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Smrke U, Abalde-Cela S, Loly C, Calbimonte JP, Pires LR, Lin S, Sánchez A, Tement S, Mlakar I. Quality of Life of Colorectal Cancer Survivors: Mapping the Key Indicators by Expert Consensus and Measures for Their Assessment. Healthcare (Basel) 2024; 12:1235. [PMID: 38921349 PMCID: PMC11203183 DOI: 10.3390/healthcare12121235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/15/2024] [Accepted: 06/18/2024] [Indexed: 06/27/2024] Open
Abstract
Quality of life (QoL) assessments are integral to cancer care, yet their effectiveness in providing essential information for supporting survivors varies. This study aimed to elucidate key indicators of QoL among colorectal cancer survivors from the perspective of healthcare professionals, and to evaluate existing QoL questionnaires in relation to these indicators. Two studies were conducted: a Delphi study to identify key QoL indicators and a scoping review of questionnaires suitable for colorectal cancer survivors. Fifty-four healthcare professionals participated in the Delphi study's first round, with 25 in the second. The study identified two primary QoL domains (physical and psychological) and 17 subdomains deemed most critical. Additionally, a review of 12 questionnaires revealed two instruments assessing the most important general domains. The findings underscored a misalignment between existing assessment tools and healthcare professionals' clinical priorities in working with colorectal cancer survivors. To enhance support for survivors' QoL, efforts are needed to develop instruments that better align with the demands of routine QoL assessment in clinical practice.
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Affiliation(s)
- Urška Smrke
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia
| | - Sara Abalde-Cela
- RUBYnanomed LDA, Praça Conde de Agrolongo, 4700-314 Braga, Portugal
| | - Catherine Loly
- Gastroenterology Department, University Hospital of Liège, 4000 Liège, Belgium
| | - Jean-Paul Calbimonte
- Institute of Informatics, University of Applied Sciences and Arts Western Switzerland HES-SO, 3960 Sierre, Switzerland
- The Sense Innovation & Research Center, 1007 Lausanne, Switzerland
| | - Liliana R. Pires
- RUBYnanomed LDA, Praça Conde de Agrolongo, 4700-314 Braga, Portugal
| | - Simon Lin
- Science Department, Symptoma GmbH, 5020 Vienna, Austria
- Department of Internal Medicine, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Alberto Sánchez
- Department of eHealth, Galician Research & Development Center in Advanced Telecommunications (GRADIANT), 26334 Vigo, Spain
| | - Sara Tement
- Department of Psychology, Faculty of Arts, University of Maribor, 2000 Maribor, Slovenia
| | - Izidor Mlakar
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia
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Chapman B, Grunfeld EA, Derakshan N. Quality of working life can protect against cognitive and emotional vulnerability in women living with metastatic breast cancer: a cross-sectional study. J Cancer Surviv 2023; 17:1295-1308. [PMID: 35038120 PMCID: PMC8761843 DOI: 10.1007/s11764-022-01169-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 01/10/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE Research focusing on the cognitive and emotional health of women with metastatic breast cancer (MBC) is limited. The focal aim of the current study was to explore how quality of working life was related to global health, perceived cognitive function, anxiety and depression. To this end, women's experience of employers after MBC diagnosis and its relationship to quality of working life was also explored. METHODS Women living with MBC (N = 88) completed online questionnaires assessing their global health status, perceived cognitive and emotional vulnerability and their experience of employers following diagnosis. Women working at the time of the study also reported on their quality of working life. RESULTS Women's experience of employers after MBC diagnosis was positively related to their quality of working life. Importantly, greater quality of working life met with better perceived cognitive function and global health, as well as lower levels of depression in working women. CONCLUSIONS Our study is the first to establish the role of quality of working life in protecting against levels of cognitive vulnerability and emotional vulnerability to depression in women with MBC. We also highlight the importance of having a positive experience with employers. Our findings suggest that educational programmes can be provided to employers to enhance their understanding and awareness of the needs of women with MBC. IMPLICATIONS FOR CANCER SURVIVORS Women with MBC may benefit from employers accessing educational (or support) programmes that can increase their awareness of the treatment-related sequelae and needs of women with MBC in the workplace.
