Jin Ah Sim

Association between information provision and decisional conflict in cancer patients

BACKGROUNDnIn this study, we aimed to identify demographic and clinical variables that correlate with perceived information provision among cancer patients and determine the association of information provision with decisional conflict (DC).nnnPATIENTS AND METHODSnWe enrolled a total of 625 patients with cancer from two Korean hospitals in 2012. We used the European Organization for Research and Treatment of Cancer (EORTC) quality-of-life questionnaire (QLQ-INFO26) to assess patients perception of the information received from their doctors and the Decisional Conflict Scale (DCS) to assess DC. To identify predictive sociodemographic and clinical variables for adequate information provision, backward selective logistic regression analyses were conducted. In addition, adjusted multivariate logistic regression analyses were carried out to identify clinically meaningful differences of perceived level of information subscales associated with high DC.nnnRESULTSnMore than half of patients with cancer showed insufficient satisfaction with medical information about disease (56%), treatment (73%), other services (83%), and global score (80%). In multiple logistic regression analyses, lower income and education, female, unmarried status, type of cancer with good prognosis, and early stage of treatment process were associated with patients perception of inadequate information provision. In addition, Information about the medical tests with high DCS values clarity [adjusted odds ratio (aOR), 0.54; 95% confidence interval (CI) 0.30-0.97] and support (aOR, 0.53; 95% CI 0.33-0.85) showed negative significance. For inadequate information perception about treatments and other services, all 5 DCS scales (uncertainty, informed, values clarity, support, and effective decision) were negatively related. Global score of inadequate information provision also showed negative association with high DCS effective decision (aOR, 0.43; 95% CI 0.26-0.71) and DCS uncertainty (aOR, 0.46; 95% CI 0.27-0.77).nnnCONCLUSIONnThis study found that inadequate levels of perceived information correlated with several demographic and clinical characteristics. In addition, sufficient perceived information levels may be related to low levels of DC.

The association of self-leadership, health behaviors, and posttraumatic growth with health-related quality of life in patients with cancer.

We tried to evaluate the association of self‐leadership, effective health behaviors, and posttraumatic growth with health‐related quality of life (HRQOL).

Health-Related Quality of Life and Sociodemographic Characteristics as Prognostic Indicators of Long-term Survival in Disease-Free Cervical Cancer Survivors:

Objectives Health-related quality-of-life (HRQOL) issues of cancer patients are considered an important clinical outcome. We aimed to investigate the prognostic value of HRQOL on long-term survival outcomes in disease-free cervical cancer survivors (CCSs). Methods The study sample consisted of 860 disease-free CCSs from 6 Korean cancer hospitals recruited for HRQOL survey during 2005 (median time from diagnosis, 5.9 years). Health-related quality-of-life measures included the European Organization for Research and Treatment of Cancer QLQ-C30 and its Cervical Cancer Module (CX24). Survival data were retrieved from the Korean Statistical Office after 6 years from the survey. Health-related quality-of-life domains along with sociodemographic and clinicopathologic variables were analyzed as prognostic factors for survival from the date of survey. Results During the median follow-up period of 6.3 years after the survey, 30 (3.5%) patients died from all causes. Age, time since diagnosis, and physical activity were independent prognostic factors, which constituted the baseline model along with cancer stage. When HRQOL domains were tested separately against the baseline model, functional scales (physical, role, social, and emotional functioning), global health status, symptom scales (pain and appetite loss), and cervical cancer module items (body image, sexual inactivity, and sexual worry) were significantly associated with survival (P < 0.05). Conclusions These findings suggest that, in addition to well-known prognostic factors, including age, time since diagnosis, and physical activity, HRQOL scores obtained from disease-free CCSs are associated with survival.

