3647 Peel Street, Montreal, Quebec H3A 1X1, Canada,Corresponding author at: 4333 Cote Ste Catherine Road, Montreal, Quebec H3T 1E4, Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Montessorilaan 3, 6525 HR, Nijmegen, the Netherlands
| | - Richard S. Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1E4, Canada,Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec H3A 1A1, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1E4, Canada
| | - Scott Patten
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada,Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada,O'Brien Institute for Public Health, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada
| | - Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1E4, Canada,Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec H3A 1A1, Canada
| | - Angelica Bourgeault
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1E4, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1E4, Canada
| | - Susan J. Bartlett
- Department of Medicine, McGill University, 1001 Decarie Boulevard, Montreal, Quebec H4A 3J1, Canada,Research Institute of the McGill University Health Centre, Centre for Outcomes Research and Evaluation, 5252 de Maisonneuve #3D.57, Montreal, Quebec H4A 2S5, Canada
| | - Luc Mouthon
- Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, 3 Avenue Victoria, 75004 Paris, France,Service de Médecine Interne, Centre de Reference Maladies Systémiques Autoimmunes Rares d'Ile de France, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - John Varga
- Northwestern Scleroderma Program, Feinberg School of Medicine, Northwestern University, 675 North St. Clair, Chicago, IL 60611, USA
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada,Department of Medicine, McGill University, 1001 Decarie Boulevard, Montreal, Quebec H4A 3J1, Canada,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, 5252 boulevard de Maisonneuve, Montreal, Quebec H4A 3S5, Canada
| | - for the SPIN Patient AdvisorsFortunéCatherineqGietzenAmyrGuillotGenevièvesLewisNancytRichardMichelleuSauvéMaureenqWellingJoepvFligelstoneKimwGottesmanKarenrLeiteCatarinaxPérezElisabetyScleroderma Society of Ontario, Hamilton, Ontario, CanadaScleroderma Foundation, Tri-State Chapter, Binghamton, NY, USASclérodermie Québec, Longueuil, Quebec, CanadaToronto, Ontario, CanadaScleroderma Atlantic, Halifax, Nova Scotia, CanadaNVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, the NetherlandsScleroderma & Raynaud's UK, London, United KingdomUniversity of Minho, Braga, PortugalAsociación Española de Esclerodermia, Madrid, Spain
| | - SPIN InvestigatorsBaronMurrayzMalcarneVanessaaaMayesMaureen D.abNielsonWarren R.acRiggsRobertaaAssassiShervinabEllsCarolynzvan den EndeCorneliaadFrechTracyaeHarelDaphnaafHinchcliffMoniqueagHudsonMariezJohnsonSindhu R.ahaiLarcheMaggieajNguyenChristelleakauPopeJanetalRannouFrançoisakReynaTatiana Sofia RodriguezamSchouffoerAnne A.anSuarez-AlmazorMaria E.aoAgardChristianapAlbertAlexandraaqBernsteinElana J.arBerthierSabineapBissonnetteLyneasBrunsAlessandraasCarreiraPatriciaatChaigneBenjaminauChungLorindaavCorreiaChaseawDentonChristopheraxDomsicRobynayDunneJames V.azDunogueBertrandauFarge-BancelDominiqueauFortinPaul R.baGordonJessicabbGranel-ReyBrigitteaubcHatronPierre-YvesbdHerrickAriane L.beHoaSabrinabfJonesNiallbgFernandesArtur Jose de B.asKafajaSuzannebhKhalidiNaderajLaunayDavidbdManningJoannebiMarieIsabellebjMartinMariaatbkMekinianArseneauMelchorSheilaatNikpourMandanablOlagneLouisapProudmanSusannabmRégentAlexisauRivièreSébastienauRobinsonDavidbnRodriguezEstheratRouxSophieasSobanskiVincentbdSteenVirginiaboSuttonEvelynbpThorneCarterbqWilcoxPearceazAyalaMara CañedobrCarboni-JiménezAndreabrGagarineMariabrNordlundJuliabrØstbøNorabrRiceDanielle B.brTurnerKimberly A.brCulos-ReedNicolebsDyasLaurabtEl-BaalbakiGhassanbuHebblethwaiteShannonbvBustamanteLaurabvDuchekDelaneybsEllisKelseybsMcGill University, Montreal, Quebec, CanadaSan Diego State University, San Diego, CA, USAUniversity of Texas McGovern School of Medicine, Houston, TX, USASt. Joseph's Health Care, London, ON, CanadaSint Maartenskliniek, Nijmegen, the NetherlandsUniversity of Utah, Salt Lake City, UT, USANew York University, New York, New York, USAYale School of Medicine, New Haven, CT, USAToronto Scleroderma Program, Mount Sinai Hospital, Toronto Western Hospital, Toronto, Ontario, CanadaUniversity of Toronto, Toronto, Ontario, CanadaMcMaster University, Hamilton, Ontario, CanadaUniversité Paris Descartes, Paris, FranceUniversity of Western Ontario, London, Ontario, CanadaInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoLeiden University Medical Center, Leiden, the NetherlandsUniversity of Texas MD Anderson Cancer Center, Houston, TX, USACentre Hospitalier Universitaire - Hôtel-Dieu de Nantes, Nantes, FranceUniversité Laval, Quebec, Quebec, CanadaColumbia University, New York, NY, USAUniversité de Sherbrooke, Sherbrooke, Quebec, CanadaServicio de Reumatologia del Hospital, 12 de Octubre, Madrid, SpainAssistance Publique - Hôpitaux de Paris, Hôpital Cochin, Paris, FranceStanford University, Stanford, CA, USANorthwestern University, Chicago, IL, USARoyal Free London Hospital, London, UKUniversity of Pittsburgh, Pittsburgh, PA, USASt. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, CanadaCHU de Québec - Université Laval, Quebec, Quebec, CanadaHospital for Special Surgery, New York City, NY, USAAix Marseille Université, Marseille, FranceCentre Hospitalier Régional Universitaire de Lille, Hôpital Claude Huriez, Lille, FranceUniversity of Manchester, Salford Royal NHS Foundation Trust, Manchester, UKCentre hospitalier de l'université de Montréal – CHUM, Montreal, Quebec, CanadaUniversity of Alberta, Edmonton, Alberta, CanadaUniversity of California, Los Angeles, CA, USASalford Royal NHS Foundation Trust, Salford, UKCHU Rouen, Hôpital de Bois-Guillaume, Rouen, FranceFrançois Maurier, Hôpitaux Privés de Metz, Hôpital Belle-Isle, Metz, FranceSt Vincent's Hospital and University of Melbourne, Melbourne, Victoria, AustraliaRoyal Adelaide Hospital and University of Adelaide, Adelaide, South Australia, AustraliaUniversity of Manitoba, Winnipeg, Manitoba, CanadaGeorgetown University, Washington, DC, USADalhousie University, Halifax, Nova Scotia, CanadaSouthlake Regional Health Centre, Newmarket, Ontario, CanadaJewish General Hospital, Montreal, Quebec, CanadaUniversity of Calgary, Alberta, CanadaScleroderma Foundation Michigan Chapter, Southfield, MI, USAUniversité du Québec à Montréal, Montreal, Quebec, CanadaConcordia University, Montreal, Quebec, Canada
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Sommer SJ, Harel D, Kwakkenbos L, Carrier ME, Gholizadeh S, Gottesman K, Leite C, Malcarne VL, Thombs BD. Assessing differential item functioning for the Social Appearance Anxiety Scale: a Scleroderma atient-centred Intervention Network (SPIN) Cohort Study. BMJ Open 2020; 10:e037639. [PMID: 33046467 PMCID: PMC7552836 DOI: 10.1136/bmjopen-2020-037639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The Social Appearance Anxiety Scale (SAAS) is a 16-item questionnaire developed to evaluate fear of appearance-based evaluation by others. The primary objective of this research was to investigate the existence of differential item functioning (DIF) for the 16 SAAS items, comparing patients who completed the SAAS in English and French, either to confirm that scores are comparable or provide guidance on calculating comparable scores. A secondary research objective was to investigate the existence of DIF based on sex and disease status. A tertiary research objective was to assess DIF related to language, sex, and disease status on the recently developed SAAS-5. DESIGN This was a cross-sectional analysis using baseline data from patients enrolled in the Scleroderma Patient-centred Intervention Network (SPIN). SETTING SPIN patients included in the present study were enrolled at 43 centres in Canada, USA, UK, France and Australia, with questionnaires completed in April 2014 to July 2019. PARTICIPANTS 1640 SPIN patients completed the SAAS in French (n=600) or English (n=1040). PRIMARY AND SECONDARY MEASURES The SAAS was collected along with demographic and disease characteristics. RESULTS Six items were identified with statistically significant language-based DIF, four with sex-based DIF and one with disease type-based DIF. However, factor scores before and after accounting for DIF were similar (Pearson correlation >0.99), and individual score differences were small. This was true for both the full and shortened versions of the SAAS. CONCLUSION SAAS and SAAS-5 scores are comparable across language, sex, and disease-type, despite small differences in how patients respond to some items.
