Dirk Hofmeister

Age- and sex-standardised prevalence rates of fatigue in a large hospital-based sample of cancer patients

Background:The aim of this longitudinal study was to determine age- and sex-standardised prevalence rates of cancer-related fatigue in different groups of patients.Methods:This was a prospective study in a cohort of N=1494 cancer patients investigating fatigue at three time points t1–t3 (t1: admission to hospital, t2: discharge, t3: half a year after t1). Fatigue was measured with the Multidimensional Fatigue Inventory. Age- and sex-adjusted norms were derived from a representative community sample of N=2037, using a cutoff at the 75th percentile.Results:At admission to the hospital, 32% of the patients were classified as fatigued. At discharge, the overall prevalence rate was 40%, and at half a year after t1, prevalence was 34%. Fatigue prevalence rates differed according to tumour stage, site, age, and sex of the patients.Conclusion:The prevalence rates provided by this study can be used for the planning of research and clinical routine.

The prevalence of depressive symptomatology in the german elderly population and the impact of methodical aspects on the identified prevalence

OBJECTIVES The issue of whether depression increases or decreases with age remains unclear. Methodical aspects play an important role in the research on depression in the elderly. METHODS In a representative survey of the German general population aged 50 years and older (n = 1.156) depressive symptomatology was assessed using the CES-D and the PHQ-2, generalized anxiety (GA) was assessed using the GAD-7. RESULTS According the CES-D 15.9 % and according to the PHQ-2 9.6 % of the population under study are classified as depressed. Prevalence rates increase with increasing age, but only few age groups show significant differences. The CES-D reveals higher prevalence rates than the PHQ-2. Nevertheless depending on the age group 3.6-7.8 % of the sample exclusively identified by the PHQ-2, and 9.0-14.9 % of the sample are exclusively identified by the CES-D. 4.8 (50-59 yrs.) to 10.3 % (80+ yrs.) report a moderate symptomatology of GA. GA is highly comorbid with depressive symptomatology. CONCLUSIONS The prevalence rates in our study are consistent with previous findings of other studies. Moreover our study underpins the importance of methodical aspects for the prevalence rates identified.AbstractThe Prevalence of Depressive Symptomatologyin the German Elderly Population and the Impactof Methodical Aspects on the Identified Prevalence ! Objectives The issue of whether depression increases or de-creaseswith ageremains unclear. Methodicalaspectsplayanim-portant role in the research on depression in the elderly.Methods In a representative surveyof the German general pop-ulationaged50yearsandolder(n=1.156)depressivesymptoma-tology was assessed using the CES-D and the PHQ-2, generalizedanxiety (GA) was assessed using the GAD-7.Results According the CES-D 15.9% and according to the PHQ-29.6% of the population under study are classified as depressed.Prevalence rates increase with increasing age, but only few agegroups show significant differences. The CES-D reveals higherprevalence rates than the PHQ-2. Nevertheless depending on theage group 3.6–7.8% of the sample exclusively identified by thePHQ-2, and 9.0–14.9% of the sample are exclusively identifiedby the CES-D. 4.8 (50–59 yrs.) to 10.3% (80+ yrs.) report a mod-eratesymptomatologyof GA. GA ishighlycomorbidwith depres-sive symptomatology.Conclusions The prevalence rates in our study are consistentwith previous findings of other studies. Moreover our study un-derpins the importance of methodical aspects for the prevalencerates identified.

Measuring quality of life in patients with head and neck cancer: Update of the EORTC QLQ-H&N Module, Phase III.

The objective of this study was to pilot test an updated version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ‐H&N60).

Quality of life in patients with head and neck cancer receiving targeted or multimodal therapy - Update of the EORTC QLQ-H&N35, Phase i

The objective of this study was to identify relevant quality of life (QOL) issues in patients with head and neck cancer receiving multimodal and/or targeted therapies.

