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Ng JPZ, Lam WYH, Pow EHN, Botelho MG. A qualitative analysis of patient's lived experience on their treatment journey with nasopharyngeal carcinoma. J Dent 2023; 134:104518. [PMID: 37088259 DOI: 10.1016/j.jdent.2023.104518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023] Open
Abstract
OBJECTIVE To explore and analyse the perspective of patients undergoing and recovering from nasopharyngeal carcinoma (NPC) therapy. METHODS Thirty-three NPC patients at different stages of treatment were enrolled. Seven were actively undergoing treatment, 13 were immediately post-treatment, and 13 were long-term. Patients were interviewed using a structured questionnaire based on a review of the literature that covered different phases of their treatment journey. The interview was recorded and transcribed for qualitative data analysis using a thematic inductive-deductive approach. RESULTS Three main domains embracing aspects of NPC patients' experiences were identified; side effects, psychosocial well-being, and the role and support of healthcare workers. Side effects were experienced orally, locally, and systemically. Oral side effects (oral mucositis, xerostomia, altered taste, dysphagia) were the most significant challenge experienced by NPC patients. Locally, skin injury (desquamation, fibrosis, darkening of the skin, erythema, pruritus, and swelling around the neck region) and hair loss, resolved after cessation of therapy. Systemic side effects from the treatment were related to general weakness, weight loss and nausea. The psychosocial well-being of NPC patients was influenced by a range of issues including support (healthcare workers and family), pain management, functional limitations, nutritional needs, perceived level of information, emotion, and finances. CONCLUSION NPC patients were significantly impacted based on the diagnosis, treatment and recovery phase affecting them locally, systemically, and psychologically. The role of family and healthcare staff was also influential in the overall treatment experience, and they have key roles to play in facilitating patients along their treatment journey. CLINICAL SIGNIFICANCE Oral and general side effects from NPC treatment have significant impact on patients physical and emotional well-being. It is important for healthcare providers to have insights of these so as to understand and support patients during their treatment journey and recovery and be able to empathetically facilitate their clinical management.
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Affiliation(s)
- Joanne Pui Zhee Ng
- Graduate Student in Prosthodontic, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Walter Yu Hang Lam
- Clinical Assistant Professor in Prosthodontics, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Edmond Ho Nang Pow
- Clinical Associate Professor in Prosthodontics, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Michael G Botelho
- Clinical Professor in Prosthodontics, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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Poon DMC, Kam MKM, Johnson D, Mo F, Tong M, Chan ATC. Durability of the parotid-sparing effect of intensity-modulated radiotherapy (IMRT) in early stage nasopharyngeal carcinoma: A 15-year follow-up of a randomized prospective study of IMRT versus two-dimensional radiotherapy. Head Neck 2021; 43:1711-1720. [PMID: 33576030 DOI: 10.1002/hed.26634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/21/2020] [Accepted: 01/21/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The durability of improved xerostomia with intensity-modulated radiotherapy (IMRT) in patients with early stage nasopharyngeal carcinoma (NPC) is uncertain. We conducted a long-term prospective assessment of participants treated with IMRT or two-dimensional radiotherapy (2DRT) in a prior randomized study. METHODS Parent study participants (IMRT, n = 28; 2DRT, n = 28) who were free of second malignancy or recurrence were eligible. Long-term radiotherapy-related toxicities were graded according to the Radiation Therapy Oncology Group (RTOG) criteria. Long-term patient-reported outcomes were assessed by the six-item xerostomia (XQ) and two European Organisation for Research and Treatment of Cancer (EORTC) questionnaires (QLQ-C30, QLQ-H&N35). Overall survival (OS), locoregional relapse-free survival (LRFS), distant relapse-free survival (DRFS), and the rate of symptomatic late complications (SLCs) were estimated for the entire cohort (n = 56). RESULTS Totally, 21 (IMRT, n = 10; 2DRT, n = 11) patients gave consent and were assessed for an overall median follow-up of 15.5 years. There was significantly less RTOG ≥grade 2 xerostomia with IMRT versus 2DRT (20% vs. 90%; p = 0.001), but no significant difference in XQ scores. Patients in the IMRT arm reported lower mean scores for the "dry mouth" domain of EORTC QLQ-H&N35 (p = 0.02) and showed trends toward better 15-year OS (81.5% vs. 53.8%, p = 0.06), LRFS (70.6% vs. 53.8%, p = 0.38), and DRFS (81.5% vs. 53.8%, p = 0.07). SLCs were more frequent in the 2DRT arm. CONCLUSIONS The parotid-sparing effect of IMRT in NPC treatment is durable, with significantly less physician- and patient-scored xerostomia at 15 years. IMRT results in better long-term survival and fewer SLCs.
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Affiliation(s)
- Darren M C Poon
- Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.,Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - Michael K M Kam
- Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - David Johnson
- Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Frankie Mo
- Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Macy Tong
- Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Anthony T C Chan
- Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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McDowell L, Corry J, Ringash J, Rischin D. Quality of Life, Toxicity and Unmet Needs in Nasopharyngeal Cancer Survivors. Front Oncol 2020; 10:930. [PMID: 32596155 PMCID: PMC7303258 DOI: 10.3389/fonc.2020.00930] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/12/2020] [Indexed: 12/19/2022] Open
Abstract
Concerted research efforts over the last three decades have resulted in improved survival and outcomes for patients diagnosed with nasopharyngeal carcinoma (NPC). The evolution of radiotherapy techniques has facilitated improved dose delivery to target volumes while reducing dose to the surrounding normal tissue, improving both disease control and quality of life (QoL). In parallel, clinical trials focusing on determining the optimal systemic therapy to use in conjunction with radiotherapy have been largely successful, resulting in improved locoregional, and distant control. As a consequence, neoadjuvant chemotherapy (NACT) prior to definitive chemoradiotherapy has recently emerged as the preferred standard for patients with locally advanced NPC. Two of the major challenges in interpreting toxicity and QoL data from the published literature have been the reliance on: (1) clinician rather than patient reported outcomes; and (2) reporting statistical rather than clinical meaningful differences in measures. Despite the lower rates of toxicity that have been achieved with highly conformal radiotherapy techniques, survivors remain at moderate risk of persistent and long-lasting treatment effects, and the development of late radiation toxicities such as hearing loss, cranial neuropathies and cognitive impairment many years after successful treatment can herald a significant decline in QoL. Future approaches to reduce long-term toxicity will rely on: (1) identifying individual patients most likely to benefit from NACT; (2) development of response-adapted radiation strategies following NACT; and (3) anticipated further dose reductions to organs at risk with proton and particle therapy. With increasing numbers of survivors, many in the prime of their adult life, research to identify, and strategies to address the unmet needs of NPC survivors are required. This contemporary review will summarize our current knowledge of long-term toxicity, QoL and unmet needs of this survivorship group.