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Affiliation(s)
- Sophia J Sommer
- Applied Statistics, Social Science and Humanities, New York University, New York, New York, USA
- PRIISM Applied Statistics Center, New York University, New York, New York, USA
| | - Daphna Harel
- Applied Statistics, Social Science and Humanities, New York University, New York, New York, USA
- PRIISM Applied Statistics Center, New York University, New York, New York, USA
| | - Linda Kwakkenbos
- Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Shadi Gholizadeh
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
- Psychiatry, McGill University, Montreal, Quebec, Canada
| | | | - Catarina Leite
- School of Psychology, University of Minho, Braga, Portugal
| | - Vanessa L Malcarne
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
- Psychology, San Diego State University, San Diego, California, USA
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Psychiatry, McGill University, Montreal, Quebec, Canada
- Medicine, McGill University, Montreal, Quebec, Canada
- Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Psychology, McGill University, Montreal, Quebec, Canada
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Thombs BD, Kwakkenbos L, Carrier ME, Bourgeault A, Tao L, Harb S, Gagarine M, Rice D, Bustamante L, Ellis K, Duchek D, Wu Y, Bhandari PM, Neupane D, Carboni-Jiménez A, Henry RS, Krishnan A, Sun Y, Levis B, He C, Turner KA, Benedetti A, Culos-Reed N, El-Baalbaki G, Hebblethwaite S, Bartlett SJ, Dyas L, Patten S, Varga J. Protocol for a partially nested randomised controlled trial to evaluate the effectiveness of the scleroderma patient-centered intervention network COVID-19 home-isolation activities together (SPIN-CHAT) program to reduce anxiety among at-risk scleroderma patients. J Psychosom Res 2020; 135:110132. [PMID: 32521358 PMCID: PMC7224675 DOI: 10.1016/j.jpsychores.2020.110132] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/03/2020] [Accepted: 05/04/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Contagious disease outbreaks and related restrictions can lead to negative psychological outcomes, particularly in vulnerable populations at risk due to pre-existing medical conditions. No randomised controlled trials (RCTs) have tested interventions to reduce mental health consequences of contagious disease outbreaks. The primary objective of the Scleroderma Patient-centered Intervention Network COVID-19 Home-isolation Activities Together (SPIN-CHAT) Trial is to evaluate the effect of a videoconference-based program on symptoms of anxiety. Secondary objectives include evaluating effects on symptoms of depression, stress, loneliness, boredom, physical activity, and social interaction. METHODS The SPIN-CHAT Trial is a pragmatic RCT that will be conducted using the SPIN-COVID-19 Cohort, a sub-cohort of the SPIN Cohort. Eligible participants will be SPIN-COVID-19 Cohort participants without a positive COVID-19 test, with at least mild anxiety (PROMIS Anxiety 4a v1.0 T-score ≥ 55), not working from home, and not receiving current counselling or psychotherapy. We will randomly assign 162 participants to intervention groups of 7 to 10 participants each or waitlist control. We will use a partially nested RCT design to reflect dependence between individuals in training groups but not in the waitlist control. The SPIN-CHAT Program includes activity engagement, education on strategies to support mental health, and mutual participant support. Intervention participants will receive the 4-week (3 sessions per week) SPIN-CHAT Program via videoconference. The primary outcome is PROMIS Anxiety 4a score immediately post-intervention. ETHICS AND DISSEMINATION The SPIN-CHAT Trial will test whether a brief videoconference-based intervention will improve mental health outcomes among at-risk individuals during contagious disease outbreak.
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Affiliation(s)
- Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada; Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada; Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada.
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Angelica Bourgeault
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Maria Gagarine
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Danielle Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Laura Bustamante
- Department of Applied Human Sciences, Concordia University, Montreal, Quebec, Canada
| | - Kelsey Ellis
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Delaney Duchek
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Yin Wu
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Parash Mani Bhandari
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Dipika Neupane
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Andrea Carboni-Jiménez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Ankur Krishnan
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, UK
| | - Chen He
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Kimberly A Turner
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Nicole Culos-Reed
- Department of Applied Human Sciences, Concordia University, Montreal, Quebec, Canada; Department of Oncology, Cumming School of Medicine, Calgary, Canada; Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, Canada
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Shannon Hebblethwaite
- Department of Applied Human Sciences, Concordia University, Montreal, Quebec, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Laura Dyas
- Scleroderma Foundation Michigan Chapter, Southfield, MI, USA
| | - Scott Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute and O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - John Varga
- Northwestern Scleroderma Program, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Carrier ME, Kwakkenbos L, Nielson WR, Fedoruk C, Nielsen K, Milette K, Pope J, Frech T, Gholizadeh S, Hummers L, Johnson SR, Piotrowski P, Jewett L, Gordon J, Chung L, Bilsker D, Turner KA, Cumin J, Welling J, Fortune C, Leite C, Gottesman K, Sauve M, Rodríguez-Reyna TS, Hudson M, Larche M, van Breda W, Suarez-Almazor ME, Bartlett SJ, Malcarne VL, Mayes MD, Boutron I, Mouthon L, Wigley F, Thombs BD. The Scleroderma Patient-Centered Intervention Network Self-Management Program: Protocol for a Randomized Feasibility Trial. JMIR Res Protoc 2020; 9:e16799. [PMID: 32329747 PMCID: PMC7210498 DOI: 10.2196/16799] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/18/2020] [Accepted: 01/24/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Systemic sclerosis (SSc), or scleroderma, is a rare disease that often results in significant disruptions to activities of daily living and can negatively affect physical and psychological well-being. Because there is no known cure, SSc treatment focuses on reducing symptoms and disability and improving health-related quality of life (HRQoL). Self-management programs are known to increase self-efficacy for disease management in many chronic diseases. The Scleroderma Patient-centered Intervention Network (SPIN) developed a Web-based self-management program (SPIN self-management; SPIN-SELF) to increase self-efficacy for disease management and to improve HRQoL for patients with SSc. OBJECTIVE The proposed study aims to assess the feasibility of conducting a full-scale randomized controlled trial (RCT) of the SPIN-SELF program by evaluating the trial implementation processes, required resources and management, scientific aspects, and participant acceptability and usage of the SPIN-SELF program. METHODS The SPIN-SELF feasibility trial will be conducted via the SPIN Cohort. The SPIN Cohort was developed as a framework for embedded pragmatic trials using the cohort multiple RCT design. In total, 40 English-speaking SPIN Cohort participants with low disease management self-efficacy (Self-Efficacy for Managing Chronic Disease Scale score ≤7), who have indicated interest in using a Web-based self-management program, will be randomized with a 3:2 ratio into the SPIN-SELF program or usual care for 3 months. Feasibility outcomes include trial implementation processes, required resources and management, scientific aspects, and patient acceptability and usage of the SPIN-SELF program. RESULTS Enrollment of the 40 participants occurred between July 5, 2019, and July 27, 2019. By November 25, 2019, data collection of trial outcomes was completed. Data analysis is underway, and results are expected to be published in 2020. CONCLUSIONS The SPIN-SELF program is a self-help tool that may improve disease-management self-efficacy and improve HRQoL in patients with SSc. The SPIN-SELF feasibility trial will ensure that trial methodology is robust, feasible, and consistent with trial participant expectations. The results will guide adjustments that need to be implemented before undertaking a full-scale RCT of the SPIN-SELF program. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/16799.