International Psychometric Validation of an EORTC Quality of Life Module Measuring Cancer Related Fatigue (EORTC QLQ-FA12)

Background The European Organisation for Research and Treatment of Cancer (EORTC) Group has developed a new multidimensional instrument measuring cancer-related fatigue to be used in conjunction with the quality of life core questionnaire (EORTC QLQ-C30). The module EORTC QLQ-FA13 assesses physical, cognitive, and emotional aspects of cancer-related fatigue. Methods The methodology follows the EORTC guidelines for phase IV validation of modules. This paper focuses on the results of the psychometric validation of the factorial structure of the module. For validation and cross-validation confirmatory factor analysis (maximum likelihood estimation), intraclass correlation and Cronbach alpha for internal consistency were employed. The study involved an international multicenter collaboration of 11 European and non-European countries. Results A total of 946 patients with various tumor diagnoses were enrolled. Based on the confirmatory factor analysis, we could approve the three-dimensional structure of the module. Removing one item and reassigning the factorial mapping of another item resulted in the EORTC QLQ-FA12. For the revised scale, we found evidence supporting good local (indicator reliability ≥ 0.60, factor reliability ≥ 0.82) and global model fit (GFI t1|t2 = 0.965/0.957, CFI t1|t2 = 0.976/0.972, RMSEA t1|t2 = 0.060/0.069) for both measurement points. For each scale, test-retest reliability proved to be very good (intraclass correlation: R t1-t2 = 0.905-0.921) and internal consistency proved to be good to high (Cronbach alpha = .79-.90). Conclusion Based on the former phase III module, the multidimensional structure was revised as a phase IV module (EORTC FA12) with an improved scale structure. For a comprehensive validation of the EORTC FA12, further aspects of convergent and divergent validity as well as sensitivity to change should be determined.

Psychometrische Überprüfung einer Kurzform des Narcissistic Personality Inventory (NPI-15): Dimensionalität und psychometrische Eigenschaften des NPI-15 in einer repräsentativen Bevölkerungsstichprobe

The Narcissistic Personality Inventory (NPI) is a commonly used measure of narcissism. This study administered a 15 item short version of the NPI (NPI-15). Central aims of the present study were to examine its dimensionality, and to provide data on its psychometric properties. NPI-15 and Hospital Anxiety and Depression Scale (HADS-D) were assessed in a representative sample of the German population (N=2,512). According to Scree-plot and model fit, a solution with 2 or 3 factors seemed feasible. Because of factor loadings and item-level associations to depression/anxiety we decided to favour a 2-factor-solution. 2 subscales reflecting different facets of narcissism were compiled (leadership ability/personality [LA/LP], grandiosity [G]). The psychometric properties of these scales were good (LA/LP) respectively unsatisfactory (G). The validity of the NPI-15 needs to be further studied.

Quality-of-life priorities in patients with thyroid cancer: A multinational european organisation for research and treatment of cancer phase I study

Background: The objectives of this study were to determine quality of life (QoL) issues that are relevant to thyroid cancer patients cross-culturally, and to identify those with highest relevance to them in addition to the more general issues covered by the core European Organisation for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30). Methods: A systematic literature search provided a list of potentially relevant QoL issues to supplement the core questionnaire EORTC QLQ-C30, which is widely used in research and in care and addresses QoL issues relevant to all groups of cancer patients. A panel of experts revised this list, and thyroid cancer patients rated the issues regarding their relevance for QoL by selecting the 25 issues that they would include in a thyroid cancer–specific QoL module. Results: The literature search and expert discussion provided a list of 71 QoL issues that was rated by thyroid cancer patients (n = 110) from seven countries. All issues were of high priority to at...1. Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany 2. CoRPS – Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands 3. Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland 4. Head & Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy 5. Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan 6. Department of Medical Psychology and Medical Sociology, University Medical Centre, Leipzig, Germany 7. Mount Vernon Hospital, Northwood, London, UK 8. Service of Surgical Oncology, Instituto Português do Oncologia do Porto Francisco Gentil, Portugal 9. Department of Nuclear Medicine and Department of Psychiatry and Psychotherapy, Medical University of Innsbruck, Austria 10. European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Translation Unit, Brussels, Belgium 11. National Association of Thyroid Cancer Patients “Bundesverband Schilddrüsenkrebs Ohne Schilddrüse leben e.V.”, Berlin, Germany 12. Surgery Department, Jules Bordet Institute, Brussels, Belgium