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Affiliation(s)
- Lachlan McDowell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - June Corry
- GenesisCare Radiation Oncology, Division Radiation Oncology, St. Vincent's Hospital, Melbourne, VIC, Australia.,Department of Medicine St Vincent's, The University of Melbourne, Melbourne, VIC, Australia
| | - Jolie Ringash
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, ON, Canada
| | - Danny Rischin
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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Liu G, Yang J, Nie X, Zhu X, Li X, Zhou J, Kabolizadeh P, Li Q, Quan H, Ding X. A Patients-Based Statistical Model of Radiotherapy Dose Distribution in Nasopharyngeal Cancer. Dose Response 2019; 17:1559325819892359. [PMID: 31857802 PMCID: PMC6913054 DOI: 10.1177/1559325819892359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/20/2019] [Accepted: 11/05/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose: To develop a patients-based statistical model of dose distribution among patients with nasopharyngeal cancer (NPC). Methods and Materials: The dose distributions of 75 patients with NPC were acquired and preprocessed to generate a dose-template library. Subsequently, the dominant modes of dose distribution were extracted using principal component analysis (PCA). Leave-one-out cross-validation (LOOCV) was performed for evaluation. Residual reconstruction errors between the doses reconstructed using different dominating eigenvectors and the planned dose distribution were calculated to investigate the convergence characteristics. Three-dimensional Gamma analysis was performed to investigate the accuracy of dose reconstruction. Results: The first 29 components contained 90% of the variance in dose distribution, and 45 components accounted for more than 95% of the variance on average. The residual error of the LOOCV model for the cumulative sum of components over all patients decreased from 8.16 to 4.79 Gy when 1 to 74 components were included in the LOOCV model. The 3-dimensional Gamma analysis results implied that the PCA model was capable of dose distribution reconstruction, and the accuracy was especially satisfactory in the high-dose area. Conclusions: A PCA-based model of dose distribution variations in patients with NPC was developed, and its accuracy was determined. This model could serve as a predictor of 3-dimensional dose distribution.
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Affiliation(s)
- Gang Liu
- Key laboratory of Artificial Micro- and Nano-Structures of the Ministry of Education and Center for Electronic Microscopy, School of Physics and Technology, Wuhan University, China.,Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Radiation Oncology, Beaumont Health System, Royal Oak, MI, USA
| | - Jing Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Nie
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaohui Zhu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoqiang Li
- Department of Radiation Oncology, Beaumont Health System, Royal Oak, MI, USA
| | - Jun Zhou
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - Peyman Kabolizadeh
- Department of Radiation Oncology, Beaumont Health System, Royal Oak, MI, USA
| | - Qin Li
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Quan
- Key laboratory of Artificial Micro- and Nano-Structures of the Ministry of Education and Center for Electronic Microscopy, School of Physics and Technology, Wuhan University, China
| | - Xuanfeng Ding
- Department of Radiation Oncology, Beaumont Health System, Royal Oak, MI, USA
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5
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Pan XB, Huang ST, Chen KH, Jiang YM, Ma JL, Qu S, Li L, Chen L, Zhu XD. Intensity-modulated radiotherapy provides better quality of life than two-dimensional conventional radiotherapy for patients with stage II nasopharyngeal carcinoma. Oncotarget 2018; 8:46211-46218. [PMID: 28515352 PMCID: PMC5542261 DOI: 10.18632/oncotarget.17582] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 04/03/2017] [Indexed: 11/25/2022] Open
Abstract
Two-dimensional conventional radiotherapy (2D-CRT) and intensity-modulated radiotherapy (IMRT) are effective for control of nasopharyngeal carcinoma (NPC). The purpose of this study was to compare the quality of life (QoL) of stage II NPC patients treated with 2D-CRT versus IMRT. We conducted a cross-sectional study of 106 patients with stage II NPC treated with 2D-CRT (n = 47) versus IMRT (n = 59) between June 2008 and June 2013. For all subjects, disease-free survival was more than 3 years. QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questions and the Head and Neck 35 (EORTC QLQ-H&N35) questions. Patients receiving IMRT with or without concurrent chemotherapy had better outcomes in head and neck related symptoms and general aspects of QoL than those receiving 2D-CRT with or without concurrent chemotherapy. Thus, IMRT improves the QoL of patients with stage II NPC as compared to 2D-CRT.
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Affiliation(s)
- Xin-Bin Pan
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Shi-Ting Huang
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Kai-Hua Chen
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Yan-Ming Jiang
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Jia-Lin Ma
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Song Qu
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Ling Li
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Long Chen
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Xiao-Dong Zhu
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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Concurrent chemoradiotherapy degrades the quality of life of patients with stage II nasopharyngeal carcinoma as compared to radiotherapy. Oncotarget 2017; 8:14029-14038. [PMID: 28152511 PMCID: PMC5355159 DOI: 10.18632/oncotarget.14932] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/28/2016] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to compare the quality of life (QoL) of stage II nasopharyngeal carcinoma (NPC) patients treated with radiotherapy (RT) versus concurrent chemoradiotherapy (CCRT). In a cross-sectional study, these patients were treated with RT (n = 55) or CCRT (n = 51) between June 2008 and June 2013. For all subjects, disease-free survival was more than 3 years. QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) questions and the Head and Neck 35 (EORTC QLQ-H&N35) questions. RT had better outcomes than CCRT for global QoL, functional scales, symptom scales of fatigue and insomnia, financial problems, and weight gain. Survivors receiving 1 cycle of concurrent chemotherapy had worse QoL outcomes than survivors receiving 2 cycles of concurrent chemotherapy. Patients receiving 3 cycles of concurrent chemotherapy had the best QoL outcomes. Thus, CCRT adversely affects the QoL of patients with stage II NPC as compared to radiotherapy.
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Faller H, Strahl A, Richard M, Niehues C, Meng K. The prospective relationship between satisfaction with information and symptoms of depression and anxiety in breast cancer: A structural equation modeling analysis. Psychooncology 2017; 26:1741-1748. [PMID: 28024096 DOI: 10.1002/pon.4358] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/15/2016] [Accepted: 12/22/2016] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Previous research has demonstrated associations between satisfaction with information and reduced emotional distress in cancer patients. However, as most studies were cross-sectional, the direction of this relationship remained unclear. We therefore aimed to test whether information satisfaction predicted subsequent depression and anxiety levels, and, reciprocally, depression and anxiety levels predicted subsequent information satisfaction, thus clarifying the direction of impact. METHODS We performed a secondary analysis of a prospective cohort study with 436 female breast cancer patients (mean age 51 years). We measured information satisfaction with 2 self-developed items, symptoms of depression with the 2-item Patient Heath Questionnaire and symptoms of anxiety with the 2-item Generalized Anxiety Disorder Scale. We created 2 structural equation models, 1 for depression and 1 for anxiety, that examined the prediction of 1-year depression (or anxiety) levels by baseline information satisfaction and, in the same model, 1-year information satisfaction by baseline depression (or anxiety) levels (cross-lagged panel analysis). RESULTS Baseline information satisfaction predicted 1-year levels of both depression (beta = -0.17, P < .01) and anxiety (beta = -0.13, P < .01), adjusting for the baseline scores of the outcome variables. Conversely, baseline levels of depression (beta = -0.12, P < .05) and anxiety (beta = -0.16, P < .01) predicted 1-year information satisfaction, adjusting for its baseline score. CONCLUSION Our results suggest a bidirectional relationship between information satisfaction and symptoms of depression and anxiety. Thus, provision of information may reduce subsequent depression and anxiety, while reducing depression and anxiety levels may increase satisfaction with received information. Combining the provision of information with emotional support may be particularly beneficial.
