Validation of Bengali version of EORTC QLQ-SWB32: A standalone measure of spiritual wellbeing for advanced cancer patients receiving palliative care

Background

Spiritual wellbeing (SWB) is one of the crucial components of holistic care for patients with terminal illnesses. The use of a validated instrument can help health professionals approach this difficult and subjective topic. There is no validated Bengali tool to measure this domain. Our study aimed to translate the EORTC QLQ SWB32 tool into Bengali, validate it among advanced cancer patients in Bangladesh, and compare the study's findings to international validation studies to determine its suitability as a measurement and intervention tool for these patients.

Methods

The original English version of the tool was translated in Bengali and back-translated by four independent translators with good command in both languages. After approval from the EORTC translation team and linguistic validation, the tool was further validated among 163 advanced cancer patients from palliative care units of four tertiary-level hospitals in Bangladesh. Reliability was tested with Cronbach's alpha, and construct validity was determined by exploratory factor analysis. Known group comparisons were performed by the Kruskal-Wallis H test and the Mann-Whitney U test.

Result

Ten adult cancer patients (two female and eight male, three Hindu and seven Muslim) participated in the linguistic validation. Six out of ten participants found the measure understandable and acceptable. A total of 163 advanced cancer patients participated in the psychometric validation phase. The majority of those participants were Muslims (94 %), with a slight male predominance. The internal consistency of each scale was satisfactory (0.7). Exploratory factor analysis also showed similarity to the original scale except item 12 (able to forgive others), which was loaded in both the EX and RO components (0.813 and 0.544, respectively). Older patients had a better relationship with themselves and a lower level of existential fulfilment than the younger group. Patients who tried to find comfort in their religion or spiritual faith, actively performed religious rituals, and had affiliations with religious or spiritual communities showed significantly higher global SWB.

Conclusion

The Bengali version of the EORTC QLQ-SWB32 is a reliable and valid tool for measuring the spiritual wellbeing of advanced cancer patients receiving palliative care.

Validation of the Bengali version of the Caregiver Collusion Questionnaire: A tool for measuring collusion among caregivers of terminally ill patients

Background

In palliative care settings, collusion or "conspiracy of silence" frequently interferes with communication and interpersonal relationships among patients, caregivers, and healthcare professionals. The "Caregiver Collusion Questionnaire" is the only tool available for assessing caregiver collusion. The purpose of the study is to translate and adapt the English version of this instrument into Bengali, followed by standard validation.

Methods

The study was carried out in two stages. Four independent translators conducted forward and backward translations of the English version of the "Caregiver Collusion Questionnaire" into Bengali. The Bengali version of the instrument was finalized following expert committee reviews, pre-testing, and cognitive debriefing. The final validation was carried out among 71 caregivers of patients with advanced incurable illnesses admitted to the palliative medicine and internal medicine departments of two Bangladeshi hospitals. In the final phase, the validity (content, face, and construct validity) and reliability (interclass item-wise correlation coefficient) of the translated tool were assessed.

Result

60% of the participants fully understood 19 items, whereas 40% struggled with one or more items. The expert committee expressed their satisfaction with the face and content validity of the translated version. The Bengali version also had quite good reliability (α = 0.62). Seven components were identified using principal component analysis with the distribution of Varimax Rotation distribution. Items under each factor had adequate factor loading, ranging from 0.4 to 0.8.

Conclusion

The Bengali version of the "Caregiver Collusion Questionnaire" was found valid reliable and culturally acceptable for measuring caregiver collusion among the Bengali-speaking people. Based on the scale, the reasons for collusion can be identified and measures can be taken for breaking the collusion.

Validation of Bengali version of Edmonton Symptom Assessment Scale-Revised (ESAS-r Bengali): A multidimensional symptom assessment tool for patients with advanced incurable diseases receiving palliative care

Objective

Routine symptom assessment represents the cornerstone of symptom management of patients with advanced incurable diseases in palliative care. At present, there is no validated tool to assess symptoms among the Bengali-speaking population with incurable diseases. The aim of the study is to translate, culturally adapt, and validate the Edmonton Symptom Assessment Scale (Revised) into Bengali language.

