Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the VSP-A (Vécu et Santé Perçue de l'Adolescent), a health-related quality of life (HRQoL) instrument for adolescents, in a healthy Brazilian population

<p>Abstract</p> <p>Background</p> <p>Health-related quality of life (HRQoL) assessment, encompassing the adolescents' perceptions of their mental, physical, and social health and well-being is increasingly considered an important outcome to be used to identify population health needs and to provide targeted medical care. Although validated instruments are essential for accurately assessing HRQoL outcomes, there are few cross-culturally adapted tools for use in Brazil, and none designed exclusively for use among adolescents. The Vécu et Santé Perçue de l'Adolescent (VSP-A) is a generic, multidimensional self-reported instrument originally developed and validated in France that evaluates HRQoL of ill and healthy adolescents.</p> <p>Purpose</p> <p>To cross-culturally adapt and validate the Brazilian-Portuguese version of the VSP-A, a generic HRQoL measure for adolescents originally developed in France.</p> <p>Methods</p> <p>The VSP-A was translated following a well-validated forward-backward process leading to the Brazilian version. The psychometric evaluation was conducted in a sample of 446 adolescents (14-18 years) attending 2 public high schools of São Gonçalo City. The adolescents self-reported the Brazilian VSP-A, the validated Psychosomatic Symptom Checklist and socio-demographic information. A retest evaluation was carried out on a sub-sample (n = 195) at a two-week interval.</p> <p>The internal construct validity was assessed through confirmatory factor analysis (CFA), multi-trait scaling analyses, Rasch analysis evaluating unidimensionality of each scale and Cronbach's alpha coefficients. The reproducibility was evaluated by intra-class correlation coefficients (ICC). Zumbo's ordinal logistic regression analysis was used to detect differential item functioning (DIF) between the Brazilian and the French items. External construct validity was investigated testing expected differences between groups using one-way analysis of variance (ANOVA), Mann-Whitney tests and the univariate general regression linear model.</p> <p>Results</p> <p>CFA showed an acceptable fit (RMSEA=0.05; CFI=0.93); 94% of scaling success was found for item-internal consistency and 98% for item discriminant validity. The items showed good fit to the Rasch model except 3 items with an INFIT at the upper threshold. Cronbach's Alpha ranged from 0.60 to 0.85. Test-retest reliability was moderate to good (ICC=0.55-0.82). DIF was evidenced in 4 out of 36 items. Expected patterns of differences were confirmed with significantly lower physical, psychological well being and vitality reported by symptomatic adolescents.</p> <p>Conclusions</p> <p>Although DIF in few items and responsiveness must be further explored, the Brazilian version of VSP-A demonstrated an acceptable validity and reliability in adolescents attending school and might serve as a starting point for more specific clinical investigations.</p

Population norms and cut-off-points for suboptimal health related quality of life in two generic measures for adolescents: the Spanish VSP-A and KINDL-R

<p>Abstract</p> <p>Background</p> <p>Health-related quality of life (HRQL) outcome measures are complex and for further application in clinical practice and health service research the meaning of their scorings should be studied in depth. The aim of this study was to increase the interpretability of the Spanish VSP-A and KINDL-R scores.</p> <p>Methods</p> <p>A representative sample of adolescents aged 12 to 18 years old was selected in Spain. The Spanish VSP-A and KINDL-R, two generic HRQL measures (range: 0–100), were self-administered along with other external anchor measures (Strengths and Difficulties Questionnaire, Oslo Social Support Scale and self-declaration of chronic conditions) and sent by post. Percentiles of both HRQL questionnaires were obtained by gender, and age group and effect sizes (ES) were calculated. Receiver Operating Characteristic curves and related sensitivity (SE) and specificity (SP) values were also computed.</p> <p>Results</p> <p>The Spanish VSP-A and KINDL-R were completed by 555 adolescents. A moderate ES was shown in Psychological well-being between younger and older girls (ES: 0.77) in the VSP-A and small ES in the KINDL (ES: 0.41) between these groups. A SE and SP value close to 0.70 was associated to a global HRQL score of 65 in the VSP-A and 70 in the KINDL-R, when compared to anchors measuring mental and psychosocial health. Adolescents with scores bellow these cut-off points showed a moderate probability of presenting more impairment in their HRQL.</p> <p>Conclusion</p> <p>The results of this study will be of help to interpret the VSP-A AND KINDL-R questionnaires by comparing with the general population and also provide cut-off points to define adolescents with health problems.</p