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Affiliation(s)
- Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - André Strahl
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| | - Matthias Richard
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
| | - Christiane Niehues
- Reha-Zentrum Ückeritz, Klinik Ostseeblick, Ückeritz, Germany`.,Deutsche Rentenversicherung Bund, Berlin, Germany
| | - Karin Meng
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany
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Su Y, Mo CW, Cheng WQ, Wang L, Xu Q, Wu ZC, Wu ZL, Liu LZ, Chen XL. Development and validation of quality of life scale of nasopharyngeal carcinoma patients: the QOL-NPC (version 2). Health Qual Life Outcomes 2016; 14:76. [PMID: 27164979 PMCID: PMC4862168 DOI: 10.1186/s12955-016-0480-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 05/03/2016] [Indexed: 11/12/2022] Open
Abstract
Background The aim was to develop and validate the quality of life scale for nasopharyngeal carcinoma (NPC) patients, the QOL-NPC (version 2), a specific instrument to measure quality of life for NPC patients. Methods The QOL-NPC was developed and validated according to standard procedures. The patients were assessed using the QOL-NPC, FACT-G, and FACT-H&N. Classical test theory was used to evaluate the reliability, validity, and responsiveness of the QOL-NPC. Results A total of 487 patients (97.4 %) completed the questionnaire. The QOL-NPC comprised four domains, as follows: physical function (eight items); psychological function (five items); social function (five items); and side effects (eight items). All of the items had a lower proportion of missing data. Cronbach's alpha values of the domains ranged from 0.72 to 0.84. The split-half reliability coefficients ranged from 0.77 to 0.84. All of the intra-class correlation coefficients were > 0.8. The normed fit index, non-normed fit index, and comparative fit index were >0.89. The root mean square error of approximation was 0.097, with a 90 % confidence interval (0.093, 0.100). The domain scores of the QOL-NPC were significantly correlated with the FACT-G and FACT-H&N (P < 0.05). All of the domain scores of patients using different amounts of radiotherapy were significantly different (P < 0.001). All domain scores decreased at the completion of radiotherapy, with effect sizes ranging from −0.82 to −0.22. Conclusions The QOL-NPC is valid for measuring QOL with good reliability, validity, and responsiveness. The QOL-NPC is recommended to measure the QOL for Chinese NPC patients.
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Affiliation(s)
- Yong Su
- Department of Radiation Oncology, Cancer Centre, Sun Yat-sen University, Guangzhou, Guangdong Province, China.,Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, China
| | - Chuan-Wei Mo
- Department of Biostatistics and Preventive Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Wan-Qin Cheng
- Department of Radiation Oncology, Cancer Centre, Sun Yat-sen University, Guangzhou, Guangdong Province, China.,Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, China
| | - Lei Wang
- Department of Radiation Oncology, Cancer Centre, Sun Yat-sen University, Guangzhou, Guangdong Province, China.,Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Guangzhou, Guangdong Province, China
| | - Qian Xu
- Department of Biostatistics and Preventive Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zu-Chun Wu
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zhe-Li Wu
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Li-Zhi Liu
- Department of Radiation Oncology, Cancer Centre, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Xin-Lin Chen
- Department of Biostatistics and Preventive Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China.
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Yi TW, Deng YT, Chen HP, Zhang J, Liu J, Huang BY, Wang YQ, Jiang Y. The discordance of information needs between cancer patients and their families in China. PATIENT EDUCATION AND COUNSELING 2015; 99:863-9. [PMID: 26763870 DOI: 10.1016/j.pec.2015.12.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/04/2015] [Accepted: 12/28/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVE We aimed at studying information needs of patients and their families, and their attitude towards the counterparts' information needs. Factors influencing psychological status of patients were investigated. METHODS Self-designed questionnaires for information needs and attitude were delivered to participants. Patient Health Questionnaire 9-item and Generalized Anxiety Disorder 7-item scale were used to evaluate psychological status of patients. RESULTS 183 eligible pairs of patients and families were involved. Except for the patients' expected life span, most patients and families needed information for all other subscales of disease-related information. Most patients wished families know more information; however, caregivers tended to prevent this. The occurrence of patients' psychiatric disorders was related to their needs for expected life span (OR 3.06 95%CI 1.36-6.93), as well as the attitude of caregivers about whether to provide more information about treatment outcomes (OR 0.24 95% CI 0.10-0.63). CONCLUSIONS Information discordance between cancer patients and their families tended to happen when it came to patients' prognostic information. The psychological status of cancer patients was found in association with their information needs and families' attitude towards it. PRACTICE IMPLICATIONS To guide oncology professionals and cancer patients' families for information provision.
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Affiliation(s)
- Ting-wu Yi
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Yao-tiao Deng
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Hui-ping Chen
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Jie Zhang
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Jie Liu
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Bo-yan Huang
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Yu-qing Wang
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Yu Jiang
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
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Huang TL, Chien CY, Tsai WL, Liao KC, Chou SY, Lin HC, Dean Luo S, Lee TF, Lee CH, Fang FM. Long-term late toxicities and quality of life for survivors of nasopharyngeal carcinoma treated with intensity-modulated radiotherapy versus non-intensity-modulated radiotherapy. Head Neck 2015; 38 Suppl 1:E1026-32. [PMID: 26041548 DOI: 10.1002/hed.24150] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 04/20/2015] [Accepted: 05/31/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate late toxicities and quality of life (QOL) of patients with nasopharyngeal carcinoma (NPC) with long-term survival after treatment by intensity-modulated radiotherapy (IMRT) versus non-IMRT. METHODS An observational, cross-sectional study of QOL and late toxicities was conducted in 242 patients with NPC with survival of >5 years after treatment with IMRT (n = 100) or non-IMRT (n = 142) by using physician-assessed toxicities (Common Terminology Criteria for Adverse Events [CTCAE] version 4) and the patient-reported European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions (EORTC QLQ-C30) and the Head and Neck 35-questions (EORTC QLQ-C30-H&N35) module. RESULTS The IMRT group had both statistically (p < .05) and clinically (difference of predicted mean scores ≥10 points) better outcome in global QOL, cognitive functioning, social functioning, fatigue, and 11 scales of the head and neck module. Late toxicities, including neuropathy, hearing loss, dysphagia, xerostomia, and neck fibrosis were significantly less severe in the IMRT group. Multivariate analysis revealed that the radiotherapy (RT) technique was statistically significantly associated with late toxicities and QOL outcome after adjusting for other clinical and demographic variables. CONCLUSION The use of the IMRT technique was associated with the improvement of physician-assessed late toxicities and patient-reported QOL in NPC survivors. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1026-E1032, 2016.
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Affiliation(s)
- Tai-Lin Huang
- Department of Hematology and Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Yen Chien
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Ling Tsai
- Department of Cosmetics and Fashion Styling, Cheng Shiu University, Kaohsiung, Taiwan
| | - Kuan-Cho Liao
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shang-Yu Chou
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsin-Ching Lin
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sheng Dean Luo
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tsair-Fwu Lee
- Department of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan
| | - Chien-Hung Lee
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fu-Min Fang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Yeung NCY, Lu Q, Lin W. Specificity may count: not every aspect of coping self-efficacy is beneficial to quality of life among Chinese cancer survivors in China. Int J Behav Med 2014; 21:629-37. [PMID: 24570036 DOI: 10.1007/s12529-014-9394-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND General self-efficacy has been shown to be a protective factor of cancer survivors' quality of life (QoL). Coping self-efficacy includes multiple aspects, such as maintaining positive attitudes, regulating emotion, seeking social support, and seeking medical information. How these various aspects are related to multiple domains of QoL is unclear. PURPOSE This study examined the associations between different aspects of coping self-efficacy and QoL among Chinese cancer survivors. METHODS A sample of 238 Chinese cancer survivors (mean age = 55.7, 74.4 % female) in Beijing, China participated in the survey. Coping self-efficacy and QoL were measured by the Cancer Behavior Inventory and Quality of Life-Cancer Survivor Instrument. RESULTS After controlling for demographic and disease-related variables, hierarchical regression analyses showed that coping self-efficacy in accepting cancer/maintaining a positive attitude was positively associated with physical, psychological, and spiritual QoL. Self-efficacy in affective regulation was positively associated with psychological and social QoL, but negatively associated with spiritual well-being. Self-efficacy in seeking support was positively associated with spiritual well-being, but negatively associated with physical QoL. Self-efficacy in seeking and understanding medical information was negatively associated with psychological and social QoL. CONCLUSIONS Our findings imply the specificity of coping self-efficacy in predicting QOL. Our findings could be helpful for designing future interventions. Increasing cancer survivors' self-efficacies in accepting cancer/maintaining a positive attitude, affective regulation, and seeking support may improve cancer survivors' QoL depending on the specific domains.
