Patient-reported outcome measures of the impact of cancer on patient’s everyday lives: a systematic review

Purpose: Patients with advanced disease are living longer and commonly used patient-reported outcome measures (PROMs) may miss relevant elements of the quality of extended survival. This systematic review examines the measures used to capture aspects of the quality of survival including impact on patients’ everyday lives such as finances, work and family roles. Methods: Searches were conducted in MEDLINE, EMBASE, CINAHL and PsycINFO restricted to English language articles. Information on study characteristics, instruments and outcomes was systematically extracted and synthesised. A predefined set of criteria was used to rate the quality of studies. Results: From 2761 potentially relevant articles, 22 met all inclusion criteria, including 10 concerning financial distress, 3 on roles and responsibilities and 9 on multiple aspects of social well-being. Generally, studies were not of high quality; many lacked bias free participant selection, had confounding factors and had not accounted for all participants. High levels of financial distress were reported and were associated with multiple demographic factors such as age and income. There were few reports concerned with impacts on patients’ roles/responsibilities in everyday life although practical and emotional struggles with parenting were identified. Social difficulties were common and associated with multiple factors including being a caregiver. Many studies were single time-point surveys and used non-validated measures. Exceptions were employment of the COST and Social Difficulties Inventory (SDI), validated measures of financial and social distress respectively. Conclusions: Impact on some important parts of patients’ everyday lives is insufficiently and inconsistently captured. Further PROM development focussing on roles and responsibilities, including work and caring for dependents, is warranted. Implications for Cancer Survivors: Factors such as finances, employment and responsibility for caring for dependents (e.g. children and elderly relatives) can affect the well-being of cancer survivors. There is a need to ensure that any instruments used to assess patients’ social well-being are broad enough to include these areas so that any difficulties arising can be better understood and appropriately supported

Second thoughts about implementing routine screening of cancer patients for distress

Recommendations for routine screening of cancer patients for distress lack evidence that screening improves patient outcomes. Settings contemplating screening should consider other options for using the same resources. This article reviews evidence relevant to decision making and calls attention to limits in using screening instruments cross-culturally and for triaging patients for receipt of services. Whether screening is the best option depends on the patient population, culture, and health system

Gender and Mathematics: Attitudes and stereotype threat susceptibility in Italian children

Two experiments investigated the development of attitudes toward mathematics and stereotype threat susceptibility in Italian children. Experiment 1 involved 476 elementary school boys and girls and produced evidence of gender differences in self-confidence in one's own mathematical ability and in gender stereotyping of mathematics during elementary school. It also provided initial evidence for a decrement in 10-year-old girls' mathematics performance when stereotype threat was made salient by reminding participants that extraordinary achievement in mathematics is typically a male phenomenon. Experiment 2 (N = 271) replicated these findings and expanded them to middle school-age participants. Its results suggest that during middle school, the patterns observed in elementary school consolidate, and the stereotypes begin to produce detrimental effects in girls

Differenze di genere in matematica e nelle carriere scientifiche in Italia: fatto, artefatto o credenza?

Il tema delle differenze di genere in matematica e nelle carriere scientifiche \ue8 complesso, controverso, rilevante ed attuale. Nel presente contributo ci si prefigge di affrontarlo, alla luce dei dati italiani, con il duplice scopo di (1) capire se queste differenze sono un fatto, una credenza o un artefatto; (2) confrontare la situazione italiana con quella degli altri Paesi occidentali. Il quadro che viene delineato stimola la riflessione e l\u2019intervento educativi e vocazionali anche in epoca molto precoce

Defining hospital anxiety and depression scale (HADS) structure by confirmatory factor analysis: a contribution to validation for oncological settings

Background: Despite its popularity, not a definitive word has yet been said about the latent structure of the Hospital Anxiety and Depression Scale (HADS). The present work is a contribution to this issue: statistically identifying the best tool structure helps in understanding which constructs the tool actually detects. Participants and methods: Five hundred and twelve Italian consecutive hospitalized cancer patients completed the HADS together with a form for the collection of personal and clinical data. Two confirmatory factor analyses (CFAs) were carried out to test the validity of both two- and one-factor models, whereas qualitative and quantitative (i.e. Akaike information criterion) indices were used to assess which model among them would fit better with the observed data. Finally, two multigroup CFAs were carried out to test the factorial invariance across gender and disease phase (diagnostic, therapeutic) of the best-fitting model. Results: Although both considered models provide a good fit to the observed data, the two-factor model is more adequate; it is invariant across gender and disease phase. Conclusions: The present study gives evidence for using HADS to detect anxious and depressive states separately as originally suggested by its authors. Given that this work involved only Italian cancer inpatients, replications in different cultural/national contexts are recommended