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Affiliation(s)
- Bethany Chapman
- Department of Psychological Sciences, The BRiC Centre (Birkbeck Centre for Building Resilience in Breast Cancer), Birkbeck University of London, Malet Street, London, WC1E 7HX, UK.
| | - Elizabeth A Grunfeld
- Department of Psychological Sciences, The BRiC Centre (Birkbeck Centre for Building Resilience in Breast Cancer), Birkbeck University of London, Malet Street, London, WC1E 7HX, UK
| | - Nazanin Derakshan
- Department of Psychological Sciences, The BRiC Centre (Birkbeck Centre for Building Resilience in Breast Cancer), Birkbeck University of London, Malet Street, London, WC1E 7HX, UK
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Bosma AL, Ouwerkerk W, Günal M, Hyseni AM, Arents BWM, Gerbens LAA, Middelkamp‐Hup MA, de Boer AGEM, Spuls PI. Work ability and quality of working life in atopic dermatitis patients treated with dupilumab. J Dermatol 2021; 48:1305-1314. [PMID: 34013539 PMCID: PMC8453967 DOI: 10.1111/1346-8138.15939] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/03/2022]
Abstract
Atopic dermatitis is associated with work productivity loss. Little is known about how patients perceive their work ability and quality of working life, and how this is affected by treatment. Our primary objective was to investigate work ability and quality of working life at baseline and during treatment in the long term. A registry-embedded prospective observational cohort study was conducted consisting of patients with atopic dermatitis starting dupilumab in routine clinical care. The instruments used were the Work Ability Index (WAI; questions 1, 2, and 3) and the Quality of Working Life Questionnaire (QWLQ). Ninety-three patients were included of whom 72 were (self-)employed (77%). From baseline to 48 weeks, the mean WAI-1 score (general work ability, range 0-10) improved from 6.8 (±2.0) to 7.9 (±1.3), WAI-2 (physical work ability, range 1-5) from 3.7 (±0.9) to 4.3 (±0.7), and WAI-3 (mental/emotional work ability, range 1-5) from 3.4 (±0.9) to 3.9 (±0.8) (p = 0.001, p = 0.005, p < 0.001, respectively). The mean QWLQ total score improved from 74.0 (±9.1) to 77.5 (±9.6) and subscale "Problems due to health situation" improved from 37.4 (±22.3) to 61.5 (±23.1) (range 0-100; p = 0.032, p < 0.001, respectively). In conclusion, patients with moderate-to-severe atopic dermatitis starting dupilumab report decreased work ability and quality of working life, mainly due to health-related problems. Significant improvement of work ability and quality of working life is observed with dupilumab treatment.
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Affiliation(s)
- Angela L. Bosma
- Department of DermatologyAmsterdam Public Health Research InstituteAmsterdam Institute for Infection and ImmunityUniversity of AmsterdamAmsterdam UMC, Location Academic Medical CenterAmsterdamThe Netherlands
| | - Wouter Ouwerkerk
- Department of DermatologyAmsterdam Public Health Research InstituteAmsterdam Institute for Infection and ImmunityUniversity of AmsterdamAmsterdam UMC, Location Academic Medical CenterAmsterdamThe Netherlands
- National Heart Centre SingaporeSingapore
| | - Merve Günal
- Department of DermatologyAmsterdam Public Health Research InstituteAmsterdam Institute for Infection and ImmunityUniversity of AmsterdamAmsterdam UMC, Location Academic Medical CenterAmsterdamThe Netherlands
| | - Ariënna M. Hyseni
- Department of DermatologyAmsterdam Public Health Research InstituteAmsterdam Institute for Infection and ImmunityUniversity of AmsterdamAmsterdam UMC, Location Academic Medical CenterAmsterdamThe Netherlands
| | - Bernd W. M. Arents
- Dutch Association for People with Atopic DermatitisNijkerkThe Netherlands
| | - Louise A. A. Gerbens
- Department of DermatologyAmsterdam Public Health Research InstituteAmsterdam Institute for Infection and ImmunityUniversity of AmsterdamAmsterdam UMC, Location Academic Medical CenterAmsterdamThe Netherlands
| | - Maritza A. Middelkamp‐Hup
- Department of DermatologyAmsterdam Public Health Research InstituteAmsterdam Institute for Infection and ImmunityUniversity of AmsterdamAmsterdam UMC, Location Academic Medical CenterAmsterdamThe Netherlands
| | - Angela G. E. M. de Boer
- Coronel Institute of Occupational HealthAmsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdam UMC, Location Academic Medical CenterAmsterdamThe Netherlands
| | - Phyllis I. Spuls
- Department of DermatologyAmsterdam Public Health Research InstituteAmsterdam Institute for Infection and ImmunityUniversity of AmsterdamAmsterdam UMC, Location Academic Medical CenterAmsterdamThe Netherlands
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Murphy M, Hollinghurst S, Salisbury C. Patient understanding of two commonly used patient reported outcome measures for primary care: a cognitive interview study. BMC FAMILY PRACTICE 2018; 19:162. [PMID: 30261850 PMCID: PMC6161379 DOI: 10.1186/s12875-018-0850-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/17/2018] [Indexed: 01/25/2023]
Abstract