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Affiliation(s)
- Nelson C Y Yeung
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204-5022, USA
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12
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Brédart A, Bottomley A. Treatment satisfaction as an outcome measure in cancer clinical treatment trials. Expert Rev Pharmacoecon Outcomes Res 2014; 2:597-606. [DOI: 10.1586/14737167.2.6.597] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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13
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Lam WWT, Ye M, Fielding R. Trajectories of quality of life among Chinese patients diagnosed with nasopharynegeal cancer. PLoS One 2012; 7:e44022. [PMID: 23028484 PMCID: PMC3445583 DOI: 10.1371/journal.pone.0044022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 07/31/2012] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE This secondary longitudinal analysis describes distinct quality of life trajectories during eight months of radiation therapy (RT) among patients with nasopharyngeal cancer (NPC) and examines factors differentiating these trajectories. METHODS 253 Chinese patients with NPC scheduled for RT were assessed at pre-treatment, and 4 months and 8 months later on QoL (Chinese version of the FACT-G), optimism, pain, eating function, and patient satisfaction. Latent growth mixture modelling identified different trajectories within each of four QoL domains: Physical, Emotional, Social/family, and Functional well-being. Multinomial logistic regression compared optimism, pain, eating function, and patient satisfaction by trajectories adjusted for demographic and medical characteristics. RESULTS We identified three distinct trajectories for physical and emotional QoL domains, four trajectories for social/family, and two trajectories for functional domains. Within each domain most patients (physical (77%), emotional (85%), social/family (55%) and functional (63%)) experienced relatively stable high levels of well-being over the 8-month period. Different Physical trajectory patterns were predicted by pain and optimism, whereas for Emotion-domain trajectories pain, optimism, eating enjoyment, patient satisfaction with information, and gender were predictive. Age, appetite, optimism, martial status, and household income predicted Social/family trajectories; household income, eating enjoyment, optimism, and patient satisfaction with information predicted Functional trajectories. CONCLUSION Most patients with NPC showed high stable QoL during radiotherapy. Optimism predicted good QoL. Symptom impacts varied by QoL domain. Information satisfaction was protective in emotional and functional well-being, reflecting the importance in helping patients to establish a realistic expectation of treatment impacts.
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Affiliation(s)
| | | | - Richard Fielding
- Centre for Psycho-oncology Research and Teaching, School of Public Health, The University of Hong Kong, Hong Kong, People's Republic of China
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15
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Howren MB, Christensen AJ, Karnell LH, Funk GF. Psychological factors associated with head and neck cancer treatment and survivorship: evidence and opportunities for behavioral medicine. J Consult Clin Psychol 2012; 81:299-317. [PMID: 22963591 DOI: 10.1037/a0029940] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Individuals diagnosed with head and neck cancer (HNC) not only face a potentially life-threatening diagnosis but must endure treatment that often results in significant, highly visible disfigurement and disruptions of essential functioning, such as deficits or complications in eating, swallowing, breathing, and speech. Each year, approximately 650,000 new cases are diagnosed, making HNC the 6th most common type of cancer in the world. Despite this, however, HNC remains understudied in behavioral medicine. In this article, the authors review available evidence regarding several important psychosocial and behavioral factors associated with HNC diagnosis, treatment, and recovery, as well as various psychosocial interventions conducted in this patient population, before concluding with opportunities for behavioral medicine research and practice.
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Affiliation(s)
- M Bryant Howren
- Veterans Affairs Iowa City Healthcare System, Iowa City, Iowa 52242, USA.
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Chan YW, Chow VLY, Wei WI. Quality of life of patients after salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma. Cancer 2011; 118:3710-8. [PMID: 22180127 DOI: 10.1002/cncr.26719] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 10/27/2011] [Accepted: 10/28/2011] [Indexed: 11/12/2022]
Abstract
BACKGROUND The objective of this study was to examine the quality of life (QOL) of patients who underwent salvage nasopharyngectomy for residual or recurrent nasopharyngeal carcinoma and to justify the value of the procedure. METHODS A self-reported, health-related QOL questionnaire was used to assess the QOL of patients after salvage nasopharyngectomy. The effects of potential complications after surgery also were evaluated. RESULTS Between 2003 and 2011, 185 patients underwent salvage nasopharyngectomy using the maxillary swing approach. Curative resection was achieved in 80% of patients. There were no significant changes in mean global health system scores after surgery, except after palliative resection requiring postoperative adjuvant chemoradiation. Social functioning scores were the lowest of the 5 functioning scales in all patient groups. Palatal fistula significantly affected social eating and weight loss, and osteoradionecrosis caused more pain and nasal discharge, severely affecting the social life of patients. CONCLUSIONS The QOL of patients after maxillary swing salvage nasopharyngectomy was good. The current results indicated that attention must be paid to the factors that adversely affect QOL after surgery, such as palliative resection, and complications like trismus, palatal fistula and osteoradionecrosis.
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Affiliation(s)
- Yu Wai Chan
- Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong SAR, China.
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Husson O, Mols F, van de Poll-Franse LV. The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol 2010; 22:761-772. [PMID: 20870912 PMCID: PMC3065875 DOI: 10.1093/annonc/mdq413] [Citation(s) in RCA: 334] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Providing information that is congruent with patients' needs is an important determinant for patient satisfaction and might also affect health-related quality of life (HRQoL) and anxiety and depression levels of cancer survivors. DESIGN The authors systematically reviewed the available literature on the relationship between information provision and HRQoL, anxiety and depression. A PubMed literature search for original articles published until February 2010 was carried out. Twenty-five articles, all conducted between 1996 and 2009, which met the predefined inclusion criteria, were subjected to a quality checklist. RESULTS Satisfied patients, patients with fulfilled information needs, and patients who experience less information barriers, in general have a better HRQoL and less anxiety and depression. Out of eight intervention studies that aimed to improve information provision, only one showed a positive association with better HRQoL. CONCLUSION Health care providers must pay more attention to patient-centred information provision. Additional research is needed to make definitive conclusions about information interventions as most results did not reach statistical significance due to methodological constraints. The quick development of the relatively young research field of patient-reported outcomes in cancer survivorship will make it possible to conduct better quality studies in the future.
