Christine Rotonda

Validation of the French version of the colorectal-specific quality-of-life questionnaires EORTC QLQ-CR38 and FACT-C

BackgroundThe aim of this study was to test the psychometric properties of the French version of the European Organization for Research and Treatment (EORTC) quality-of-life colorectal questionnaire (QLQ-CR38) and the functional assessment of cancer therapy-colorectal version 4 (FACT-C).MethodThis prospective study included 209 patients with colorectal cancer: 71 undergoing chemotherapy, 56 radiation, 15 surgery, and 67 survivors. Patients first completed in random order the FACT-C and the EORTC QLQ-CR38 and were asked if they had any preference for either questionnaire. The timing of administration of instruments differed according to patients’ treatment to better assess psychometric properties.ResultsThe FACT-C showed good acceptability, good reproducibility and excellent internal consistency. The QLQ-CR38 had lower internal consistency. Patients did not express a preference for one survey over another.ConclusionThis study confirms the value of the FACT-C and suggests some limits of the QLQ-CR38 for patients with colorectal cancer.

Factors Associated With Fatigue After Surgery in Women With Early-Stage Invasive Breast Cancer

PURPOSEnFatigue is one of the most frequent symptoms in patients with cancer. However, the precise determinants of fatigue are still unknown. This study was conducted to investigate factors correlated with cancer-related fatigue before surgery and just before subsequent adjuvant therapy.nnnMETHODSnPatients completed the Multidimensional Fatigue Inventory (MFI-20), the European Organization for Research and Treatment of Cancer 30-item quality-of-life questionnaire before and after surgery, the Trait Anxiety Inventory and the Life Orientation Test before surgery, and the State Anxiety Inventory before the start of adjuvant therapy. Multiple regression analysis of determinants of change in MFI-20 total score after surgery was conducted.nnnRESULTSnA series of 466 eligible patients with stage I-III breast cancer with planned surgery were recruited. An increase in MFI-20 total score after surgery was significantly correlated with higher preoperative fatigue and lower role functioning before surgery; a decrease in role functioning, physical functioning, and cognitive functioning after surgery; an increase in insomnia after surgery; and a higher state anxiety after surgery. Disease stage, lymph node metastases, surgical procedure, and demographic characteristics (e.g., age, marital status, having children, educational level) were not correlated with fatigue in multivariate analysis.nnnCONCLUSIONnThese results suggest that worsening fatigue after surgery for breast cancer is associated with a decrease in physical functioning and an increase in psychological distress rather than with the cancer characteristics. Therefore, screening measures should be implemented at the time of diagnosis-before starting treatment-to identify psychologically vulnerable patients and to offer them professional support.

Early Psychological Preventive Intervention For Workplace Violence: A Randomized Controlled Explorative and Comparative Study Between EMDR-Recent Event and Critical Incident Stress Debriefing

This randomized controlled trial study aims to investigate the efficacy of an early psychological intervention called EMDR-RE compared to Critical Incident Stress Debriefing on 60 victims of workplace violence, which were divided into three groups: ‘EMDR-RE’ (n = 19), ‘CISD’ (n = 23), and ‘delayed EMDR-RE’ (n = 18). EMDR-RE and CISD took place 48 hours after the event, whilst third intervention was delayed by an additional 48 hours. Results showed that after 3 months PCLS and SUDS scores were significantly lower with EMDR-RE and delayed EMDR-RE compared to CISD. After 48 hours and 3 months, none of the EMDR-RE-treated victims showed PTSD symptoms.

The impact of physical activity on fatigue and quality of life during and after adjuvant treatment for breast cancer: Physical Activity and Breast Cancer

Although physical activity (PA) can alleviate fatigue and improve quality of life (QoL) in patients with breast cancer (BC), not all domains of PA may have equal impact. The objective of the current study was to examine the longitudinal impact of PA components on the evolution of fatigue and QoL during and after adjuvant treatment for BC.

Can the e-OAKHQOL be an alternative to measure health-related quality of life in knee osteoarthritis?

ObjectiveTo assess the validity of the e-OAKHQOL questionnaire and analyze whether the answers were affected by the form of administration (electronic vs. paper).MethodsTwo samples of patients with knee osteoarthritis were constituted. The first was recruited by general practitioners. Patients could choose to respond to the electronic or paper version. The second included subjects who responded to the paper version and were matched with respondents to the electronic version in the first sample. The OAKHQOL questionnaire measures health-related quality of life in five dimensions (43 items): physical activity, mental health, pain, social functioning, and social support. Validity was assessed by the classical test theory (CTT) and a Rasch measurement model (partial credit model).ResultsThe electronic form was preferred by 471 (89.7%) patients: 345 were matched to respondents of the paper version. The percentage of missing responses was lower with the electronic than paper form (1.6 vs. 2.0%, pu2009=u2009.01). Rasch analysis revealed four items with underfitting. Internal consistency was excellent for physical activity (PSIu2009=u20090.96) and mental health (PSIu2009=u20090.93) but was slightly <u20090.85 for the other dimensions. The top–down purification highlighted the significance of DIF by gender in the pain dimension and by form of questionnaire in the mental health dimension.ConclusionCTT and Rasch analysis demonstrated acceptable measurement properties for the five dimensions of the e-OAKHQOL, so it may be a valuable alternative to the paper form for measuring HRQoL.

Qualitative Methods Used to Generate Questionnaire Items: A Systematic Review:

A systematic review of articles using qualitative methods to generate questionnaire items identified in MEDLINE and PsycINFO from 2000 to 2014 was carried out. Articles were analyzed for (a) year of publication and journal domain, (b) qualitative data collection methods, (c) method of data content analysis, (d) professional experts’ input in item generation, and (e) debriefing of the newly developed items. In total, 371 articles were included and results showed (a) an acceleration of published articles, (b) individual interviews and focus groups were common ways of generating items and no emergent approach was identified, (c) the content analysis was usually not described (43% of articles), (d) experts were involved in eliciting concepts in less than a third of articles, (e) 61% of articles involved a step of further submission of newly developed items to the population of interest. This review showed an insufficient reporting of qualitative methods used to generate new questionnaires despite previous recommendations.

Identifying patterns of adaptation in breast cancer patients with cancer-related fatigue using response shift analyses at subgroup level

Fatigue is the most prevalent symptom in breast cancer. It might be perceived differently among patients over time as a consequence of the differing patients’ adaptation and psychological adjustment to their cancer experience which can be related to response shift (RS). RS analyses can provide important insights on patients’ adaptation to cancer but it is usually assumed that RS occurs in the same way in all individuals which is unrealistic. This study aimed to identify patients’ subgroups in which different RS effects on self‐reported fatigue could occur over time using a combination of methods for manifest and latent variables. The FATSEIN study comprised 466 breast cancer patients followed over a 2‐year period. Fatigue was measured with the Multidimensional Fatigue Inventory questionnaire (MFI‐20) during 10 visits. A novel combination of Mixed Models, Growth Mixture Modeling, and Structural Equation Modeling was used to assess the occurrence of RS in fatigue changes to identify subgroups displaying different RS patterns over time. An increase in fatigue was evidenced over the 8‐month follow‐up, followed by a decrease between the 8‐ and 24‐month. Four latent classes of patients were identified. Different RS patterns were detected in all latent classes between the inclusion and 8 months (last cycle of chemotherapy). No RS was evidenced between 8‐ and 24‐month. Several RS effects were evidenced in different groups of patients. Women seemed to adapt differently to their treatment and breast cancer experience possibly indicating differing needs for medical/psychological support.