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Affiliation(s)
- Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, Netherlands
| | | | - Claire Fedoruk
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Karen Nielsen
- Scleroderma Society of Ontario, Hamilton, ON, Canada
| | - Katherine Milette
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Janet Pope
- University of Western Ontario, London, ON, Canada
| | - Tracy Frech
- University of Utah, Salt Lake City, UT, United States
| | - Shadi Gholizadeh
- California School of Professional Psychology/Alliant, Los Angeles, CA, United States
| | - Laura Hummers
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Sindhu R Johnson
- Toronto Scleroderma Program, Mount Sinai Hospital & Toronto Western Hospital, Toronto, ON, Canada.,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | | | - Lisa Jewett
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Jessica Gordon
- Hospital for Special Surgery, New York, NY, United States
| | - Lorinda Chung
- Departments of Pediatrics, Biomedical Data Science, Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Dan Bilsker
- Simon Fraser University, Burnaby, BC, Canada.,University of British Columbia, Vancouver, BC, Canada
| | - Kimberly A Turner
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Julie Cumin
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada
| | - Joep Welling
- NVLE Dutch patient organization for systemic autoimmune diseases, Utrecht, Netherlands
| | | | | | | | - Maureen Sauve
- Scleroderma Society of Ontario, Hamilton, ON, Canada.,Scleroderma Canada, Hamilton, ON, Canada
| | | | - Marie Hudson
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
| | | | - Ward van Breda
- Faculty of Behavioural and Movement Sciences, Vrije University, Amsterdam, Netherlands
| | | | | | | | - Maureen D Mayes
- University of Texas McGovern School of Medicine, Houston, TX, United States
| | - Isabelle Boutron
- Université Paris Descartes, Paris, France.,Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Luc Mouthon
- Université Paris Descartes, Paris, France.,Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Fredrick Wigley
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Brett D Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Psychology, McGill University, Montreal, QC, Canada.,Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
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Thombs BD, Aguila K, Dyas L, Carrier ME, Fedoruk C, Horwood L, Cañedo-Ayala M, Sauvé M, Kwakkenbos L, Malcarne VL, El-Baalbaki G, Peláez S, Connolly K, Hudson M, Platt RW. Protocol for a partially nested randomized controlled trial to evaluate the effectiveness of the Scleroderma Patient-centered Intervention Network Support Group Leader EDucation (SPIN-SSLED) Program. Trials 2019; 20:717. [PMID: 31831073 PMCID: PMC6909446 DOI: 10.1186/s13063-019-3747-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/23/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Some people with rare diseases rely on peer-led support groups for disease-specific education and emotional and practical support. Systemic sclerosis (SSc), or scleroderma, is a rare autoimmune connective tissue disease. Many people with SSc cannot access support groups, and, when support groups exist, they may not be sustained due to challenges that could be addressed via leader training. The Scleroderma Patient-centered Intervention Network (SPIN), along with SSc patient organization partners, developed a training program for SSc patient support group leaders, the Scleroderma Support group Leader EDucation (SPIN-SSLED) Program. We recently completed a feasibility trial in which we successfully delivered the program to two groups of support group leaders who reported a high level of satisfaction with the program and its delivery. The primary objective of the full-scale SPIN-SSLED trial is to evaluate the effect of the program on support group leaders' self-efficacy for carrying out their leadership role. Secondary objectives include evaluating effects on leader burnout, leader satisfaction (participation efficacy), and emotional distress. METHODS/DESIGN The SPIN-SSLED trial is a pragmatic randomized controlled trial (RCT) in which 180 support group leaders will be randomly allocated to training groups of 6 participants each or to a waitlist control. We will use a partially nested RCT design to reflect dependence between individuals in training groups, but not in the waitlist control. Participants allocated to the training program will receive the 13-module SPIN-SSLED Program, delivered via webinar over the course of 3 months in weekly 60-90-min sessions. The primary outcome is leader self-efficacy, measured by the Scleroderma Support Group Leader Self-efficacy Scale post-intervention. Secondary outcomes are leader self-efficacy at 3 months post-intervention, and leader burnout, volunteer job satisfaction (participation efficacy), and emotional distress post-intervention and at 3 months post-intervention. DISCUSSION The SPIN-SSLED trial will test whether a training program for SSc patient support group leaders increases the self-efficacy of group leaders to carry out leadership tasks. The program has the potential to significantly improve the effectiveness and sustainability of existing SSc support groups, to increase the number of available support groups, and to be adapted for other chronic diseases. TRIAL REGISTRATION ClinicalTrials.gov, NCT03965780. Registered on 29 May 2019.
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Affiliation(s)
- Brett D. Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
- Department of Psychiatry, McGill University, Montreal, QC Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC Canada
- Department of Medicine, McGill University, Montreal, QC Canada
- Department of Psychology, McGill University, Montreal, QC Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC Canada
- Biomedical Ethics Unit, McGill University, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4 Canada
| | - Kylene Aguila
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
| | - Laura Dyas
- Scleroderma Foundation Michigan Chapter, Southfield, MI USA
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
| | - Claire Fedoruk
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
| | - Linda Horwood
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
- Department of Psychiatry, McGill University, Montreal, QC Canada
| | - Mara Cañedo-Ayala
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
| | - Maureen Sauvé
- Scleroderma Society of Ontario and Scleroderma Canada, Hamilton, ON Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Vanessa L. Malcarne
- Department of Psychology, San Diego State University, California, USA
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, California, USA
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montreal, QC Canada
| | - Sandra Peláez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC Canada
| | | | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
- Department of Medicine, McGill University, Montreal, QC Canada
| | - Robert W. Platt
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC Canada
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Thombs BD, Dyas L, Pépin M, Aguila K, Carrier ME, Tao L, Harb S, Malcarne VL, El-Baalbaki G, Peláez S, Sauve M, Hudson M, Platt RW. Scleroderma Patient-centered Intervention Network-Scleroderma Support group Leader EDucation (SPIN-SSLED) program: non-randomised feasibility trial. BMJ Open 2019; 9:e029935. [PMID: 31719073 PMCID: PMC6858260 DOI: 10.1136/bmjopen-2019-029935] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 09/27/2019] [Accepted: 10/16/2019] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES The Scleroderma Patient-centered Intervention Network-Scleroderma Support group Leader EDucation (SPIN-SSLED) Programme was designed to improve confidence and self-efficacy and to reduce burden for support group leaders. Objectives were to (1) evaluate feasibility of programme delivery, including required resources, management issues and scientific aspects (eg, performance of outcome measures) and (2) assess user satisfaction and identify any modifications needed to improve programme content or delivery based on participant feedback. DESIGN Non-randomised feasibility trial. SETTING North American patient organisations. PARTICIPANTS Current support group leaders or potential new leaders referred by patient organisations. INTERVENTION The programme included 13 modules delivered live via videoconference over 3 months (April to July 2018) in 60 to 90 min sessions. OUTCOME MEASURES (1) Elements of feasibility, including enrolment and consent procedures, percentage of referred group leaders who consented to participate, session attendance and technical support requirements; (2) programme usability, understandability, organisation and clarity; (3) leader satisfaction with the programme and (4) planned trial outcome measures, including support group leader self-efficacy, burnout, emotional distress and physical function. RESULTS All 12 referred potential participants consented to enrol, and 10 were included in two training groups of five participants each. Participants attended 95% of sessions. Required technical support was minimal, and videoconferencing technology functioned well. Overall programme satisfaction rating was 9.4/10. Mean item rating on the eight items of the Client Satisfaction Questionnaire-8 was 3.83 (1=low satisfaction; 4=high satisfaction). Pre-post scores on the Scleroderma Support Group Leader Self-efficacy Scale increased by 1.7 SDs (large effect); scores on burnout, emotional distress and physical function improved by 0.44, 0.38 and 0.45 SDs (moderate effects). CONCLUSION The SPIN-SSLED Programme was feasibly delivered, including management, resource and scientific aspects. Participant satisfaction was high. The programme is ready to be tested in a full-scale randomised controlled trial. TRIAL REGISTRATION NUMBER NCT03508661.