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Affiliation(s)
- O Husson
- Department of Medical Psychology and Neuropsychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg; Comprehensive Cancer Centre South (CCCS), Department of Research, Eindhoven Cancer Registry, Eindhoven, The Netherlands.
| | - F Mols
- Department of Medical Psychology and Neuropsychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg; Comprehensive Cancer Centre South (CCCS), Department of Research, Eindhoven Cancer Registry, Eindhoven, The Netherlands
| | - L V van de Poll-Franse
- Department of Medical Psychology and Neuropsychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg; Comprehensive Cancer Centre South (CCCS), Department of Research, Eindhoven Cancer Registry, Eindhoven, The Netherlands
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A longitudinal analysis of patient satisfaction and subsequent quality of life in Hong Kong Chinese breast and nasopharyngeal cancer patients. Med Care 2009; 47:875-81. [PMID: 19584760 DOI: 10.1097/mlr.0b013e3181a393cf] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We evaluated the longitudinal course of the relationship between patient satisfaction and quality of life (QoL) in Chinese breast and nasopharyngeal cancer patients. METHODS A sample of Chinese breast (n = 250) and nasopharyngeal (n = 242) cancer patients were assessed during their first outpatient visit (baseline) and at 2 follow-up interviews (FU1 and FU2). The Chinese version of the Functional Assessment of Cancer Therapy-General Scale (FACT-G (Ch)) was adopted to assess QoL. Patient satisfaction was assessed by the 9-item Chinese Patient Satisfaction Questionnaire (ChPSQ-9) and the cognitive subscale of the Medical Interview Satisfaction Scale (MISS-Cog). Linear mixed effects models were fitted to identify predictors of patient satisfaction and QoL. RESULTS Recurrence after baseline (std beta = 0.58; 95% CI: 0.17, 0.98; P < 0.05) was the only predictor of MISS-Cog, age (std beta = 0.01; 95% CI: 0.00, 0.02; P < 0.05) and depressed mood (std beta = 0.20; 95% CI: 0.10, 0.30; P < 0.001) of ChPSQ-9. After adjusting for sociodemographic and psychosocial variables, both ChPSQ-9 (std beta = 0.13; 95% CI: 0.07, 0.19; P < 0.001) and MISS-Cog (std beta = 0.07; 95% CI: 0.02, 0.12; P < 0.05) independently predicted FACT-G (Ch) scores. CONCLUSIONS These findings suggest both general emotional support and informational support are important in predicting QoL among Chinese breast and nasopharyngeal cancer patients.
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Wong WS, Fielding R. Eating ability predicts subsequent quality of life in Chinese patients with breast, liver, lung, or nasopharyngeal carcinoma: a longitudinal analysis. Acta Oncol 2009; 47:71-80. [PMID: 18097779 DOI: 10.1080/02841860701441814] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Eating dysfunction is a well-recognized consequence of orophagic tract cancers, but also occurs with other cancers. There is a relative absence of data assessing the impact of eating function on QoL in cancer populations other than those with disease of the oro-phagic tract. We assessed longitudinal changes in eating function and quality of life (QoL), and examined whether eating function predicted QoL over time in a sample of Chinese patients with breast, lung, liver, and nasopharyngeal cancers. Overall, 1 079 patients with breast, liver, lung, or nasopharyngeal carcinoma were assessed during their first outpatient visit (baseline) and at two follow-up interviews (FU1 and FU2). Three dimensions of eating function, including ability, appetite, and enjoyment, were assessed using three 11-point self-rated items. QoL was measured by the Chinese version of the Functional Assessment of Cancer Therapy-General Scale (FACT-G (Ch)). Linear mixed effects (LME) models evaluated mean differences on eating function and QoL scores across interviews and across cancer groups, and the effects of eating function on QoL. After adjustment for socio-demographic and medical variables, pain and depression, eating function significantly predicted patient overall (standardized betas ranged from 0.091 to 0.163, ps < 0.05), physical (standardized betas ranged from 0.101 to 0.200, ps < 0.05), and functional (standardized betas ranged from 0.120 to 0.162, ps < 0.05) aspects of QoL scores over time. Eating dysfunction significantly impacts QoL in cancer populations other than those with orophagic disease. Change of eating function appears to be a common problem in cancer patients regardless of cancer site.
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Tong MCF, Lo PSY, Wong KH, Yeung RMW, van Hasselt CA, Eremenco S, Cella D. Development and validation of the functional assessment of cancer therapy nasopharyngeal cancer subscale. Head Neck 2009; 31:738-47. [DOI: 10.1002/hed.21023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Wong WS, Fielding R, Wong C, Hedley A. Confirmatory factor analysis and sample invariance of the Chinese Patient Satisfaction Questionnaire (ChPSQ-9) among patients with breast and lung cancer. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2009; 12:597-605. [PMID: 19159414 DOI: 10.1111/j.1524-4733.2008.00480.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES Previous exploratory factor analysis of the 9-item Chinese Patient Satisfaction Questionnaire (ChPSQ-9) identified two dominant factors: doctor and nurse. The present study employed confirmatory factor analysis (CFA) to examine the factorial invariance of the ChPSQ-9 between and within samples of Chinese patients with breast or lung cancer. METHODS Longitudinal data were analyzed from Chinese breast and lung cancer patients who had completed the ChPSQ-9 during their first outpatient visit, at 3 months, and at 6 months after baseline. CFAs tested the fit of a one-factor model, a hierarchical model that comprised a general latent factor and two first-order factors, and a correlated model that comprised two correlated first-order factors to the data. The factorial invariance of the ChPSQ-9 between six independent samples across time was investigated using multigroup CFAs. RESULTS The CFA's results demonstrated a better fit of the correlated model over the one-factor model and the hierarchical model in the breast and lung cancer samples. The correlated model showed evidence of cross-sample and longitudinal factorial invariance. Patients were generally satisfied with services provided by doctors and nurses. Internal consistency of the scale was also good for both cancer samples across time. CONCLUSIONS The ChPSQ-9 is a valid and reliable instrument to be employed among breast and lung cancer patients, in clinical settings or intervention research, to evaluate group differences in patient satisfaction and its association with intervention effectiveness.
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Affiliation(s)
- Wing Sze Wong
- Department of Applied Social Studies, City University, Kowloon, Hong Kong, China
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The Association Between Patient Satisfaction and Quality of Life in Chinese Lung and Liver Cancer Patients. Med Care 2008; 46:293-302. [DOI: 10.1097/mlr.0b013e31815b9785] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wong WS, Fielding R, Wong CM, Hedley AJ. Psychometric properties of the Nine-Item Chinese Patient Satisfaction Questionnaire (ChPSQ-9) in Chinese patients with hepatocellular carcinoma. Psychooncology 2008; 17:292-9. [PMID: 17647218 DOI: 10.1002/pon.1247] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Patient-centered approaches to health-care delivery have increased interest in patient satisfaction with care. However, there is no instrument currently available which takes into account the specific concerns of Chinese patients. This study aimed to evaluate the psychometric properties of the Nine-Item Chinese Patient Satisfaction Questionnaire (ChPSQ-9) in a Chinese hepatocellular carcinoma (HPC) sample. A total of 222 Chinese patients with primary HPC completed the ChPSQ-9, the Medical Interview Satisfaction Scale (MISS), and eating satisfaction measures. The principal component analysis yielded two factors in the ChPSQ-9, named 'doctor' and 'nurse' subscales, which explained 79% of the total variance. The instrument also possessed good internal consistency (Cronbach alpha = 0.93) and concurrent validity with MISS. The divergent validity was indicated by inverse relationships between the ChPSQ-9 and eating satisfaction. The current results support the use of the ChPSQ-9 as a self-report measure of patient satisfaction among Chinese HPC populations and suggest that a caring orientation was highly valued by these patients.
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Affiliation(s)
- Wing S Wong
- Health Behavioral Research Group, The University of Hong Kong, Pokfulam, Hong Kong
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Abstract
AIMS To determine the interest in and use of quality-of-life (QOL) questionnaires among international experts in nasopharyngeal cancer (NPC). MATERIALS AND METHODS An anonymous cross-sectional 12-question survey was conducted among participants in an international symposium on NPC held in Toronto, Canada, in June 2005. A descriptive analysis is presented. RESULTS Among 161 participants, 60 returned surveys (response rate 37%); 38/63 physicians (60%) responded. The respondents were evenly divided between men and women, with a median age of 42 years. QOL was familiar to 53 (88%); 38 (63%) used QOL instruments for head and neck cancer (HNC) patients and 30 (50%) used QOL instruments for NPC patients. The most commonly used instruments were the European Organization for Research and Treatment of Cancer questionnaire and the Functional Assessment of Cancer Therapy. English was the most frequently used questionnaire language (46; 77%); 16 (27%) used multiple languages. Questionnaires were used for research only (33; 55%), clinically (10; 17%) or for both (3; 5%). Published QOL data were read by 48 (80%) respondents, with 28 (47%) using these data to inform patients or as an aid to the choice of treatment. All who answered the survey endorsed the collection of QOL data in NPC trials at least 'sometimes' (39 [65%] 'always'). Participants raised concerns about the ability of current HNC QOL questionnaires to measure issues unique to NPC patients. CONCLUSIONS International investigators are interested in using QOL instruments. Collaboration to improve current instruments to meet the needs of NPC patients is warranted.