EORTC QLQ-COMU26: a questionnaire for the assessment of communication between patients and professionals. Phase III of the module development in ten countries

PurposeCommunication between patients and professionals is one major aspect of the support offered to cancer patients. The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group (QLG) has developed a cancer-specific instrument for the measurement of different issues related to the communication between cancer patients and their health care professionals.MethodsQuestionnaire development followed the EORTC QLG Module Development Guidelines. A provisional questionnaire was pre-tested (phase III) in a multicenter study within ten countries from five cultural areas (Northern and South Europe, UK, Poland and Taiwan). Patients from seven subgroups (before, during and after treatment, for localized and advanced disease each, plus palliative patients) were recruited. Structured interviews were conducted. Qualitative and quantitative analyses have been performed.ResultsOne hundred forty patients were interviewed. Nine items were deleted and one shortened. Patients’ comments had a key role in item selection. No item was deleted due to just quantitative criteria. Consistency was observed in patients’ answers across cultural areas. The revised version of the module EORTC QLQ-COMU26 has 26 items, organized in 6 scales and 4 individual items.ConclusionsThe EORTC COMU26 questionnaire can be used in daily clinical practice and research, in various patient groups from different cultures. The next step will be an international field test with a large heterogeneous group of cancer patients.

La comunicación entre el paciente oncológico y los profesionales. El cuestionario de comunicación de la EORTC

The aims of the present work are to introduce to the field of communication between the cancer patient and the professionals, to remark the positive influence communication may have on the patient, and to present the EORTC communication questionnaire. Communication between patient and professional is a key element in the support that is offered to cancer patients. It is important to consider different professionals communicate with cancer patients. There is a need of research in communication between patients and professionals. Two main models of patient care are presented: Paternalistic and Patient-Centered Cancer Care. Patient-Centered Care includes Patient- Centered Communication - PCC. The relation between communication and other PROs - Quality of Life, Information and Satisfaction with Care - is presented. There are cross-cultural differences in communication that could be related to the model of patient care. The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group is developing a questionnaire to assess communication between cancer patient and the professionals. This Communication questionnaire mainly assesses professionals’ behaviors. Cultural aspects have a key role in the development of the EORTC questionnaire. This instrument is based on the Patient- Centered Communication – PCC model. The EORTC QLQ-COMU26 is presented. It includes six scales and four individual items. The three phases of the questionnaire development process are described. At the present moment the EORTC QLQ-COMU26 is being field-tested in a larger international study (phase IV), to ensure it is an appropriate and psychometrically valid instrument.

Quality of life priorities in patients with thyroid cancer - a multi-national EORTC phase I study.

Background: The objectives of this study were to determine quality of life (QoL) issues that are relevant to thyroid cancer patients cross-culturally, and to identify those with highest relevance to them in addition to the more general issues covered by the core European Organisation for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30). Methods: A systematic literature search provided a list of potentially relevant QoL issues to supplement the core questionnaire EORTC QLQ-C30, which is widely used in research and in care and addresses QoL issues relevant to all groups of cancer patients. A panel of experts revised this list, and thyroid cancer patients rated the issues regarding their relevance for QoL by selecting the 25 issues that they would include in a thyroid cancer–specific QoL module. Results: The literature search and expert discussion provided a list of 71 QoL issues that was rated by thyroid cancer patients (n = 110) from seven countries. All issues were of high priority to at...1. Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany 2. CoRPS – Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands 3. Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland 4. Head & Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy 5. Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan 6. Department of Medical Psychology and Medical Sociology, University Medical Centre, Leipzig, Germany 7. Mount Vernon Hospital, Northwood, London, UK 8. Service of Surgical Oncology, Instituto Português do Oncologia do Porto Francisco Gentil, Portugal 9. Department of Nuclear Medicine and Department of Psychiatry and Psychotherapy, Medical University of Innsbruck, Austria 10. European Organisation for Research and Treatment of Cancer (EORTC) Headquarters, Translation Unit, Brussels, Belgium 11. National Association of Thyroid Cancer Patients “Bundesverband Schilddrüsenkrebs Ohne Schilddrüse leben e.V.”, Berlin, Germany 12. Surgery Department, Jules Bordet Institute, Brussels, Belgium