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Affiliation(s)
- Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
| | - Laura Dyas
- Scleroderma Foundation Michigan Chapter, Southfield, Michigan, USA
| | - Mia Pépin
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
| | - Kylene Aguila
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
| | - Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, California, USA
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Sandra Peláez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Maureen Sauve
- Scleroderma Society of Ontario, Scleroderma Canada, Hamilton, Ontario, Canada
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Robert W Platt
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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Kwakkenbos L, Cumin J, Carrier ME, Bartlett SJ, Malcarne VL, Mouthon L, Nielson WR, Rannou F, Welling J, Thombs BD. Factors associated with patient-reported likelihood of using online self-care interventions: a Scleroderma Patient-centered Intervention Network (SPIN) cohort study. BMJ Open 2019; 9:e029542. [PMID: 31615796 PMCID: PMC6797412 DOI: 10.1136/bmjopen-2019-029542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 08/26/2019] [Accepted: 08/29/2019] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES The Scleroderma Patient-centered Intervention Network (SPIN) Cohort uses the cohort multiple randomised controlled trial design to embed trials of online self-care interventions for people living with systemic sclerosis (SSc; scleroderma). To offer interventions to patients interested in using them, participants complete signalling items that query about the likelihood that patients would agree to participate in nine different hypothetical online programmes addressing common SSc-related problems. It is not known what factors influence patient-reported interest in participating in a particular online intervention and if intervention-specific signalling questions provide unique information or replicate broader characteristics, such as overall willingness to participate or self-efficacy. This study assessed factors that explain responses to intervention-specific signalling items. DESIGN Cross-sectional survey. SETTING SPIN Cohort participants enrolled at 42 centres from Canada, the USA, the UK, France, Spain and Mexico who completed study questionnaires from March 2014 to January 2018 were included. MEASURES Demographic and disease characteristics, self-efficacy and symptoms related to each specific intervention were completed in addition to signalling items. General likelihood of using interventions was calculating by taking the mean score of the remaining signalling questions. PARTICIPANTS 1060 participants with complete baseline data were included in the analyses. RESULTS For all individual signalling questions, controlling for other variables, the mean of the remaining signalling questions was the strongest predictor (standardised regression coefficient β from 0.61 (sleep) to 0.80 (self-management)). Smaller, but statistically significant, associations were found with the symptom associated with the respective signalling question and with general self-efficacy for 7 of 9 signalling questions. CONCLUSIONS The main factor associated with patients' interest in participating in a disease-specific online self-care intervention is their general interest in participating in online interventions. Factors that may influence this general interest should be explored and taken into consideration when inviting patients to try online interventions.
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Affiliation(s)
- Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, The Netherlands
| | - Julie Cumin
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Monteal, Québec, Canada
- McGill University Health Center, Montréal, Québec, Canada
- Department of Medicine, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, California, USA
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
| | - Luc Mouthon
- Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Descartes, Paris, France
- Service de Médecine Interne, Hôpital Cochin, Paris, France
| | - Warren R Nielson
- Beryl & Richard Ivey Rheumatology Day Programs, St. Joseph's Health Care, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - François Rannou
- Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Descartes, Paris, France
| | - Joep Welling
- NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Québec, Canada
- Department of Medicine, McGill University, Monteal, Québec, Canada
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
- Department of Psychology, McGill University, Montréal, Québec, Canada
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Pépin M, Kwakkenbos L, Carrier ME, Peláez S, El-Baalbaki G, Malcarne VL, Thombs BD. Reasons for attending support groups and organizational preferences: A replication study using the North American Scleroderma Support Group Survey. J Scleroderma Relat Disord 2019; 4:173-186. [PMID: 35382506 PMCID: PMC8922561 DOI: 10.1177/2397198319849806] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/20/2019] [Indexed: 09/26/2023]
Abstract
Peer-facilitated support groups are an important source for receiving disease-related information and support for people with systemic sclerosis (or scleroderma). A recent survey explored reasons for attending systemic sclerosis support groups in Europe and Australia and used exploratory factor analysis to group reasons for attendance into three main themes: (1) interpersonal and social support, (2) disease treatment and symptom management strategies, and (3) other aspects of living with systemic sclerosis. The objective of the present study was to replicate this study in a sample of patients from North America using confirmatory factor analysis. A 30-item survey was used to assess reasons for attendance and organizational preferences among systemic sclerosis patients in Canada and the United States. In total, 171 members completed the survey. In the confirmatory factor analysis, the three-factor model showed good fit to the data (χ2(399) = 646.0, p < 0.001, Tucker-Lewis index = 0.97, comparative fit index = 0.97, root mean square error approximation = 0.06). On average, respondents rated 22 (73%) of 30 items as "important" or "very important" reasons for attending support groups. Among organizational preferences, respondents emphasized the importance of the ability to share feelings and concerns, as well as educational aspects. Findings of our study suggest that reasons for attending support groups are similar for patients from Europe, Australia, and North America and that support groups should facilitate social support as well as disease education. These results inform the development of training programs for current and future systemic sclerosis support group leaders across the globe.