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Affiliation(s)
- J Ringash
- Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada.
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Wong WS, Fielding R. Change in quality of life in Chinese women with breast cancer: changes in psychological distress as a predictor. Support Care Cancer 2007; 15:1223-1230. [PMID: 17205280 DOI: 10.1007/s00520-006-0190-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Accepted: 11/08/2006] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The effect of fluctuating psychological distress on quality of life (QoL) scores is not well delineated. We examined how changes in psychological distress affected change in QoL over time in 259 Chinese women recovering from breast cancer (BC). PATIENTS AND METHODS Women were interviewed during their first postoperative outpatient visit for chemotherapy (Baseline), at 3 months (FU1), and at 6 months after Baseline (FU2). Respondents completed the Chinese version of the FACT-G version-3 scale [FACT-G (Ch)]. Psychological distress was assessed using three categorical measures of depression, mood, and boredom. Linear mixed effects (LME) models examined whether changes in psychological distress predicted subsequent changes in QoL. RESULTS Respondents' mood improved significantly over time from baseline to FU2 (Baseline/FU2: standardized beta = -0.266, p < 0.005; FU1/FU2: standardized beta = -0.243, p < 0.005). Changes in depression scores consistently predicted subsequent changes in overall (standardized beta = 4.96; 95% CI, 3.749, 6.171, p < 0.001), physical (standardized beta = 1.752; 95% CI, 1.209, 2.294, p < 0.001), and functional (standardized beta = 0.872; 95% CI, 0.308, 1.436, p < 0.001) QoL scores. CONCLUSIONS The magnitude of change in psychological distress significantly impacted physical and functional, but not social QoL in Chinese BC patients. These data highlight the need to address psychological and physical distress as part of the drive to improve physical and functional QoL for women with BC.
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Affiliation(s)
- Wing S Wong
- Health Behavioral Research Group, Department of Community Medicine & Unit for Behavioral Sciences, School of Public Health, The University of Hong Kong, 5/F William M. W. Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Richard Fielding
- Health Behavioral Research Group, Department of Community Medicine & Unit for Behavioral Sciences, School of Public Health, The University of Hong Kong, 5/F William M. W. Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong.
- Centre for Psycho-Oncology Research & Training, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F William M. W. Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong.
- Department of Community Medicine & Unit for Behavioral Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F William M. W. Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong.
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Wong WS, Fielding R. Quality of life and pain in Chinese lung cancer patients: Is optimism a moderator or mediator? Qual Life Res 2006; 16:53-63. [PMID: 17091368 DOI: 10.1007/s11136-006-9106-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2006] [Accepted: 07/27/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To clarify if optimism exerts a primarily moderating or mediating influence on the pain-QoL association in Chinese lung cancer patients. METHODS About 334 Chinese lung cancer patients were interviewed at baseline during the first outpatient visit (Baseline), at 4 months after Baseline (FU1), and at 8 months after Baseline (FU2). Respondents completed the Chinese version of the FACT-G version-3 scale (FACT-G (Ch)). Optimism and pain were assessed using two 11-point self-rated items. Linear mixed effects (LME) models tested the moderating and mediating effects of optimism on QoL. RESULTS Optimism, pain, and QoL were most strongly correlated at FU1. LME models failed to show any moderating effect by optimism on the pain-QoL association (standardized beta = -0.049, 95% CI -0.097 to 0.001). After adjustment for age, cancer stage, and disease recurrence, a modest mediating effect was observed for optimism on the pain-QoL association over the duration of the study (standardized beta = 0.047; Sobel test z = -4.317, p < 0.001). CONCLUSIONS Optimism qualifies as a mediator between pain and QoL suggesting that pessimistic lung cancer patients are likely to experience greater QoL decrements in response to pain in the early post-diagnostic period. Effective pain control may be enhanced by inclusion of interventions that facilitate optimistic perspectives in patients. This study lends further support to the view that lung cancer patients' psychological needs are important in both pain control and QoL.
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Affiliation(s)
- Wing S Wong
- Unit for Behavioural Science, Department of Community Medicine, The University of Hong Kong, 5/F, Academic & Admin. Block, 21 Sassoon Road, Pokfulam, Hong Kong
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Llewellyn CD, McGurk M, Weinman J. How satisfied are head and neck cancer (HNC) patients with the information they receive pre-treatment? Results from the satisfaction with cancer information profile (SCIP). Oral Oncol 2006; 42:726-34. [PMID: 16529976 DOI: 10.1016/j.oraloncology.2005.11.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2005] [Revised: 11/18/2005] [Accepted: 11/22/2005] [Indexed: 10/24/2022]
Abstract
Recent UK government recommendations state that high quality information must be provided for cancer patients. The objectives of this study were firstly, to explore how satisfied head and neck cancer (HNC) patients were with information provided about their illness and treatment, in order to identify areas of improvement. Secondly, to assess the extent to which satisfaction with information before treatment was predictive of long-term outcomes. Patients completed the satisfaction with information profile (SCIP), the Hospital Anxiety and Depression Scale (HADS) and the SF-12 Health Survey (SF-12v2) before treatment (n=82), 1 month after the end of treatment (n=68) and 6-8 months later (n=50). Patients were generally satisfied with information, however key areas of improvement were identified, such as the provision of information about support groups, where to go for financial advice and the long-term affects of treatment on ability to work, physical functioning and QoL. Satisfaction with information before treatment was predictive of depression and Mental Component Summary scores (HR-QoL) 6-8 months after the end of treatment. This study highlights the need for tailored information provision and the impact on longitudinal outcomes of satisfying patient's needs for information prior to treatment.
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Affiliation(s)
- C D Llewellyn
- Health Psychology Section, Division of Psychology, Institute of Psychiatry (Guy's Campus) King's College London, and Department of Oral Surgery, Guy's Hospital NHS Trust, SE1 9RT, UK.
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Sheard C, Garrud P. Evaluation of generic patient information: effects on health outcomes, knowledge and satisfaction. PATIENT EDUCATION AND COUNSELING 2006; 61:43-7. [PMID: 16533676 DOI: 10.1016/j.pec.2005.02.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2004] [Revised: 02/08/2005] [Accepted: 02/17/2005] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To establish whether the provision of commercially produced written information in addition to routine hospital information can improve patients' knowledge and satisfaction and affect their health-related quality of life. METHODS Elective surgical patients were randomised into an experimental group (N = 54) who received three commercially produced information booklets at pre-assessment, before surgery and at discharge, and a control group (N = 55) who received standard hospital information only. RESULTS The experimental group were significantly less anxious immediately before their operation, and reported greater perceived control compared to controls post-operatively. Two weeks after discharge, health status for the two groups was similar except the experimental group reported significantly less pain. Overall satisfaction was fairly high and similar in both groups. The experimental group demonstrated greater knowledge at pre-admission, but not at discharge or follow-up. DISCUSSION Patients increasingly expect written information; however amount, quality and timeliness vary considerably. Combining commercially produced information with standard hospital information may be to the patient's benefit. PRACTICE IMPLICATIONS Providing patients with commercially produced standardised information in addition to internally produced hospital information could have an additional, though limited, benefit to patients' health outcomes. This could be a way of incorporating the expertise of both providers to the patient's benefit.