Methods

The study was conducted in two phases. Forward and backward translations of the English version of the Edmonton Symptom Assessment Scale (Revised) into Bengali were conducted by four independent translators. After obtaining reviews from an expert committee, pre-testing and cognitive debriefing the Bengali version of the tool was finalized. The final validation was conducted among 110 patients admitted to the Palliative Medicine Department of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Validity (content, face, and construct validity) and reliability (internal consistency) were assessed in the final validation phase.

Result

All participants responded to all items. Seventy percent of the participants completely understood all questions but 30% had difficulty with three questions. The expert committee expressed their satisfaction regarding the face and content validity of the questionnaire. The Bengali version also had high reliability (α = 0.862). Principal component analysis with the distribution of varimax rotation of Edmonton Symptom Assessment Scale (Revised) Bengali ranged from 0.41 to 0.83.

Conclusion

After the translation and cross-cultural adaptation, the Bengali version of the Edmonton Symptom Assessment Scale (Revised) achieved good levels of validity and reliability. It can be used as a symptom assessment tool for Bengali speaking population receiving palliative care.

Nanorod-like Structure of ZnO Nanoparticles and Zn8O8 Clusters Using 4-Dimethylamino Benzaldehyde Liquid to Study the Physicochemical and Antimicrobial Properties of Pathogenic Bacteria

To study their physicochemical and antimicrobial properties, zinc oxide nanoparticles were synthesized using a simple chemical route and 4-dimethylaminobenzaldehyde (4DB) as an organic additive. ZnO nanoparticles were characterized with XRD analysis, which confirmed the presence of a hexagonal wurtzite structure with different crystalline sizes. The SEM morphology of the synthesized nanoparticles confirmed the presence of nanorods in both modifications of ZnO nanoparticles. EDS analysis proved the chemical composition of the synthesized samples via different chemical approaches. In addition, the optical absorption results indicated that the use of 4DB increased the band gap energy of the synthesized nanoparticles. The synthesized Zn₈O₈ and Zn₈O₈:4DB clusters were subjected to HOMO-LUMO analysis, and their ionization energy (I), electron affinity (A), global hardness (η), chemical potential (σ), global electrophilicity index (ω), dipole moment (μ), polarizability (α_tot), first-order hyperpolarizability (β_tot), and other thermodynamic properties were determined. Furthermore, the antimicrobial properties of the ZnO nanoparticles were studied against G+ (S. aureus and B. subtilis) and G- (K. pneumoniae and E. coli) bacteria in a nutrient agar according to guidelines of the Clinical and Laboratory Standards Institute (CLSI).

Hemichorea associated with polycythaemia vera

Chorea is a rare complication of polycythaemia vera. Polycythaemic chorea occurs predominantly in females and usually in generalised form. We present a 66-year-old woman with acute onset hemichorea-ballism with no vascular pathology in the basal ganglia region. A clear relationship was observed between the onset of chorea and worsening of haematological parameters in the patient. After repeated phlebotomies the patient's clinical status was improved. Polycythaemic chorea must be considered, especially in the elderly, as early diagnosis leads to effective treatment and prevention of complications.

Tardive dystonia associated with olanzapine therapy

A 21-year-old man with the diagnosis of paranoid schizophrenia was admitted to our clinic with cervical dystonia developing at the end of the first year of olanzapine therapy. The present case suggests that tardive dystonia in this patient is most likely associated with olanzapine administration as this is the main antipsychotic he received. Regarding the few case reports of olanzapine-associated tardive syndromes, patients taking olanzapine should be carefully screened for the appearance of tardive movements.

Uncommon ultrasound findings in traumatic extracranial vertebral artery dissection

We report a case of internal carotid artery dissection (ICAD) associated with contralateral vertebral artery dissection (VAD). The interest of this case is to discuss an unusual Doppler pattern manifesting by a spectrum of an alternating vertebral artery flow suggesting a hemodynamic contribution from the contralateral vertebral artery (VA) and a clear depiction of both antegrade (red) and retrograde (blue) flow within the false and true lumen of the VAD by color Duplex flow imaging.