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Affiliation(s)
- Mia Pépin
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Sandra Peláez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada
- Department of Psychiatry, McGill University, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, QC, Canada
- Department of Psychology, McGill University, Montréal, QC, Canada
| | - the Scleroderma Patient-centered Intervention Network (SPIN) Support Group Project Advisory Team
- SPIN Support Group Project Advisory Team Members: Kerri Connolly, Director of Programs and Services of the Scleroderma Foundation, Danvers, MA, USA; Laura Dyas, Executive Director of the Scleroderma Foundation Michigan Chapter, Southfield, MI, USA; Stephen Elrod, Southern California Patient Group, Los Angeles, CA, USA; Catherine Fortune, Ontario Patient Group, Ottawa, ON, Canada; Karen Gottesman, Director of Pharma & Biotech Engagement Scleroderma Foundation, Los Angeles, CA, USA; Karen Nielsen, Scleroderma Society of Ontario, Hamilton, ON, Canada; Geneviève Guillot, Sclerodermie Quebec, Montreal, QC, Canada; Ken Rozee, Scleroderma Society of Nova Scotia, Halifax, NS, Canada; Amy Gietzen, Scleroderma Tri-State Chapter, Binghamton, NY, USA; Michelle Richard, President of Scleroderma Canada, Halifax, NS, Canada; Robert Riggs, Chief Executive Officer of the Scleroderma Foundation, Danvers, MA, USA; Maureen Sauve, VP Advocacy and Public Relations of Scleroderma Canada and the Scleroderma Society of Ontario, Hamilton, ON, Canada; Nancy Stephens, Michigan Patient Group, Detroit, MI, USA
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Kwakkenbos L, Carboni-Jiménez A, Carrier ME, Pépin M, Peláez S, Malcarne VL, El-Baalbaki G, Thombs BD. Reasons for not participating in scleroderma patient support groups: a comparison of results from the North American and European scleroderma support group surveys. Disabil Rehabil 2019; 43:1279-1286. [PMID: 31522575 DOI: 10.1080/09638288.2019.1656292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE Many people with scleroderma rely on peer-led support groups as a coping resource. Reasons for not attending support groups in scleroderma have been investigated only in North American participants. This study assesses reasons for nonattendance in European countries and compares results with previously published North American findings. MATERIALS AND METHODS The same 21-item survey as used in the North American sample assessed possible reasons for not attending scleroderma support groups. Proportions of items rated Important or Very Important were compared between samples. RESULTS Consistent with the North American survey findings (N = 242), the two items most commonly rated as (Very) Important reasons for nonattendance among 228 European participants were (1) already having enough support (57%), and (2) not knowing of any local scleroderma support groups (58%). Compared to North American non-attenders, European patients were significantly more likely to rate not knowing enough about what happens at support groups (46% vs 19%), not having reliable ways to get to meetings (35% vs 17%), and being uncomfortable sharing experiences with a group (22% vs 11%) as (Very) Important reasons for nonattendance. CONCLUSIONS Improving access to European support groups, providing education about support groups and group leader training may encourage participation.IMPLICATIONS FOR REHABILITATIONRehabilitation professionals might help develop local support groups for people with systemic sclerosis (scleroderma) to address the lack of access to these groups for many patients.The need for transportation and limited local accessibility may also be addressed by implementing online systemic sclerosis support groups.Professionals in the field of rehabilitation may work with people with systemic sclerosis and patient organizations to provide education about support groups to improve support group attendance in Europe.
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Affiliation(s)
- Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, The Netherlands
| | - Andrea Carboni-Jiménez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Mia Pépin
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Sandra Peláez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA.,Joint Doctoral Program in Clinical Psychology, San Diego State University, University of California, San Diego, CA, USA
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada.,Department of Psychiatry, McGill University, Montréal, QC, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, QC, Canada.,Department of Psychology, McGill University, Montréal, QC, Canada
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Mills SD, Kwakkenbos L, Carrier ME, Gholizadeh S, Fox RS, Jewett LR, Gottesman K, Roesch SC, Thombs BD, Malcarne VL. Validation of the Social Appearance Anxiety Scale in Patients With Systemic Sclerosis: A Scleroderma Patient-Centered Intervention Network Cohort Study. Arthritis Care Res (Hoboken) 2019; 70:1557-1562. [PMID: 29342510 DOI: 10.1002/acr.23514] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 01/09/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Systemic sclerosis (SSc) is an autoimmune disease that can cause disfiguring changes in appearance. This study examined the structural validity, internal consistency reliability, convergent validity, and measurement equivalence of the Social Appearance Anxiety Scale (SAAS) across SSc disease subtypes. METHODS Patients enrolled in the Scleroderma Patient-centered Intervention Network Cohort completed the SAAS and measures of appearance-related concerns and psychological distress. Confirmatory factor analysis (CFA) was used to examine the structural validity of the SAAS. Multiple-group CFA was used to determine whether SAAS scores can be compared across patients with limited and diffuse disease subtypes. Cronbach's alpha was used to examine internal consistency reliability. Correlations of SAAS scores with measures of body image dissatisfaction, fear of negative evaluation, social anxiety, and depression were used to examine convergent validity. SAAS scores were hypothesized to be positively associated with all convergent validity measures, with correlations significant and moderate to large in size. RESULTS A total of 938 patients with SSc were included. CFA supported a 1-factor structure (Comparative Fit Index 0.92, Standardized Root Mean Residual 0.04, and Root Mean Square Error of Approximation 0.08), and multiple-group CFA indicated that the scalar invariance model best fit the data. Internal consistency reliability was good in the total sample (α = 0.96) and in disease subgroups. Overall, evidence of convergent validity was found with measures of body image dissatisfaction, fear of negative evaluation, social anxiety, and depression. CONCLUSION The SAAS can be reliably and validly used to assess fear of appearance evaluation in patients with SSc, and SAAS scores can be meaningfully compared across disease subtypes.
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Affiliation(s)
- Sarah D Mills
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego
| | - Linda Kwakkenbos
- McGill University and Jewish General Hospital, Montreal, Quebec, Canada, and Radboud University, Nijmegen, The Netherlands
| | | | - Shadi Gholizadeh
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego
| | - Rina S Fox
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, and Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lisa R Jewett
- McGill University and Jewish General Hospital, Montreal, Quebec, Canada
| | - Karen Gottesman
- Scleroderma Foundation, Southern California Chapter, Los Angeles
| | - Scott C Roesch
- San Diego State University/ University of California San Diego Joint Doctoral Program in Clinical Psychology and San Diego State University, San Diego
| | - Brett D Thombs
- McGill University and Jewish General Hospital, Montreal, Quebec, Canada
| | - Vanessa L Malcarne
- San Diego State University/ University of California San Diego Joint Doctoral Program in Clinical Psychology and San Diego State University, San Diego
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Becetti K, Kwakkenbos L, Carrier ME, Gordon JK, Nguyen JT, Mancuso CA, Mouthon L, Nguyen C, Rannou F, Welling J, Thombs BD, Spiera RF. Physical or Occupational Therapy Use in Systemic Sclerosis: A Scleroderma Patient-centered Intervention Network Cohort Study. J Rheumatol 2019; 46:1605-1613. [PMID: 31043542 DOI: 10.3899/jrheum.181130] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Systemic sclerosis (SSc) is characterized by significant disability because of musculoskeletal involvement. Physical and occupational therapy (PT/OT) have been suggested to improve function. However, the rate of PT/OT use has been shown to be low in SSc. We aimed to identify demographic, medical, and psychological variables associated with PT/OT use in SSc. METHODS Participants were patients with SSc enrolled in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort. We determined the rate and indication of PT/OT use in the 3 months prior to enrollment. Multivariable logistic regression was used to identify variables independently associated with PT/OT use. RESULTS Of the 1627 patients with SSc included in the analysis, 23% used PT/OT in the preceding 3 months. PT/OT use was independently associated with higher education (OR 1.08, 95% CI 1.04-1.12), having moderately severe small joint contractures (OR 2.09, 95% CI 1.45-3.03), severe large joint contractures (OR 2.33, 95% CI 1.14-4.74), fewer digital ulcerations (OR 0.70, 95% CI 0.51-0.95), and higher disability (OR 1.54, 95% CI 1.18-2.02) and pain scores (OR 1.04, 95% CI 1.02-1.06). The highest rate of PT/OT use was reported in France (43%) and the lowest, in the United States (17%). CONCLUSION Despite the potential of PT/OT interventions to improve function, < 1 in 4 patients with SSc enrolled in a large international cohort used PT/OT services in the last 3 months. Patients who used PT/OT had more severe musculoskeletal manifestations and higher pain and disability.
