Screening for fear of cancer recurrence : instrument validation and current status in early stage lung cancer patients

Background Fear of cancer recurrence (FCR) is one of the most distressing concerns for cancer patients. A psychometrically validated brief scale is urgently needed for use in busy clinical oncology settings. This study aimed to (1) develop and validate the 7-item fear of cancer recurrence scale Chinese version (FCR7-C), and (2) explore the severity of FCR in post-operative early-stage lung cancer patients in Taiwan. Methods Early-stage lung cancer patients were recruited from a medical center in Taiwan. The FCR7-C was evaluated for content and construct validity and internal consistency reliability. Construct validity of FCR7-C was determined by the empirically supported correlation and confirmatory factor analysis (CFA). Results A total of 160 subjects were recruited. The FCR7-C was shown to have satisfactory content validity and internal consistency reliability (Cronbach's α = 0.9). The uni-dimensional structure was confirmed by CFA that showed a good fit for the model. The FCR7-C score correlates positively with the degree of most of the physical symptoms, anxiety, and depression, but correlates negatively with patient age, performance status, and quality of life. We found that 81.9% of patients reported at least some FCR, with a mean FCR severity of 15.18 (SD = 7.78). Conclusion FCR7-C is a brief screening tool with good psychometrics. Patients with early-stage lung cancer still revealed mild to moderate level of FCR. Applying the FCR7-C for to screen cancer patients’ distress and further develop personalized psychological interventions would be strongly suggested.Publisher PDFPeer reviewe

Awareness and Attitudes toward Cancer Clinical Trials － Family Perspective

本研究目的是探討癌症病人家屬對臨床試驗的察覺度、看法及態度與相關影響因素。針對實質性癌症病人家屬進行問巻調查，於98年5月到6月期間在北臺灣某醫學中心進行收案，使用問巻測量工具包括：家屬對癌症臨床試驗的察覺度及看法問巻、家屬對隨機臨床試驗態度問巻、中文版疾病不確定感量表及厄運感信念量表，共計收案87位癌症病人家屬。究結果如下：聽過臨床試驗的癌症病人家屬，對臨床試驗有較正確的認識。癌症病人家屬對參與臨床試驗的認知態度偏正向。家屬不支持病人參與臨床試驗，主要前三項理由為：以抽籤的方式決定治療方法、對參與臨床試驗可能會發生的事說明較少及醫師對臨床試驗的興趣高於治療家人的疾病；而支持病人參與臨床試驗的前三項理由為：參與臨床試驗能得到較仔細的治療資訊、臨床試驗的新治療有很大機會可治癒癌症及治療的醫師是這個領域的專家，是家屬支持病人參與臨床試驗的主要原因。家屬不支持病人參與臨床試驗的因素為：病人生活功能狀況較佳（介於80-100間）、病人癌症期別較輕、本身參與意願低的家屬、家屬對支持病人參與臨床試驗認知態度偏負向、認為參與試驗造成不便性及較無利他想法者。癌症病人家屬照顧病人時間愈長，家屬對參與臨床試驗造成不便性的考量態度愈低，對支持病人參與臨床試驗的意願愈高。研究結果期望提供臨床試驗的相關醫護人員，瞭解癌症病人家屬對臨床試驗的察覺度、想法及態度，針對錯誤或偏見部份加以說明，以確保病人及家屬在正確認知下決定是否參與臨床試驗。The purpose of this study was to explore cancer patient families'' awareness、perception, attitude and influential factors for cancer clinical trial participation. A cross sectional survey was undertaken among cancer patient family. A total of 86 subjects were recruited from a medical center in Northern Taiwan. his result of study revealed solid cancer families had better awareness of clinical trial. Their attitudes toward clinical trial participation were more positive. The major reasons declining to participate in clinical trials were : treatment being selected at random、less said in what happens on the clinical trial、the doctor seems more interested in the clinical trial than treating patients. And the major reasons to participate in clinical trials were : more detailed information about their family treatment on clinical trial、treatment given in the clinical trial may had a great chance of cure、the doctor was an expert in the field. Family more impact from the negative aspects of clinical trial and significantly less willing to enroll trial were patients with less disease stage、better performance status,. hese finding of study might afford information about concern and prejudices for cancer clinical trial by families of cancer patient to clinical physicians, while enrolling these patients into clinical trials. These results might improved informing cancer patient and their family, and could also increase participation rate after realizing the purpose of clinical trial.口試委員會審定書 …………………………………………….………………. I謝 ……………………………………………………………….…………….… II文摘要 ……………………………………………………….…………….…. III文摘要…………………………………………………………….……………. IV錄………………………………………………………………….……………... V、表目錄………………………………………………………….…………... VIII壹章 緒論 1一節 研究動機 1二節 研究目的 3貳章 文獻查證 4一節 癌症臨床試驗 4、何謂臨床試驗 4、台灣臨床試驗發展的現況 5二節 家屬對癌症病人參與臨床試驗所扮演的角色 6三節 影響癌症病人參與臨床試驗意願的因素 7四節 家屬對癌症病人參與臨床試驗支持與否的影響因素 8參章 研究方法 10一節 研究架構 10二節　名詞界定 11三節 研究設計 12、研究場所及對象 12、選樣標準 12、樣本數 13四節 研究工具 14、癌症家屬背景特質 14、癌症病人背景特質 14、家屬對癌症臨床試驗的察覺度及看法量表 14、家屬對臨床試驗態度量表 14、中文版疾病不確定感量表 15、疾病厄運感信念量表 16五節 資料收集過程 18、測試階段 18、正式收案階段 18六節 資料統計及分析 19、描述性統計 19、推論性統計 19八節 倫理考量 20、自主原則 20、隱私原則 20、利益不傷害原則 20肆章 研究結果 21一節 癌症病人及家屬人口學特質 21、癌症病人背景特質 21、癌症病人家屬特質 22二節 癌症病人家屬對臨床試驗的察覺度、看法及態度 29、癌症家屬對臨床試驗察覺度與看法之現況 29、癌症病人家屬人口對參與臨床試驗態度之現況 30三節 影響癌症家屬支持病人參與臨床試驗的相關因素 38、家屬對參與臨床試驗支持度在不同人口學特質之分佈及影響 38、家屬對參與臨床試驗支持度在家屬對疾病不確定感及負向想法得分間之差異 38、家屬對參與臨床試驗支持度在對病人參與臨床試驗態度得分間之差異 38四節 影響癌症病人家屬對臨床試驗態度的因素 41、病人及家屬年齡、教育程度、診斷及照顧時間與試驗態度間之相關性 41、不確定感、負向認知與對臨床試驗態度間之相關性 41、家屬對臨床試驗態度在不同人口學特質間之得分差異 42、家屬對臨床試驗態度在不同察覺度間之得分差異 42伍章 討論 47一節 癌症家屬對臨床試驗察覺度看法 47、癌症家屬對臨床試驗察覺度 47、癌症家屬對臨床試驗的看法 49二節 癌症家屬對臨床試驗之態度及相關影響因素 50、癌症家屬對臨床試驗的態度及相關的影響因素 50陸章 結論、建議與限制 53一節 結論 53二節 護理上應用與建議 54三節 研究限制 55考文獻 56文文獻 56文文獻 57錄一　臺大醫院研究倫理委員會審查同意書 6