Background Standardised generic patient-reported outcome measures (PROMs) which measure health status are often unresponsive to change in primary care. Alternative formats, which have been used to increase responsiveness, include individualised PROMs (in which respondents specify the outcomes of interest in their own words) and transitional PROMs (in which respondents directly rate change over a period). The objective of this study was to test qualitatively, through cognitive interviews, two PROMs, one using each respective format. Methods The individualised PROM selected was the Measure Yourself Medical Outcomes Profile (MYMOP). The transitional PROM was the Patient Enablement Instrument (PEI). Twenty patients who had recently attended the GP were interviewed while completing the questionnaires. Interview data was analysed using a modification of Tourangeau’s model of cognitive processing: comprehension, response, recall and face validity. Results Patients found the PEI simple to complete, but for some it lacked face validity. The transitional scale was sometimes confused with a status scale and was problematic in situations when the relevant GP appointment was part of a longer episode of care. Some patients reported a high enablement score despite verbally reporting low enablement but high regard for their GP, which suggested hypothesis-guessing. The interpretation of the PEI items was inconsistent between patients. MYMOP was more difficult for patients to complete, but had greater face validity than the PEI. The scale used was open to response-shift: some patients suggested they would recalibrate their definition of the scale endpoints as their illness and expectations changed. Conclusions The study provides information for both users of PEI/MYMOP and developers of individualised and transitional questionnaires. Users should heed the recommendation that MYMOP should be interview-administered, and this is likely to apply to other individualised scales. The PEI is open to hypothesis-guessing and may lack face-validity for a longer episode of care (e.g. in patients with chronic conditions). Developers should be cognisant that transitional scales can be inconsistently completed: some patients forget during completion that they are measuring change from baseline. Although generic questionnaires require the content to be more general than do disease-specific questionnaires, developers should avoid questions which allow broad and varied interpretations. Electronic supplementary material The online version of this article (10.1186/s12875-018-0850-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mairead Murphy
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Sandra Hollinghurst
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Chris Salisbury
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
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de Jong M, Tamminga SJ, van Es RJJ, Frings-Dresen MHW, de Boer AGEM. The quality of working life questionnaire for cancer survivors (QWLQ-CS): factorial structure, internal consistency, construct validity and reproducibility. BMC Cancer 2018; 18:66. [PMID: 29321006 PMCID: PMC5763640 DOI: 10.1186/s12885-017-3966-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 12/21/2017] [Indexed: 11/24/2022] Open
Abstract
Background To assess the factorial structure, internal consistency, construct validity and reproducibility of the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS). Methods An Exploratory Factor Analysis (EFA) was performed on QWLQ-CS data from a sample of employed cancer survivors to establish the final number of items and factorial structure of the QWLQ-CS. Internal consistency was assessed using Cronbach’s alpha. In a second sample of (self-)employed cancer survivors, construct validity was tested by convergent validity (correlations of QWLQ-CS with construct-related questionnaires), and discriminative validity (difference in QWLQ-CS scores between cancer survivors and employed people without cancer). In a subgroup of stable cancer survivors subtracted from the second sample, reproducibility was evaluated by Intraclass Correlation Coefficient (ICC) and Standard Error of Measurement (SEM). Results EFA on QWLQ-CS data of 302 cancer survivors resulted in 23 items and five factors. The internal consistency of the QWLQ-CS was Cronbach’s α = 0.91. Convergent validity on data of 130 cancer survivors resulted in r = 0.61–0.70. QWLQ-CS scores of these cancer survivors statistically differed (p = 0.04) from employed people without cancer (N = 45). Reproducibility of QWLQ-CS data from 87 cancer survivors demonstrated an ICC of 0.84 and a SEM of 9.59. Conclusions The five-factor QWLQ-CS with 23 items and adequate internal consistency, construct validity, and reproducibility at group level can be used in clinical and occupational healthcare, and research settings. Electronic supplementary material The online version of this article (10.1186/s12885-017-3966-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Merel de Jong
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Academic Medical Center, P.O. box 22660, 1100, DD, Amsterdam, the Netherlands
| | - Sietske J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Academic Medical Center, P.O. box 22660, 1100, DD, Amsterdam, the Netherlands
| | - Robert J J van Es
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, P.O. box 85500, 3508, GA, Utrecht, the Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Academic Medical Center, P.O. box 22660, 1100, DD, Amsterdam, the Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Academic Medical Center, P.O. box 22660, 1100, DD, Amsterdam, the Netherlands.