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Tao L, Fedoruk C, Turner KA, Cumin J, Carrier ME, Carboni-Jiménez A, Pépin MR, Kwakkenbos L, Thombs BD. The Scleroderma Research Topics Survey for patients and health care professionals: A Scleroderma Patient-centered Intervention Network Project. Journal of Scleroderma and Related Disorders 2019; 4:165-172. [DOI: 10.1177/2397198319842969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/19/2019] [Indexed: 11/17/2022]
Abstract
Involving patients and health care professionals in research has been shown to be a useful strategy to generate program development ideas and establish research priorities. Online surveys can be used to identify patient research priorities. The Scleroderma Patient-centered Intervention Network is an international collaboration dedicated to researching problems important to people with scleroderma and developing, testing, and disseminating educational, self-management, rehabilitation, and psychological tools to support coping within the disease. The objectives of the Scleroderma Patient-centered Intervention Network Scleroderma Research Topics Survey were to (1) obtain input on online programs that Scleroderma Patient-centered Intervention Network could develop, (2) identify research topics important to members of the scleroderma community that could be addressed via the Scleroderma Patient-centered Intervention Network Cohort, and (3) identify potentially understudied groups. Eligible survey respondents included individuals with scleroderma and their caregivers, health care professionals, and patient organization representatives. Responses were evaluated separately for online programs, possible research questions, and understudied groups. In each category, thematic analysis was used to group responses into themes. A total of 125 participants (100 patients, 24 health care professionals, and 1 caregiver) completed the survey, and responses from patients and health care professionals were reported. For online programs, frequent recommendations included Interactive Platforms to facilitate communication between patients, as well as interventions targeting physical activity, and emotions and stress. Common responses for possible research questions were related to calcinosis, accessing health care, and quality of life. The most common suggestions for understudied groups were young patients, minority patients, and patients with calcinosis. Research topic suggestions provided in the survey will inform Scleroderma Patient-centered Intervention Network priorities and can be considered by other researchers.
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Affiliation(s)
- Lydia Tao
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Claire Fedoruk
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Kimberly A Turner
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Julie Cumin
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | | | | | - Mia R Pépin
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Linda Kwakkenbos
- Behavioural Science Institute, Department of Clinical Psychology, Radboud University, Nijmegen, The Netherlands
| | - Brett D Thombs
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
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Harel D, Mills SD, Kwakkenbos L, Carrier ME, Nielsen K, Portales A, Bartlett SJ, Malcarne VL, Thombs BD. Shortening patient-reported outcome measures through optimal test assembly: application to the Social Appearance Anxiety Scale in the Scleroderma Patient-centered Intervention Network Cohort. BMJ Open 2019; 9:e024010. [PMID: 30798308 PMCID: PMC6398718 DOI: 10.1136/bmjopen-2018-024010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The Social Appearance Anxiety Scale (SAAS) is a 16-item measure that assesses social anxiety in situations where appearance is evaluated. The objective was to use optimal test assembly (OTA) methods to develop and validate a short-form SAAS based on objective and reproducible criteria. DESIGN This study was a cross-sectional analysis of baseline data from adults enrolled in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort. SETTING Adults in the SPIN Cohort in the present study were enrolled at 28 centres in Canada, the USA and the UK. PARTICIPANTS The SAAS was administered to 926 adults with scleroderma. PRIMARY AND SECONDARY MEASURES The SAAS, Brief Fear of Negative Evaluation II (BFNE II), Brief Satisfaction with Appearance Scale (Brief-SWAP), Patient Health Questionnaire-8 (PHQ8) and Social Interaction Anxiety Scale-6 (SIAS-6) were collected, as well as demographic characteristics. RESULTS OTA methods identified a maximally informative shortened version for each possible form length between 1 and 15 items. The final shortened version was selected based on prespecified criteria for reliability, concurrent validity and statistically equivalent convergent validity with the BFNE II scale. A five-item short version was selected (SAAS-5). The SAAS-5 had a Cronbach's α of 0.95 and had high concurrent validity with the full-length form (r=0.97). The correlation of the SAAS-5 with the BFNE II was 0.66, which was statistically equivalent to that of the full-length form. Furthermore, the correlation of the SAAS-5 with the two subscales of the Brief-SWAP, and the SIAS-6, were statistically equivalent to that of the full-length form. CONCLUSIONS OTA was an efficient method for shortening the full-length SAAS to create the SAAS-5.
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Affiliation(s)
- Daphna Harel
- Applied Statistics, Social Science, Humanities, New York University, New York City, New York, USA
- PRIISM Applied Statistics Center, New York University, New York City, New York, USA
| | - Sarah D Mills
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, UK
| | - Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Karen Nielsen
- Scleroderma Society of Ontario, Hamilton, Ontario, Canada
| | | | - Susan J Bartlett
- Department of Medicine, McGill University, Monteal, Quebec, Canada
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, California, USA
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, USA
| | - Brett D Thombs
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Rice DB, Cañedo-Ayala M, Carboni-Jiménez A, Carrier ME, Cumin J, Malcarne VL, Hagedoorn M, Thombs BD. Challenges and support service preferences of informal caregivers of people with systemic sclerosis: a cross-sectional survey. Disabil Rehabil 2019; 42:2304-2310. [PMID: 30696293 DOI: 10.1080/09638288.2018.1557268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To evaluate the importance of different challenges experienced by informal caregivers to persons with systemic sclerosis (SSc) and identify priorities for support services that could be developed.Materials and Methods: Caregivers of people with SSc from three continents completed an online questionnaire to rate the importance of possible caregiver challenges and likelihood of using different forms of support services. Importance of challenges and likelihood of using support services were rated from 1 (not important; not likely to use) to 4 (very important; very likely to use).Results: Two hundred and two informal caregivers completed the survey (79 women, 123 men). Mean age was 58 years (standard deviation = 13). The most important challenges were related to supporting the care recipient with emotional difficulties and physical discomfort. Caregivers indicated that they would be more likely to use support services that involved online or hard-copy information resources, including those provided soon after diagnosis, compared to support that involved interacting with others.Conclusions: Supporting the care recipient in managing emotional difficulties and physical discomfort were important challenges among caregivers. Interventions delivered through hardcopy or online resources, including those delivered soon after the care recipient's diagnosis, were rated as being most likely to be used by caregivers.Implications for rehabilitationMany caregivers for individuals with systemic sclerosis report struggling to support their care recipient with emotional difficulties and physical discomfort.Rehabilitation professionals can aid in the development of support services that caregivers have identified as being likely to use and can refer caregivers to resources that they have identified as being helpful, such as educational information about the disease.The development of support services should focus on aspects of caring that caregivers found most challenging and be delivered in a format that considers caregiver preferences.
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Affiliation(s)
- Danielle B Rice
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychology, McGill University, Montreal, QC, Canada
| | | | | | | | - Julie Cumin
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA.,San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Mariët Hagedoorn
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Brett D Thombs
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychology, McGill University, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada.,Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
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Dougherty DH, Kwakkenbos L, Carrier ME, Salazar G, Assassi S, Baron M, Bartlett SJ, Furst DE, Gottesman K, van den Hoogen F, Malcarne VL, Mouthon L, Nielson WR, Poiraudeau S, Sauvé M, Boire G, Bruns A, Chung L, Denton C, Dunne JV, Fortin P, Frech T, Gill A, Gordon J, Herrick AL, Hinchcliff M, Hudson M, Johnson SR, Jones N, Kafaja S, Larché M, Manning J, Pope J, Spiera R, Steen V, Sutton E, Thorne C, Wilcox P, Thombs BD, Mayes MD. The Scleroderma Patient-Centered Intervention Network Cohort: baseline clinical features and comparison with other large scleroderma cohorts. Rheumatology (Oxford) 2018; 57:1623-1631. [PMID: 29868924 DOI: 10.1093/rheumatology/key139] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Indexed: 11/14/2022] Open
Abstract
Objectives The Scleroderma Patient-centered Intervention Network (SPIN) Cohort is a web-based cohort designed to collect patient-reported outcomes at regular intervals as a framework for conducting trials of psychosocial, educational, self-management and rehabilitation interventions for patients with SSc. The aim of this study was to present baseline demographic, medical and patient-reported outcome data of the SPIN Cohort and to compare it with other large SSc cohorts. Methods Descriptive statistics were used to summarize SPIN Cohort characteristics; these were compared with published data of the European Scleroderma Trials and Research (EUSTAR) and Canadian Scleroderma Research Group (CSRG) cohorts. Results Demographic, organ involvement and antibody profile data for SPIN (N = 1125) were generally comparable with that of the EUSTAR (N = 7319) and CSRG (N = 1390) cohorts. There was a high proportion of women and White patients in all cohorts, though relative proportions differed. Scl70 antibody frequency was highest in EUSTAR, somewhat lower in SPIN, and lowest in CSRG, consistent with the higher proportion of interstitial lung disease among dcSSc patients in SPIN compared with in CSRG (48.5 vs 40.3%). RNA polymerase III antibody frequency was highest in SPIN and remarkably lower in EUSTAR (21.1 vs 2.4%), in line with the higher prevalence of SSc renal crisis (4.5 vs 2.1%) in SPIN. Conclusion Although there are some differences, the SPIN Cohort is broadly comparable with other large prevalent SSc cohorts, increasing confidence that insights gained from the SPIN Cohort should be generalizable, although it should be noted that all three cohorts include primarily White participants.