Bipartite patella associated with tophaceous invasion: A rare case report

We report the case of 32-year-old male who had a painful knee due to tophus formation in the interosseous area of the bipartite patella. There was neither a history of previous trauma to his patella nor a family history of gouty arthritis. Intraoperatively, we found chalky white-yellow material deposited at the bipartite space and it was curetted. The second part of the patella was fixed by a screw for functional preservation. In addition, hyperuricemia was also noted and controlled by uricosuric agents postoperatively. Gout should be included in the differential diagnosis of painful bipartite patella, and we suggest surgical intervention in combination with antihyperuricemic therapy for tophaceous deposits of the bipartite patella

阿里山溪集水區源頭崩塌機制之探討

本研究目的係以Strahler's 河川級序之概念劃定源頭集水區並探討其崩塌發生機制。利用數位地形模型及遙測影像處理技術，萃取樣區之地文水文資訊，藉由河道輸砂量與坡面泥砂產量之比值，建立源頭崩塌潛勢指標。結果顯示源頭崩塌潛勢指標可有效反映集水區源頭土砂堆積能量狀況，若逢極端事件來臨時，源頭崩塌潛勢較高之區位可能發生大規模土砂災害，可做為源頭集水區監測及管理之參考。This study focused on the mechanisms of landslides which occurred in the headwater watershed to establish the index of potential headwater landslides. The index of potential headwater landslide is defined as a ratio of the amount of channel sediment output to the slopeland sediment yield for a given storm event in the headwater watershed. The spatial distribution of headwater watershed was delineated in the interested watershed according to the rule of Strahler's stream order and a conceptual model (index of potential headwater landslide) is introduced to quantitatively measure the potential headwater landslide for the references of policy and decision making

Prophylactic Fixation of an Incomplete Subtrochanteric Femur Fracture Due to a Low-velocity Gunshot Injury: A Unique Case

We report on a 17-year-old man who underwent prophylactic fixation of the incomplete subtrochanteric femur fracture produced by a low-velocity gunshot. The subtrochanteric region is a high-stress site. Therefore, to avoid progression to complete fracture and displacement requiring secondary surgical stabilization, we used a proximal femoral nail for prophylactic fixation of the incomplete subtrochanteric femur fracture. The patient was able to walk and bear weight on the injured side immediately after surgery. At the 1-year follow-up, the patient was pain-free with a full range of motion of his right hip and had a bony union

Material characterizations and light/gas dual-sensing properties of ZnO nanorods incorporating buried carbon nanotube in the seed layer

In this study, ZnO nanorods (NRs) are grown on the ZnO seed layer incorporating carbon nanotubes (CNTs). Field emission scanning electron microscope (FESEM) and transmission electron microscope (TEM) images show that CNTs are well distributed in the seed layer. X-ray photoelectron spectra (XPS) reveal the enhancement of oxygen defect-related chemical bindings and photoluminescence (PL) spectra show the increase of defect-related PL intensity. The enhanced oxygen defects for ZnO NRs on CNT-incorporated seed layer improve the electron concentration and the conductivity after light/gas sensing; as a result, the light/gas dual-sensing behaviors for CNT-incorporated ZnO NRs sensor are boosted. Owing to steady response, simple fabrication, and compact size, light/gas dual-sensing chips with ZnO NRs on CNT-incorporated seed layer are promising for ultraviolet (UV) light and gas detection