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de Jong M, Tamminga SJ, Frings-Dresen MHW, de Boer AGEM. Quality of Working Life of cancer survivors: associations with health- and work-related variables. Support Care Cancer 2016; 25:1475-1484. [PMID: 28019005 PMCID: PMC5378750 DOI: 10.1007/s00520-016-3549-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 12/04/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE This study aimed to (1) describe the Quality of Working Life (QWL) of cancer survivors and (2) explore associations between the QWL of cancer survivors and health- and work-related variables. METHODS Employed and self-employed cancer survivors were recruited through hospitals and patient organizations. They completed the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS) and health- and work-related variables in this cross-sectional study. The QWL scores of cancer survivors were described, and associations between QWL and health- and work-related variables were assessed. RESULTS The QWLQ-CS was completed by 302 cancer survivors (28% male) with a mean age of 52 ± 8 years. They were diagnosed between 0 and 10 years ago with various types of cancer, such as breast cancers, gastrointestinal cancers, urological cancers, and haematological cancers. The QWL mean score of cancer survivors was 75 ± 12 (0-100). Cancer survivors had statistically significant lower QWL scores when they had been treated with chemotherapy or when they reported co-morbidity (p ≤ 0.05). Cancer survivors without managerial positions, with low incomes or physically demanding work, and who worked a proportion of their contract hours had statistically significantly lower QWL scores (p ≤ 0.05). CONCLUSIONS This study described the QWL of cancer survivors and associations between QWL and health- and work-related variables. Based on these variables, it is possible to indicate groups of cancer survivors who need more attention and support regarding QWL and work continuation.
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Affiliation(s)
- Merel de Jong
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, P.O. box 22660, 1100 DD, Amsterdam, the Netherlands
| | - Sietske J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, P.O. box 22660, 1100 DD, Amsterdam, the Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, P.O. box 22660, 1100 DD, Amsterdam, the Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, P.O. box 22660, 1100 DD, Amsterdam, the Netherlands.
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Tamminga SJ, Hoving JL, Frings-Dresen MHW, de Boer AGEM. Cancer@Work - a nurse-led, stepped-care, e-health intervention to enhance the return to work of patients with cancer: study protocol for a randomized controlled trial. Trials 2016; 17:453. [PMID: 27634549 PMCID: PMC5025547 DOI: 10.1186/s13063-016-1578-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 08/31/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although the importance of work for patients with cancer is nowadays more acknowledged both in the literature as well as in cancer survivorship care, effective interventions targeting the return to work of these patients are still scarce. Therefore, we developed a nurse-led, stepped-care, e-health intervention aimed at enhancing the return to work of patients with cancer. The objective of this study is to describe the content of the intervention and the study design used to evaluate the feasibility and (cost) effectiveness of the intervention. METHODS We designed a multi-centre randomised controlled trial with a follow-up of 12 months. Patients who have paid employment at the time of diagnosis, are on sick leave and are between 18-62 years old will be eligible to participate. After patients have signed the informed consent form and filled in the baseline questionnaire, they are randomly allocated to either the nurse-led, stepped-care, e-health intervention called Cancer@Work, or care as usual. The primary outcome is sustainable return to work. Secondary outcomes are sick leave days, work ability, work functioning, quality of life, quality of working life and time from initial sick leave to full return to work without extensive need for recovery. The feasibility of the Cancer@Work intervention and direct and indirect costs will be determined. Outcomes will be assessed by questionnaires at 3, 6, 9 and 12 months of follow-up. DISCUSSION The results of this study will provide new insights into the feasibility and (cost) effectiveness of Cancer@Work, a nurse-led, stepped-care, e-health intervention for cancer patients aimed at enhancing their return to work. If proven effective, the intention is to implement the Cancer@Work intervention in usual psycho-oncological care. TRIAL REGISTRATION NTR (Netherlands Trial Registry): NTR5190 . Registered on 18 June 2015.
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Affiliation(s)
- Sietske J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Jan L Hoving
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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