Validation of Chinese and English versions of the Holistic Well-being Scale in patients with cancer

Study Protocol for Mindfulness-Based Yoga Versus Physical Exercise on the Psychological Well-Being in Students With Early Visual Impairment: A Three-Armed, Multi-Centered, Randomized Controlled Trial

Background People with visual impairment (VI) tend to face more psychological distress than normally sighted individuals due to mobility restrictions, fear of falling, and sleep disturbances. However, research to address these problems is rare. This study aims to investigate the effect of mindfulness-based yoga versus physical exercise on the psychological well-being of individuals with VI. Methods This study will be a single-blinded, three-armed, multicentered, randomized controlled trial (RCT). A total of 132 participants with VI (ages 15-25) will be recruited in the study and will be randomly assigned to either group 1 (mindfulness-based yoga), group 2 (physical exercise), or group 3 (wait-list control). Groups 1 and 2 will receive intervention for 40 hours (eight weeks, weekly five days, one hour/day), whereas group 3 will continue their daily activities as usual. The intervention will take place in the afternoon from Monday to Friday. The timing varies between 4-5 pm according to the different time schedules of the institutions of the blind. Three times, assessments will be conducted at T0 (baseline), T1 (eighth week at the completion of the intervention), and T2 (sixth month following the completion of the intervention). ANOVA will be used to find out the differences between groups; repeated measures ANOVA will be used to check within-group changes. Trial status The study was first screened in December 2021. The recruitment of participants has been completed in two centers covering 62 individuals with VI, and intervention started in August 2022. The data collection is still ongoing due to the nature of the study design, a specific demographic, complex logistics, and administrative bottlenecks. The study incorporates three different groups and a substantial sample size (n=132). The specific demographic, people with visual impairments, are rare and difficult to locate. In addition, a six-month follow-up assessment contributes to complex procedures while coordinating between various institutions and securing necessary authorizations. Discussion This study will be the first comprehensive RCT to investigate the psychological well-being of the VI population with various psychophysiological and hormonal parameters in multiple centers. The presence of physical exercise and a wait-list control group will further elucidate the potential mechanism of Mindfulness-based yoga. Mindfulness-based yoga can be integrated into educational and rehabilitation systems to enhance the well-being of individuals with VI.

Measurement Properties and Optimal Cutoff Point of the WHO-5 Among Chinese Healthcare Students

Purpose

The World Health Organization-Five Well-Being Index (WHO-5) is widely used to assess subjective well-being. Nevertheless, measurement invariance and optimal cutoff point of the WHO-5 have not been examined in Chinese samples. We aimed to assess measurement properties of the Chinese version of the WHO-5 (WHO-5-C) among healthcare students.

Patients and Methods

A two-wave longitudinal assessment was conducted among 343 Chinese healthcare students from September to November 2022. Measurement properties of the WHO-5-C were assessed through structural validity using confirmatory factor analysis (CFA), measurement invariance using multigroup CFA (MGCFA) and longitudinal CFA (LCFA), convergent validity using correlation analysis with the Self-Rated Health Questionnaire (SRHQ) and Patient Health Questionnaire-4 (PHQ-4), reliability using internal consistency and test-retest reliability, and optimal cutoff point using receiver operating characteristic (ROC) analysis.

Results

The WHO-5-C demonstrated satisfactory structural validity with comparative fit index (CFI) of 0.968 at baseline and 0.980 at follow-up, and adequate measurement invariance in different sociodemographic variables at baseline (gender, age, major, home location, being only child, monthly household income, part-time job, physical exercise, hobby, frequency of visiting home, and stress coping strategy) (CFI changes [ΔCFI] = -0.009-0.003) and over a week (ΔCFI = -0.006-0.000). The WHO-5-C also had good internal consistency (Cronbach's α = 0.907-0.934; McDonald's ω = 0.908-0.935) and test-retest reliability (intraclass correlation coefficient [ICC] = 0.803). Convergent validity was supported by moderate correlations of the WHO-5-C with the SRHQ and PHQ-4. The optimal cutoff point of the WHO-5-C was found to be 50, with an area under the ROC curve of 0.882 at baseline data, with sensitivity of 0.803 and specificity of 0.762 at follow-up.

Conclusion

The WHO-5-C demonstrated adequate measurement properties, especially concerning cross-sectional and longitudinal measurement invariance, with a recommended optimal cutoff point of ≥ 50 for assessing adequate level of psychological well-being in healthcare students.

Prevalence of psychological distress among cancer patients in Southeast Asian countries: A systematic review

Psychological distress (including depression and anxiety) is common in the first years of cancer diagnosis but can differ by country and region. The aim of the present paper was to review the prevalence of psychological distress among cancer patients in the Southeast Asia (SEA) region. A systematic literature search was carried out using several databases (i.e., PubMed, PsychARTICLES, Embase, CINAHI, Web of Sciences, Plus, Scopus, and AHMED). Papers originally published in English language were taken into consideration if they (i) were published from 2010 to 2021 and (ii) reported the prevalence of psychological distress among patients with different types of cancer. A total of 23 studies met the inclusion criteria. The most frequently employed psychometric instrument for anxiety and depression screening was the Hospital Anxiety and Depression Scale (HADS). The prevalence of anxiety (ranging from 7% to 88%) was wider than that of depression (ranging from 3% to 65.5%) among patients with different types of cancer and living in various countries in the SEA region. The overall prevalence rate of psychological distress among cancer patients from the SEA region was not fundamentally very different from that of general populations. These findings provide useful information for health professionals and cancer patients to understand the negative role of psychological distress in quality of life and health. The research findings demonstrate the importance of counselling for psychological distress among cancer patients as means of effectively resolving their psychological problems and ultimately improving the quality of oncology medical care. Clinical recommendations for cancer management should incorporate the early identification of (and therapy for) psychological distress, as well as their monitoring during treatment.

Understanding domains of health-related quality of life concerns of Singapore Chinese patients with advanced cancer: a qualitative analysis

PURPOSE

Quality of life concerns in patients with advanced diseases might be different from other patients and are shaped by sociocultural context. The objective of this qualitative study was to identify domains and themes of health-related quality of life (HRQoL) that Chinese patients with advanced cancer in Singapore considered relevant and important.

METHODS

English- and Chinese-speaking patients with advanced solid cancer were recruited from a tertiary cancer center and a community-based hospice for in-depth interview or focused group discussion. Thematic analysis was used to identify subthemes, themes, and domains from the transcripts.

RESULTS

Forty-six ethnic Chinese (aged 26-86, 48% male) participated in the study. Six domains of HRQoL concerns were identified: pain and suffering, physical health, social health, mental health, financial well-being, and spiritual health. Pain and suffering are not limited to the physical domain, reflecting the multidimensional nature of this concept. Pain and suffering must also be understood within the cultural context. Healthcare relations (i.e., social health), existential well-being and religious well-being (i.e., spiritual health), and suffering (i.e., pain and suffering) are not fully captured in the existing HRQoL instruments. In addition, financial issues and the practice of secrecy in interpersonal relationships emerged as unique features possibly arising from our sociocultural context and healthcare financing landscape.

CONCLUSION

Socioculturally specific issues not measured by the existing HRQoL instruments for use in patients with advanced cancers or terminal diseases were found in our study. These are non-physical pain and suffering, meaning of illness, meaning of death, financial issues, and practice of secrecy in interpersonal relationships.