32 research outputs found
The "Palliative Care Quality of Life Instrument (PQLI)" in terminal cancer patients
BACKGROUND: This paper describes the development of a new quality of life instrument in advanced cancer patients receiving palliative care. METHODS: The Palliative Care Quality of Life Instrument incorporates six multi-item and one single-item scale. The questionnaire was completed at baseline and one-week after. The final sample consisted of 120 patients. RESULTS: The average time required to complete the questionnaire, in both time points, was approximately 8 minutes. All multi-item scales met the minimal standards for reliability (Cronbach's alpha coefficient ≥.70) either before or during palliative treatment. Test-retest reliability in terms of Spearman-rho coefficient was also satisfactory (p < 0.05). Validity was demonstrated by inter-item correlations, comparisons with ECOG performance status, factor analysis, criterion-related validation, and correlations with the Assessment of Quality of Life in Palliative Care Instrument (AQEL), and the European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30, version 3.0). CONCLUSION: The PQLI is a reliable and valid measure for the assessment of quality of life in patients with advanced stage cancer
Oral transmucosal fentanyl citrate in cancer pain management: a practical application of nanotechnology
Pain is experienced by most cancer patients and represents an important
issue in the clinical setting. Breakthrough pain is a transitory flare
of pain that occurs in most cancer patients on a background of otherwise
controlled persistent pain. Treatment of breakthrough pain is a
challenging phenomenon. Oral transmucosal fentanyl citrate (OTFC; Actiq
(R), Cephalon, UK), a new opioid formulation with a unique delivery
system, utilizing the advantages that nanotechnology offers, reflects
the characteristics of breakthrough pain (rapid onset of action and
short duration), which makes it an effective treatment to cancer
patients who are already receiving opioids and continue to experience
such flares of pain. Oral transmueosal fentanyl citrate is specifically
developed and approved for the management of breakthrough pain in cancer
patients and it has the potential to be a useful tool for clinicians
Psychometric properties of the impact of event scale in Greek cancer patients
To develop the Greek version of the Impact of E vent Scale-Revised
(IES-R-Gr), assess its Psychometric properties, and finally to examine
the impact of cancer diagnosis to a palliative care patient sample, the
IES-R was translated into Greek using the “forward-backward”
procedure. It was administered twice, at one-week intervals, to 82
eligible patients with advanced cancer. Together with the IES-R-Gr
scale, the patients also completed the Hospital Anxiety and Depression
(HAD) Scale. Reliability was assessed in terms of internal consistency
(Cronbach’s alpha coefficients) and test/retest (Spearman’s r value and
Kendall’s tau-b). Construct validity was demonstrated through
association with the HAD Scale, and convergence and discriminative
validity and interscale correlations were also assessed. The Greek
version of the IES-R had Cronbach’s alphas for the intrusion, avoidance,
and hyperarousal scales of 0.72, 0.77, and 0.85, respectively. Overall
test-retest reliability was satisfactory at P < 0.0005. Satisfactory
construct validity was supported by the correlation analysis between the
IES-R-Gr subscales and anxiety and depression. Factor analysis yielded
three factors, explaining 57.26% of the variance. Interscale and
interitem correlations were found satisfactory at P < 0.0005. These
results demonstrate that the IES-R-Gr is an instrument with satisfactory
psychometric properties and is a valid research tool for the impact of
cancer diagnosis in advanced cancer patients
The families evaluation on management, care and disclosure for terminal stage cancer patients