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Affiliation(s)
- Dane H Dougherty
- Department of Internal Medicine, Division of Rheumatology, University of Texas McGovern Medical School, Houston, TX, USA
| | - Linda Kwakkenbos
- Department of Psychiatry, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, the Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Gloria Salazar
- Department of Internal Medicine, Division of Rheumatology, University of Texas McGovern Medical School, Houston, TX, USA
| | - Shervin Assassi
- Department of Internal Medicine, Division of Rheumatology, University of Texas McGovern Medical School, Houston, TX, USA
| | - Murray Baron
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, QC, Canada.,Division of Rheumatology, Johns Hopkins School of Medicine, Baltimore, MD, USA.,McGill University Health Center, Montréal, QC, Canada
| | - Daniel E Furst
- Division of Rheumatology, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.,Medicine, University of Washington, Seattle, WA, USA.,Medicine, University of Florence, Florence, Italy
| | | | - Frank van den Hoogen
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA.,San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Luc Mouthon
- Médecine interne, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, France.,Service de Médecine Interne, Centre de Référence Maladies Systémiques Autoimmunes Rares, vascularites nécrosantes et sclérodermie systémique, Hôpital Cochin, Paris, France
| | - Warren R Nielson
- Beryl & Richard Ivey Rheumatology Day Programs, St Joseph's Health Care, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada
| | - Serge Poiraudeau
- Médecine interne, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, France.,Service de Médecine Physique et Réadaptation, Hôpital Cochin, France.,IFR Handicap INSERM, Paris, France
| | - Maureen Sauvé
- Scleroderma Society of Ontario, Hamilton.,Scleroderma Society of Canada, Ottawa, ON, Canada
| | - Gilles Boire
- Département de médecine, Sherbrooke University, Sherbrooke, QC, Canada
| | - Alessandra Bruns
- Département de médecine, Sherbrooke University, Sherbrooke, QC, Canada
| | - Lorinda Chung
- Medicine - Med/Immunology & Rheumatology, Stanford University, Stanford, CA, USA
| | | | - James V Dunne
- Rheumatology, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul Fortin
- Département de médecine, Université Laval, Québec, QC, Canada
| | - Tracy Frech
- Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Anna Gill
- Rheumatology, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Jessica Gordon
- Department of Rheumatology, Hospital for Special Surgery, New York City, NY, USA
| | - Ariane L Herrick
- Division of Musculoskeletal & Dermatological Sciences, University of Manchester, Salford Royal NHS Foundation Trust, Manchester, UK
| | | | - Marie Hudson
- Department of Medicine, McGill University, Montreal, QC, Canada.,Center for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montréal, QC, Canada
| | - Sindhu R Johnson
- Toronto Scleroderma Program, Mount Sinai Hospital, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Niall Jones
- Division of Rheumatology, University of Alberta, Edmonton, AB, Canada
| | - Suzanne Kafaja
- Division of Rheumatology, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Maggie Larché
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Joanne Manning
- Clinical and Research Vascular Laboratories, Salford Royal NHS Foundation Trust, Salford, UK
| | - Janet Pope
- Bone & Joint Institute, University of Western Ontario, London, ON, Canada
| | - Robert Spiera
- Department of Rheumatology, Hospital for Special Surgery, New York City, NY, USA
| | - Virginia Steen
- Department of Medicine, Georgetown University, Washington, DC, USA
| | - Evelyn Sutton
- Division of Rheumatology, Dalhousie University, Halifax, NS
| | | | - Pearce Wilcox
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Département de médecine, Université Laval, Québec, QC, Canada
| | - Brett D Thombs
- Department of Psychiatry, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, QC, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada.,Department of Psychology, McGill University, Montréal, QC, Canada.,School of Nursing, McGill University, Montréal, QC, Canada
| | - Maureen D Mayes
- Department of Internal Medicine, Division of Rheumatology, University of Texas McGovern Medical School, Houston, TX, USA
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Cañedo-Ayala M, Rice DB, Levis B, Carrier ME, Cumin J, Malcarne VL, Hagedoorn M, Thombs BD. Factors associated with symptoms of depression among informal caregivers of people with systemic sclerosis: a cross-sectional study. Disabil Rehabil 2018; 42:394-399. [DOI: 10.1080/09638288.2018.1500647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Mara Cañedo-Ayala
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | - Danielle B. Rice
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
| | - Brooke Levis
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | - Julie Cumin
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
| | - Vanessa L. Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Mariët Hagedoorn
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Brett D. Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, Canada
- Department of Psychology, McGill University, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
- Department of Medicine, McGill University, Montreal, Canada
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Kwakkenbos L, Sanchez TA, Turner KA, Mouthon L, Carrier ME, Hudson M, van den Ende CHM, Schouffoer AA, Welling JJKC, Sauvé M, Thombs BD. The association of sociodemographic and disease variables with hand function: a Scleroderma Patient-centered Intervention Network cohort study. Clin Exp Rheumatol 2018; 36 Suppl 113:88-94. [PMID: 30277865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/02/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Impaired hand function in systemic sclerosis (SSc) is a primary cause of disability and contributes diminished health-related quality of life. The objective of the present study was to evaluate sociodemographic, lifestyle, and disease-related factors independently associated with hand function in SSc. METHODS Patients enrolled in the Scleroderma Patient-centered Intervention Network Cohort who completed baseline study questionnaires between March 2014 and September 2017 were included. Hand function was measured using the Cochin Hand Function Scale (CHFS). Multiple linear regression analysis was used to identify independent correlates of impaired hand function. RESULTS Among 1193 participants (88% female), the mean CHFS score was 13.3 (SD=16.1). Female sex (standardised regression coefficient, beta (β)=.05), current smoking (β=.07), higher BMI (β=.06), diffuse SSc (β=0.14), more severe Raynaud's scores (β=.23), more severe finger ulcer scores (β=.23), moderate (β=0.19) or severe small joint contractures (β=.20), rheumatoid arthritis (β=0.07), and idiopathic inflammatory myositis (β=0.06) were significantly associated with higher CHFS scores (more impaired hand function). Consumption of 1-7 alcoholic drinks per week (β=-0.07) was associated with lower CHFS scores (less impaired hand function) compared to no drinking. CONCLUSIONS Multiple factors are associated with hand function in SSc. The presence of moderate or severe small joint contractures, the presence of digital ulcers, and severity of Raynaud's phenomenon had the largest associations. Effective interventions are needed to improve the management of hand function in patients with SSc.
