B. Alex Matthews

The skin cancer index: clinical responsiveness and predictors of quality of life.

Objective: To establish the clinical responsiveness of the Skin Cancer Index (SCI), a new disease‐specific quality of life (QOL) instrument, and to assess demographic and clinical factors which impact QOL in patients with nonmelanoma skin cancer (NMSC).

Family caregivers' quality of life: influence of health protective stance and emotional strain

The goal of this cross-sectional study was to examine whether health protective behaviors and emotional strain is associated with the quality of life of family members who provide care to cancer survivors and to examine some of the factors that might explain this association. The relative influence of these factors on each of the domains of caregiver quality of life (CGQOL) was examined. A total of 203 family caregivers completed self-report questionnaires; only those without missing data on any measure (N = 152) were included in the current analyses. Measures of physical, psychological, social, and spiritual well being were assessed by the 36-item CGQOL tool. Predictor variables included caregiver sociodemographic data (age, income, and gender), care characteristics (cancer stage, duration of care, and time since care), health stance (positive expectancies and physical behavior generally thought to be healthy), and emotional strain (feelings of entrapment, overload, and isolation). Data were analyzed using regression methods. Results demonstrated that health stance and emotional strain are inversely related and that both contribute significantly to overall and separate dimensions of CGQOL. Pinpointing domain-specific effects may suggest ways to more precisely target challenges associated with caregiving and develop effective interventions accordingly.

Creation of a quality of life instrument for nonmelanoma skin cancer patients.

Objective: Malignancies of the skin are the most common cancers among humans. The cervicofacial region is most affected by cutaneous malignancies, with approximately 80% of nonmelanoma skin cancers (NMSC) occurring in the head and neck. Treatment of cervicofacial skin cancers also is more likely to result in significant patient morbidity, because of the functional and cosmetic importance of this region. Unlike other malignancies, skin cancer has not been well investigated in terms of patient quality of life (QOL) assessment. Furthermore, no validated disease‐specific QOL instrument currently exists for skin cancer. The aim of this study was to construct a new QOL instrument, The Facial Skin Cancer Index (FSCI), that captures the relevant QOL issues for NMSC patients.

Oncology professionals and patient requests for cancer support services

ObjectiveTo examine the kinds of psychosocial support services that cancer patients most often request across a multidisciplinary sample of currently practicing U.S. oncological health care professionals (OHCPs) representative of a typical cancer care team.ParticipantsPrimary data collection. A randomly selected sample of 1,180 OHCPs (44% physicians, 24% nurses, 32% social workers) who were active members of their respective oncological associations completed a brief four-page mailed survey during the spring of 2001.MethodsCross-sectional, descriptive study. Descriptive statistics were computed for all study variables. ANOVA procedures were used to examine demographic difference between respondents and nonrespondents. Frequencies were calculated for patient inquires for cancer support services inquiries, and logistic regression was used to evaluate professional group differences on inquiries. Chi-square statistics were used to test for significant differences between professional groups.ResultsApproximately 94% of OHCPs were asked about cancer-related support services by their patients. Quantitative data indicated that information and education about cancer (72%), support groups (65%), and hospice referral (52%) were paramount among patient concerns. Qualitatively, comments about transportation, lodging during treatment, and alternative medicine reflected the general sentiment that basic needs and opportunities for options may still be unmet. Patient inquiries for services varied significantly by professional group (p <.001).ConclusionThis information reflects the need for a multidisciplinary perspective and will be useful for planning patient-based cancer education and support initiatives, refining existing programs, and targeting materials to specific oncological professionals.

Objective risk, subjective risk, and colorectal cancer screening among a clinic sample

Abstract Among cancers, colorectal (CRC) is the third most incident and the second most lethal. Although screening for the disease has been shown to be effective in reducing morbidity and mortality, screening rates remain low. Risk of disease has been shown to increase screening uptake, but different types of risk may influence intent to screen, screening in a timely manner, or participating in screening at all. A cross-sectional design was used to select a diverse sample of CRC asymptomatic patients 50 or more years of age (N = 104) visiting one of three Midwestern medical clinics. Results showed a positive relationship between receipt of CRC screening and planning to screen for CRC in the future. Objective risk factors (personal/family history and having a primary care physician) were associated with CRC screening uptake and screening within the time intervals recommended by professional screening guidelines, but subjective risk did not obtain significance for screening participation. Both objective (primary care physician) and subjective risk (long-term comparative risk, knowledge) were associated with future plans to screen. Findings suggest that CRC screening behaviors may be differentially influenced by type of risk.