Prognostic value of quality of life score in disease-free survivors of surgically-treated lung cancer

BackgroundWe aimed to evaluate the prognostic value of quality of life (QOL) for predicting survival among disease-free survivors of surgically-treated lung cancer after the completion of cancer treatment.MethodsWe administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), the Quality of Life Questionnaire Lung Cancer Module (QLQ-LC13), Hospital Anxiety and Depression Scale (HADS), and Posttraumatic Growth Inventory (PTGI) to 809 survivors who were surgically-treated for lung cancer at two hospitals from 2001 through 2006. We gathered mortality data by linkage to the National Statistical Office through December 2011. We used Cox proportional hazard models to compute adjusted hazard ratios (aHRs) and 95xa0% confidence intervals (CIs) to estimate the relationship between QOL and survival.ResultsAnalyses of QOL items adjusted for age, sex, stage, body mass index, and physical activity showed that scores for poor physical functioning, dyspnea, anorexia, diarrhea, cough, personal strength, anxiety, and depression were associated with poor survival. With adjustment for the independent indicators of survival, final multiple proportional hazard regression analyses of QOL show that physical functioning (aHR, 2.39; 95xa0% CI, 1.13–5.07), dyspnea (aHR, 1.56; 95xa0% CI, 1.01–2.40), personal strength (aHR, 2.36; 95xa0% CI, 1.31–4.27), and anxiety (aHR, 2.13; 95xa0% CI, 1.38–3.30) retained their independent prognostic power of survival.ConclusionThis study suggests that patient-reported QOL outcomes in disease-free survivors of surgically-treated lung cancer after the completion of active treatment has independent prognostic value for long-term survival.

Patient‐reported assessment of self‐management strategies of health in cancer patients: development and validation of the Smart Management Strategy for Health Assessment Tool (SAT)

The objective of this study was to evaluate the psychometric properties of the Smart Management Strategy for Health Assessment Tool (SAT), which we developed to enable cancer patients to assess their self‐management (SM) strategies of health by themselves.

A randomized controlled trial of physical activity, dietary habit, and distress management with the Leadership and Coaching for Health (LEACH) program for disease-free cancer survivors

BackgroundWe aimed to evaluate the potential benefits of the Leadership and Coaching for Health (LEACH) program on physical activity (PA), dietary habits, and distress management in cancer survivors.MethodsWe randomly assigned 248 cancer survivors with an allocation ratio of two-to-one to the LEACH program (LP) group, coached by long-term survivors, or the usual care (UC) group. At baseline, 3, 6, and 12xa0months, we used PA scores, the intake of vegetables and fruits (VF), and the Post Traumatic Growth Inventory (PTGI) as primary outcomes and, for secondary outcomes, the Ten Rules for Highly Effective Health Behavior adhered to and quality of life (QOL), the Hospital Anxiety and Depression Scale (HADS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).ResultsFor primary outcomes, the two groups did not significantly differ in PA scores or VF intake but differed marginally in PTGI. For secondary outcomes, the LP group showed a significantly greater improvement in the HADS anxiety score, the social functioning score, and the appetite loss and financial difficulties scores of the EORTC QLQ-C30 scales from baseline to 3xa0months. From baseline to 12xa0months, the LP group showed a significantly greater decrease in the EORTC QLQ-C30 fatigue score and a significantly greater increase in the number of the Ten Rules for Highly Effective Health Behavior.ConclusionOur findings indicate that the LEACH program, coached by long-term survivors, can provide effective management of the QOL of cancer survivors but not of their PA or dietary habits.Trial registrationClinical trial information can be found for the following: NCT01527409 (the date when the trial was registered: February 2012).

Development and Validity Testing of the Worksite Health Index: An Assessment Tool to Help and Improve Korean Employees' Health-Related Outcome.

Objectives: The objective of this study was to develop the Worksite Health Index (WHI) and validate its psychometric properties. Methods: The development of the WHI questionnaire included item generation, item construction, and field testing. To assess the instruments reliability and validity, we recruited 30 different Korean worksites. Results: We developed the WHI questionnaire of 136 items categorized into five domains, namely Governance and Infrastructure, Need Assessment and Planning, Health Prevention and Promotion Program, Occupational Safety, and Monitoring and Feedback. All WHI domains demonstrated a high reliability with good internal consistency. The total WHI scores differentiated worksite groups effectively according to firm size. Each domain was associated significantly with employees’ health status, absence, and financial outcome. Conclusions: The WHI can assess comprehensive worksite health programs. This tool is publicly available for addressing the growing need for worksite health programs.