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Affiliation(s)
- Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, the Netherlands; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal; Department of Psychiatry, McGill University, Montreal, Canada
| | - Tatiana A Sanchez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Kimberly A Turner
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Luc Mouthon
- Université Paris Descartes, Assistance Publique-Hopitaux de Paris; Service de Medicine Interne, Centre de Reference Maladies Systémiques Autoimmunes Rares, vascularites nécrosantes et sclérodermie systémique, Hopital Cochin, Paris, France
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Marie Hudson
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal; Department of Medicine, McGill University, Montreal, Canada
| | | | - Anne A Schouffoer
- Leiden University Medical Center, Leiden; Haga Teaching Hospital, The Hague, the Netherlands
| | - Joep J K C Welling
- NVLE Dutch patient organisation for systemic autoimmune diseases, Utrecht, the Netherlands; and Federation of European Scleroderma Associations, Brussels, Belgium
| | - Maureen Sauvé
- Scleroderma Society of Ontario, Hamilton; and Scleroderma Society of Canada, Ottawa, Canada
| | - Brett D Thombs
- Lady Davis Inst. Med. Res., Jewish General Hosp., Montreal; Dept.of Psychiatry, Dept.of Medicine, Dept.of Epidemiology, Biostatistics and Occupational Health, Dept.of Educational & Counselling Psychology, Dept.of Psychology , McGill Univ., Montreal, Canada
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Delisle VC, Gumuchian ST, El-Baalbaki G, Körner A, Malcarne VL, Peláez S, Carrier ME, Pépin M, Thombs BD. Training and support needs of scleroderma support group facilitators: the North American Scleroderma Support Group Facilitators Survey. Disabil Rehabil 2018; 41:2477-2482. [PMID: 29696997 DOI: 10.1080/09638288.2018.1467970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: Peer-facilitated support groups are an important resource for people with scleroderma, but little is known about challenges faced by support group facilitators. The objective was to identify training and support needs of scleroderma support group facilitators to inform the development of an educational training program. Methods: A 32-item survey assessed confidence of support group facilitators to execute tasks necessary for successfully facilitating support groups. Survey items were grouped into seven themes using content analysis. Results: Eighty North American scleroderma support group facilitators completed the survey. Facilitators were generally confident in their ability to complete tasks related to: (1) Organizing, Structuring, and Facilitating the group; (2) Addressing Individual Member Needs and Diversity of the Group; (3) Helping Members Cope with Grief and Loss; and (4) Attaining and Responding to Member Feedback. They were less confident in their ability to perform tasks related to (1) Managing Difficult Group Dynamics; (2) Promoting and Sustaining the Group; and (3) Balancing Personal and Group Needs. Conclusion: Results suggest that a training program for scleroderma support group facilitators should address a broad range of topics, including managing difficult group interactions, promotion and maintaining the group, and balancing personal and support group needs. Implications for Rehabilitation Many patients with the rare autoimmune connective tissue disease scleroderma depend on peer-facilitated support groups for disease-related education and peer support, but the lack of training for facilitators is a barrier to forming and sustaining groups. Rehabilitation professionals can support the formation and management of local support groups by providing education and support to peer group facilitators or by referring them to national scleroderma organizations who are developing training resources. Training for support group facilitators should focus on areas where facilitators were least confident in their abilities, including managing difficult group dynamics, promoting and sustaining the group, and balancing personal and group needs.
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Affiliation(s)
- Vanessa C Delisle
- Jewish General Hospital, Lady Davis Institute for Medical Research, Montréal, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal , Canada
| | - Stephanie T Gumuchian
- Jewish General Hospital, Lady Davis Institute for Medical Research, Montréal, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal , Canada
| | | | - Annett Körner
- Jewish General Hospital, Lady Davis Institute for Medical Research, Montréal, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal , Canada
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University, San Diego, CA, USA.,San Diego Joint Doctoral Program in Clinical Psychology San Diego State University/University of California, San Diego, CA, USA
| | - Sandra Peláez
- Jewish General Hospital, Lady Davis Institute for Medical Research, Montréal, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal , Canada
| | - Marie-Eve Carrier
- Jewish General Hospital, Lady Davis Institute for Medical Research, Montréal, Canada
| | - Mia Pépin
- Jewish General Hospital, Lady Davis Institute for Medical Research, Montréal, Canada
| | - Brett D Thombs
- Jewish General Hospital, Lady Davis Institute for Medical Research, Montréal, Canada.,Department of Educational and Counselling Psychology, McGill University, Montréal , Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Canada.,Department of Medicine, McGill University, Montréal, Canada.,Department of Psychiatry, McGill University, Montréal, Canada.,Department of Psychology, McGill University, Montréal, Canada
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50
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Merz EL, Kwakkenbos L, Carrier ME, Gholizadeh S, Mills SD, Fox RS, Jewett LR, Williamson H, Harcourt D, Assassi S, Furst DE, Gottesman K, Mayes MD, Moss TP, Thombs BD, Malcarne VL. Factor structure and convergent validity of the Derriford Appearance Scale-24 using standard scoring versus treating 'not applicable' responses as missing data: a Scleroderma Patient-centered Intervention Network (SPIN) cohort study. BMJ Open 2018; 8:e018641. [PMID: 29511009 PMCID: PMC5855329 DOI: 10.1136/bmjopen-2017-018641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Valid measures of appearance concern are needed in systemic sclerosis (SSc), a rare, disfiguring autoimmune disease. The Derriford Appearance Scale-24 (DAS-24) assesses appearance-related distress related to visible differences. There is uncertainty regarding its factor structure, possibly due to its scoring method. DESIGN Cross-sectional survey. SETTING Participants with SSc were recruited from 27 centres in Canada, the USA and the UK. Participants who self-identified as having visible differences were recruited from community and clinical settings in the UK. PARTICIPANTS Two samples were analysed (n=950 participants with SSc; n=1265 participants with visible differences). PRIMARY AND SECONDARY OUTCOME MEASURES The DAS-24 factor structure was evaluated using two scoring methods. Convergent validity was evaluated with measures of social interaction anxiety, depression, fear of negative evaluation, social discomfort and dissatisfaction with appearance. RESULTS When items marked by respondents as 'not applicable' were scored as 0, per standard DAS-24 scoring, a one-factor model fit poorly; when treated as missing data, the one-factor model fit well. Convergent validity analyses revealed strong correlations that were similar across scoring methods. CONCLUSIONS Treating 'not applicable' responses as missing improved the measurement model, but did not substantively influence practical inferences that can be drawn from DAS-24 scores. Indications of item redundancy and poorly performing items suggest that the DAS-24 could be improved and potentially shortened.
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Affiliation(s)
- Erin L Merz
- Department of Psychology, California State University, Dominguez Hills, Carson, California, USA
| | - Linda Kwakkenbos
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Behavioral Science Institute, Clinical Psychology, Radboud University, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Shadi Gholizadeh
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Sarah D Mills
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Rina S Fox
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lisa R Jewett
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Educational and Counseling Psychology, McGill University, Montreal, Quebec, Canada
| | - Heidi Williamson
- Centre for Appearance Research, Faculty of Health and Life Science, University of the West of England, Bristol, UK
| | - Diana Harcourt
- Centre for Appearance Research, Faculty of Health and Life Science, University of the West of England, Bristol, UK
| | - Shervin Assassi
- Department of Internal Medicine, Division of Rheumatology, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Daniel E Furst
- Division of Rheumatology, Geffen School of Medicine at the University of California, Los Angeles, California, USA
| | | | - Maureen D Mayes
- Department of Internal Medicine, Division of Rheumatology, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Tim P Moss
- Centre for Appearance Research, Faculty of Health and Life Science, University of the West of England, Bristol, UK
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Department of Educational and Counseling Psychology, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Vanessa L Malcarne
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
- Department of Psychology, San Diego State University, San Diego, California, USA
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