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Affiliation(s)
- Charlotte Sheard
- Behavioural Sciences Section, Division of Psychiatry, Queen's Medical Centre, A Floor, South Block, University of Nottingham, Nottingham NG7 2UH, UK.
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Llewellyn CD, Horne R, McGurk M, Weinman J. Development and preliminary validation of a new measure to assess satisfaction with information among head and neck cancer patients: The satisfaction with cancer information profile (SCIP). Head Neck 2006; 28:540-8. [PMID: 16673422 DOI: 10.1002/hed.20450] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Our objective was to develop and examine the psychometric properties of the Satisfaction With Cancer Information Profile (SCIP), a new measure designed to assess the extent to which patients with head and neck cancer (HNC) are satisfied with information received about their treatment. METHODS Patients with head and neck cancer (HNC) from 4 hospitals in the UK completed the SCIP before treatment and again 1 month after treatment. Psychometric properties of the measure were evaluated: internal consistency, subscale intercorrelations, discriminant validity, concurrent validity, and predictive validity. The responsiveness of the measure to change and ease of completion was also assessed. RESULTS The SCIP performed well on all the psychometric tests; level of satisfaction with information was related to a number of key outcomes and patient beliefs, demonstrating criterion-related validity. CONCLUSIONS The SCIP was developed to assess HNC patient satisfaction with treatment information and has demonstrated good reliability and validity. This measure may prove appropriate for use with patients with different types of cancer due to its applicability with a variety of treatment modalities. Preliminary psychometric testing has demonstrated its potential for use in routine clinical settings and research settings as a predictive tool or for audit, in addition to assessing individual patient satisfaction with information.
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Affiliation(s)
- Carrie D Llewellyn
- Health Psychology Section, Division of Psychology, Institute of Psychiatry, Guy's Campus, 5th Floor, King's College, University of London, Thomas-Guy House, Guy's Hospital, London SE1 9RT, UK.
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30
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Cengiz M, Ozyar E, Esassolak M, Altun M, Akmansu M, Sen M, Uzel O, Yavuz A, Dalmaz G, Uzal C, Hiçsönmez A, Sarihan S, Kaplan B, Atasoy BM, Ulutin C, Abacioğlu U, Demiral AN, Hayran M. Assessment of quality of life of nasopharyngeal carcinoma patients with EORTC QLQ-C30 and H&N-35 modules. Int J Radiat Oncol Biol Phys 2005; 63:1347-53. [PMID: 16169671 DOI: 10.1016/j.ijrobp.2005.05.057] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2005] [Revised: 05/31/2005] [Accepted: 05/31/2005] [Indexed: 11/20/2022]
Abstract
PURPOSE The current study reports on long-term quality of life (QoL) status after conventional radiotherapy in 187 nasopharyngeal carcinoma patients from 14 centers in Turkey. PATIENTS AND METHODS Patients with the diagnosis of nasopharyngeal carcinoma, who were treated in 14 centers in Turkey with minimum 6 months of follow-up and were in complete remission, were asked to complete Turkish versions of EORTC QLQ-C30 questionnaire and the HN-35 module. Each center participated with the required clinical data that included age at diagnosis, gender, symptoms on admission, follow-up period, treatment modalities, radiotherapy dose, and AJCC 1997 tumor stage. Each patient's 33 QoL scores, which included function, global health status, and symptoms, were calculated as instructed in EORTC QLQ-C30 scoring manual. All of the scales and single-item measures range from 0 to 100. A high score represents a higher response level. Kruskal-Wallis and Mann-Whitney U nonparametric tests were used for comparisons. RESULTS One hundred eighty-seven patients with median age of 46 years (range, 16-79 years) participated and completed the questionnaires. Median follow-up time was 3.4 years (range, 6 months-24 years). All patients have received external-beam radiotherapy. Beside external-beam radiotherapy, 59 patients underwent brachytherapy boost, 70 patients received concomitant chemotherapy, and 95 patients received adjuvant/neoadjuvant chemotherapy. Most of the patients in the analysis (75%) were in advanced stage (Stage III, n = 85 [45.4%]; Stage IV, n = 55 [29%]). Mean global health status was calculated as 73. Parameters that increased global health status were male gender, early-stage disease, and less than 4-year follow-up (p < 0.05). Functional parameters were better in males and in early-stage disease. Factors that yielded better symptom scores were short interval after treatment (10 scores), male gender (7 scores), and lower radiation dose (6 scores). Neoadjuvant or adjuvant chemotherapy did not have any effect on QoL, whereas concomitant chemotherapy adversely affected 5 symptom scores. CONCLUSION Quality of life is adversely affected in our nasopharyngeal carcinoma patients treated with combined therapies. The factors that adversely affect quality of life are advanced tumor stage, female gender, and long-term follow-up. Further controlled studies to evaluate both preradiotherapy and postradiotherapy status are necessary to clarify the contribution of each treatment modality to QoL.
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Affiliation(s)
- Mustafa Cengiz
- Turkish Oncology Group (TOG)--Head and Neck Cancer Working Party, Hacettepe University, Sihhiye, Ankara, Turkey.
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Chan YM, Lee PWH, Fong DYT, Fung ASM, Wu LYF, Choi AYY, Ng TY, Ngan HYS, Wong LC. Effect of individual psychological intervention in Chinese women with gynecologic malignancy: a randomized controlled trial. J Clin Oncol 2005; 23:4913-24. [PMID: 15939927 DOI: 10.1200/jco.2005.02.069] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the effectiveness of psychological intervention in the care of cancer patients and to determine whether routine use of individual psychological therapies is indicated. PATIENTS AND METHODS Patients with newly diagnosed gynecologic malignancies from August 1999 to November 2000 were recruited and randomly assigned to either a control group receiving routine medical care or to an intervention group receiving individual psychotherapy. A set of fixed-choice, self-report questionnaires assessing the patients' psychological status, quality of life, and their perceptions related to the medical consultations was completed at recruitment and then every 3 months for 18 months. Data analysis was performed according to the intention-to-treat principle by fitting the data into a linear mixed-effects model. Multivariable analyses were performed to examine the effects of confounding factors. RESULTS One hundred fifty-five patients participated in the trial. There were no statistically significant differences between the two groups at baseline. There was a trend toward better quality of life and functional status and also improvement of the symptoms over time for both groups. No differences were found between the groups in the scores measured by any of the instruments at baseline and at any time points after the cancer diagnosis. Psychological intervention had no significant effects on the psychosocial parameters. CONCLUSION Routine use of psychological therapies as given in our format has no significant effect on the patients' quality of life and psychological status.
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Affiliation(s)
- Y M Chan
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong, China.