Perceived needs for the information communication technology (ICT)-based personalized health management program, and its association with information provision, health-related quality of life (HRQOL), and decisional conflict in cancer patients

The use of information communication technology (ICT)–based tailored health management program can have significant health impacts for cancer patients. Information provision, health‐related quality of life (HRQOL), and decision conflicts were analyzed for their relationship with need for an ICT‐based personalized health management program in Korean cancer survivors.

Serial intermediate-term quality of life comparison after endoscopic submucosal dissection versus surgery in early gastric cancer patients

BackgroundEndoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is expected to provide better long-term health-related quality of life (HRQOL) by preserving the entire stomach. We aimed to compare serial changes in HRQOL characteristics between patients who underwent ESD versus surgery for EGC.MethodsA gastric cancer patient cohort was prospectively enrolled from 2004 to 2007. HRQOL of 161 EGC patients was prospectively assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC-QLQ-C30) and the stomach cancer-specific module EORTC-QLQ-STO22 at baseline (i.e., diagnosis) and at 1, 6, 12, 18, and 24xa0months of post-treatment.ResultsOf 161 patients, 48 (29.8%) underwent ESD and 113 (70.2%) underwent surgery. HRQOL parameters of ESD patients were similar to or better than baseline values. At 1-month post-treatment, the surgery group had significantly poorer scores than the ESD group (Pu2009<u20090.05) for factors except emotional and cognitive functioning, financial problems, anxiety, and hair loss. However, most of the HRQOL parameters in the surgery group improved during the first post-treatment year, with between-group differences becoming insignificant. Only five parameters (physical functioning, eating restriction, dysphagia, diarrhea, and body image) remained significantly better in the ESD group than the surgery group for >u20091-year post-treatment (Pu2009<u20090.05). The surgery group had significantly higher treatment-associated complications than the ESD group (15.0 vs. 2.1%; Pu2009=u20090.017). The overall survival was not different between the both groups (5-year overall survival rates, 97.7% in the ESD group vs. 99.1% in the surgery group; Pu2009=u20090.106 by the log-rank test).ConclusionCompared with surgery, ESD can provide better HRQOL benefits for EGC patients, especially during the early post-treatment period. However, surgical treatment should not be rejected only due to the concern about HRQOL impairments because most of them improved during follow-up periods.

Development and validation of the smart management strategy for health assessment tool-short form (SAT-SF) in cancer survivors

PurposeThe aim of this study was to develop and validate a short form (SF) of the Smart Management Strategy for Health Assessment Tool (SAT) for cancer patients.MethodsData for item reduction were derived from cancer patient data (nu2009=u2009300) previously used to develop the original SAT. We used regression methods to select and score the new SAT-SF. To assess the instrument’s reliability and validity, we recruited another 354 cancer patients from the same hospitals who were older than 18xa0years and accustomed to using the web. All results were compared with that of the long-form SAT (original SAT).ResultsThe SAT-SF used is the shorter version, a 30-item (from the original 91-item) instrument, to measure cancer patient’s health. The 30-item SAT-SF explained 97.7% of total variance of the full 91-item long-form SAT. All SAT-SF subscales demonstrated a high reliability with good internal consistency compared with the original SAT. The total short-form scores of the three SAT sets (SAT-Core, SAT-Preparation, SAT-Implementation) differentiated participant groups according to their stage of goal implementation and percentage of actions taken in the 10 Rules for Highly Effective Health Behavior. We found acceptable correlations between the three SAT-SF sets and the additional assessment tools compared with the original SAT.ConclusionsThe 30-item SAT-SF had a satisfactory internal consistency and validity for cancer patients with minimal loss of information compared with the original SAT.