Abstract Background Quality of life is an important concept which is subjective and personal; what is an acceptable quality of life to one may be 'worse than death' to another. The objective of this study was to develop and validate a questionnaire to assess relatives' perceptions and attitudes towards their terminal stage cancer patients' management (information disclosure, treatment choice, hospitalization and support-communication and care) including aspects regarding end-of-life and quality-of-life decisions. Methods The final study consisted of 146 relatives of advanced terminal stage cancer patients receiving palliation, attending a Pain Relief and Palliative Care Unit. The questionnaire incorporated 6 multi-item and 7 single-item scales, and was developed following a systematic review of measures appropriate for use in palliative care settings. Results Following analysis of the 25-item scale, the questionnaire has been validated as a shortened 21-item scale consisting of 5 multi-item and 5 single-item scales. Factor analysis was based upon information disclosure, hospitalization, and support-communication demonstrating Cronbach's alpha coefficients of 0.66, 0.5 and 0.70 respectively. Average item totals and inter-item scale correlations were between 0.62–0.70, with convergent validity correlations between 0.60–0.86. The questionnaire was well accepted by all subjects with an 8–10 minute completion time. Conclusion The shortened 21-item self-assessment questionnaire may provide acceptable and valid assessment of caregiver(s)/Greek cancer patients' relatives perceptions on palliative care.</p
Psychological distress of patients with advanced cancer - Influence and contribution of pain severity and pain interference
The growing interest in the psychological distress and the
multidimensionality of pain in patients with cancer has been the major
reason for the conduction of this study. The aims we; re to evaluate
psychological distress and pain in patients with advanced cancer and the
impact of pain severity and pain interference dimensions on the anxiety
and depression. One hundred twenty patients with advanced cancer were
surveyed at a palliative care unit in Athens, Greece. Greek versions of
the Hospital Anxiety and Depression (G-HAD) scale and the Brief Pain
Inventory were administered. Information concerning patients’ treatment
received was acquired from the medical records, whereas physicians
recorded their clinical condition. The analysis showed that significant
associations were found between pain interference to “mood” and
HAD-A (anxiety) (r = 0.252, P =.005) and between pain interference to
“relations with other people” and HAD-A (r = 0.474, P <.0005).
Multiple regression analyses showed that “average pain” (P <.05),
pain interference’to “walking ability” (P <.05), “normal work”
(P <.05, and “relations with other people” are significant
predictors of HAD-anxiety (HAD-A) (P <.0005), explaining 46.2% of total
variance. For depression (HAD-D), the Greek version of the Brief Pain
Inventory dimension that serve as predictor is “enjoyment of life,”
as well as the demographic variables of “age,” and “gender” (P
<.05), explaining 22.2% of variance. Moreover, a further analysis of
the pain severity and pain interference scales showed that they
differentiate the anxiety of the patients with cancer. In this patient
sample, pain interference and, to a lesser extent, pain severity was
significantly associated with psychological distress (anxiety and pain),
whereas pain interference to “walking ability,” “normal work,”
and “relations with other people” was found to be more prominent and
troublesome to patients’ anxiety than that to patients’ depression
Personal growth and psychological distress in advanced breast cancer
Aims: the experience of posttraumatic growth following breast cancer,
its association with psychological distress and the predictive value of
psychological distress, sociodemographic and clinical characteristics of
cancer patients in their personal growth.
Methods: The Posttraumatic Growth Inventory and the Greek version of the
Hospital Depression and Anxiety Scale (G-HADS) were administered to 100
breast cancer patients. Sociodemographic and clinical characteristics
were recorded.
Results: The analysis showed that significant associations were found
between PTGI-Total patients’ age (p = 0.001), and being married (p =
0.007). Moreover, significant associations was observed between PTGI-II
(”New Possibilities”) and HADS-Depression (r = -0.314, p < 0.05).
Multiple regression analyses showed that age is a significant predictor
of PTGI-II (”New Possibilites”) (p = 0.005), PTGI-V
(”Apreciation of Life”) (p = 0.0005) and PTGI-Total (p = 0.037),
while marital status is a significant predictor of PTGI-Total (p =
0.009).
Conclusion: Specific patients’ characteristics, such as young age and
being with a partner with a partner, influence the experience of
posttraumatic growth in breast cancer patients. (c) 2008 Elsevier Ltd.
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