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Llewellyn CD, McGurk M, Weinman J. Striking the right balance: A qualitative pilot study examining the role of information on the development of expectations in patients treated for head and neck cancer. PSYCHOL HEALTH MED 2005. [DOI: 10.1080/1354850042000326593] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lam WWT, Fielding R, Chow L, Chan M, Leung GM, Ho EYY. Brief communication: The Chinese medical interview satisfaction scale-revised (C-MISS-R): Development and validation. Qual Life Res 2005; 14:1187-92. [PMID: 16041913 DOI: 10.1007/s11136-004-2391-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The Medical Interview Satisfaction Scale (MISS) measures patient consultation satisfaction. We validated a translated short-form of the original MISS on Hong Kong Chinese women with breast cancer. METHODS The four highest scoring MISS Cognitive and Affective sub-scales items were administered in Chinese (C-MISS) to 224 female out patients. Phrasing revisions (C-MISS-R) were tested on 82 women. Random split tested factor structure stability. Convergent, divergent and criterion validation against other instruments was performed on 405 women. RESULTS Two-factors accounted for 61.7% of variance but factor loadings differed from the original. Phrasing revision increased Affective sub-scale item-item correlations exceeding 0.3-64%. Two factors matching those of the original MISS, accounting for 65.2% of variance, explained 36.6% (Cognitive) and 28.8% (Affective) of variance, respectively. Alpha was 0.84,0.74 and 0.83 for the Cognitive and Affective sub-scales and total respectively. Correlations of difficulties with treatment decision making (r = -0.298), Self-efficacy (r = 0.194), optimism (r = 0.33), psychological morbidity (r = -209), marital status, education and age indicated acceptable validity. Test-retest reliability was 0.410. DISCUSSION The Chinese MISS-Revised (C-MISS-R) has suitable factor structure and psychometric properties for use in consultation studies among Chinese female populations. Further validation is needed for males.
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Affiliation(s)
- W W T Lam
- Centre for Psycho-Oncological Research and Teaching, The University of Hong Kong, Pokfulam
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Tercyak KP, DeMarco TA, Mars BD, Peshkin BN. Women's satisfaction with genetic counseling for hereditary breast-ovarian cancer: psychological aspects. Am J Med Genet A 2005; 131:36-41. [PMID: 15389697 PMCID: PMC3548224 DOI: 10.1002/ajmg.a.30317] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Women who participate in BRCA1/2 cancer genetic counseling do so for a variety of reasons, including learning quantitative risk information about their chances of developing hereditary breast-ovarian cancer at some point during their lifetimes. For these women, obtaining pre-test and disclosure genetic counseling with a professional affords them numerous potential benefits, including adequate preparation for, and accurate interpretation of, their test results. In consequence, women commonly report being highly satisfied with their cancer genetic counseling experience, even if the information learned through testing suggests they are at increased cancer risk. This occurrence raises an interesting question, namely, what are the psychological aspects of satisfaction with genetic counseling for hereditary breast-ovarian cancer in women? To answer this question, we administered the Genetic Counseling Satisfaction Scale (GCSS) to a convenience sample of 61 women participating in BRCA1/2 pretest genetic counseling, and re-administered the GCSS to approximately one-third of these women at disclosure. Available psychological data included personality, distress, and family functioning. In bivariate analyses, optimism and family functioning were positively associated with pretest satisfaction. With respect to satisfaction at disclosure, general and cancer-specific distress were negatively associated with satisfaction. Our findings suggest that psychological aspects of satisfaction with cancer genetic counseling vary, with individual differences and family functioning playing a role at pretest, and distress playing a role at disclosure. The implications for future research and clinical practice are discussed.
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Affiliation(s)
- Kenneth P. Tercyak
- Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia
- Department of Oncology, School of Medicine, Georgetown University Medical Center, Washington, District of Columbia
- Department of Pediatrics, School of Medicine, Georgetown University Medical Center, Washington, District of Columbia
- Correspondence to: Kenneth P. Tercyak, Ph.D., Cancer Control Program, Lombardi Comprehensive Cancer Center, 2233 Wisconsin Avenue, NW, Suite 317, Washington, DC 20007-4104.
| | - Tiffani A. DeMarco
- Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia
| | - Bryn D. Mars
- Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia
| | - Beth N. Peshkin
- Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia
- Department of Oncology, School of Medicine, Georgetown University Medical Center, Washington, District of Columbia
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Lovell SJ, Wong HB, Loh KS, Ngo RYS, Wilson JA. Impact of dysphagia on quality-of-life in nasopharyngeal carcinoma. Head Neck 2005; 27:864-72. [PMID: 16114007 DOI: 10.1002/hed.20250] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Little is known about dysphagia or quality of life (QOL) in patients treated for nasopharyngeal carcinoma (NPC). The aim of this study was to determine the impact of dysphagia on QOL in patients treated for NPC as measured by two standard tools, the University of Washington Quality-of-Life Questionnaire(1) (UW-QOL) and the Swallow Quality-of-Life Questionnaire(3) (SWAL-QOL). METHODS This is a cross-sectional survey of 59 consecutive disease-free survivors of NPC attending the head and neck cancer clinic at the National University Hospital, Singapore. The UW-QOL and SWAL-QOL underwent minor modification and were translated into Mandarin. A linear regression analysis was performed to identify significant predictors of health-related QOL. RESULTS Fifty-one patients (86%) responded; of these, 43 had self-reported swallowing difficulties. On the UW-QOL, respondents indicated the three most important issues to be swallowing (59%), hearing (45%), and saliva/dry mouth (41%). Respondents with swallowing difficulty reported a lower UW-QOL composite score (p = .002) and a lower health-related QOL score (HR-QOL) than those without swallowing difficulty (p = .004). Self-reported swallowing difficulty predicted a lower HR-QOL score (p = .004). A longer time since treatment predicted a better score in HR-QOL (p = .024). A lower score in fatigue predicted a lower HR-QOL score (p = .001). CONCLUSIONS Swallowing difficulties negatively impact QOL. It is recommended that future QOL studies aimed specifically at swallowing function in NPC use a swallowing specific questionnaire (eg, SWAL-QOL) in addition to a head and neck-specific measure. Further research is needed to look at the adaptation and usefulness of swallowing-specific QOL surveys for use with people treated for NPC.
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Affiliation(s)
- Sarah J Lovell
- Department of Otolaryngology-Head & Neck Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074.
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Lam W, Fielding R, Chan M, Chow L, Ho E. Participation and satisfaction with surgical treatment decision-making in breast cancer among Chinese women. Breast Cancer Res Treat 2003; 80:171-80. [PMID: 12908820 DOI: 10.1023/a:1024568732213] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE To report Chinese women's preferred and perceived participation in breast cancer treatment decision making (TDM), describe influences on women's participation preference and participation congruence (PC) (correspondence between preferred and actual amount of participation in TDM), and explore subsequent satisfaction with TDM. PATIENTS AND METHODS Of 172/211 eligible and available Chinese women recently undergoing breast cancer surgery at one of six Hong Kong government hospitals 154 (89.5%) were recruited. Within 12 days after surgery, women provided interview information on preferred and perceived TDM participation, satisfaction with TDM consultation, difficulties in TDM, and medical and demographic information. RESULTS Half (55%) reported a treatment choice: 33% wanted the choice to be their own, 59% wanted to share and 8% wanted to delegate the decision. Only age predicted participation preference with older women preferring a more passive role. Eighty percent of women participated as much as, 13% more than and 6% less than desired. Adjusted for age, women reporting PC had fewer difficulties in TDM (beta = 0.21, p = 0.009) than women not reporting PC, while over-involved women had more doubts about their choice (beta = -0.23, p = 0.005). PC was associated with being offered a treatment option (chi2 = 15.59, p < 0.001) and surgeons expressing a surgical preference (chi2 = 6.63, p = 0.036). Satisfaction was unrelated to PC. CONCLUSION Most Chinese women want shared TDM and to know their surgeon's treatment preference. Over-involved women are at greater risk of difficulties and doubts in TDM and under-involved women perceive a lack of time and information to make their decision.
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Affiliation(s)
- Wendy Lam
- Center for Psycho-Oncology Research and Teaching, Department of Community Medicine, University of Hong Kong, Pokfulam, Hong Kong SAR, China
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