A randomized trial comparing adjuvant chemotherapy with gemcitabine plus cisplatin with docetaxel plus cisplatin in patients with completely resected non-small-cell lung cancer with quality of life as the primary objective

International audienceOBJECTIVES: Adjuvant chemotherapy with vinorelbine plus cisplatin (VC) improves survival in resected non-small-cell lung cancer (NSCLC), but has negative impact on quality of life (QoL). In advanced NSCLC, gemcitabine plus cisplatin (GC) and docetaxel plus cisplatin (DC) exhibit comparable efficacy, with possibly superior QoL compared to VC. This trial investigated these regimens in the adjuvant setting. METHODS: Patients with Stage IB to III NSCLC were eligible following standardized surgery. Overall, 136 patients were included, with 67 and 69 assigned to the GC and DC arms, respectively. Cisplatin (75 mg/m(2), Day [D] 1) plus gemcitabine (1250 mg/m(2), D1 and D8) or docetaxel (75 mg/m(2) D1) were administered for three cycles. Primary end-point was QoL (EORTC QLQ-C30), with the study designed to detect a 10-point difference between arms. Overall survival, safety and cost were secondary end-points. RESULTS: No between-group imbalance was observed in terms of patient characteristics. At inclusion, global health status (GHS) scores (/100) were 63.5 and 62.7 in GC and DC, respectively (P = 0.8), improving to 64.5 and 65.4 after 3 months (P = 0.8). No significant difference in functional or symptoms scores was observed between the arms except for alopecia. Grade 3/4 haematological and non-haematological toxicities were found in 33.8 and 21.7% (P = 0.11), and 33.8 and 26.1% (P = 0.33) of patients, in GC and DC, respectively. At 2 years, 92.9 and 89.8% of patients remained alive in GC and DC, respectively (P = 0.88). CONCLUSIONS: DC and GC adjuvant chemotherapies for completely resected NSCLC were well tolerated and appear free of major QoL effects, and are therefore representing candidates for comparison with the standard VC regimen

Conceptualisation et validation d'une échelle de mesure de qualité de vie liée à la santé chez l'adolescent

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF

Optimisation de l'évaluation globale de l'enfant atteint de paralysie cérébrale à potentiel de marche (intégration de la qualité de vie liée à la santé et des capacités et performances dans le domaine de la vie quotidienne)

La prise en charge des enfants atteints de paralysie cérébrale (PC) est devenue multidisciplinaire. Pour le chirurgien la finalité du geste est d améliorer l état fonctionnel du patient, mais comment en juger ? La vie de tous les jours du patient a-t-elle été modifiée ? Dans une première partie théorique il s agissait de faire le point sur les composantes lors de la réalisation d une évaluation globale des enfants PC, d identifier les méthodes existantes et d apporter des réponses supplémentaires aux outils et connaissances existants. Puis dans une seconde partie pratique deux projets dans le cadre de cette évaluation globale de l enfant PC sont présentés : - le premier projet nous a permis d appliquer ces connaissances acquises dans le cadre de la conceptualisation, la réalisation et l analyse d un projet multicentrique, - le second projet rapporte les démarches de la création et l étude préliminaire d un nouvel outil d évaluation des capacités et performances de la vie quotidienne.Treatment in cerebral palsy (CP) children is now multidisciplinary. Outcome objectives for orthopaedic surgeons changed and are now to improve the patient s functional status. But how to evaluate the outcome ? Was patient s daily life improved ? In a first theoretical part the components of a global outcome assessment in CP patients were reviewed, existing methods identified and detected tools and knowledge were supplemented. In a second part two projects were presented based on the principles of global assessment : - the first project to apply the acquired knowledge in terms of conceptualisation, realisation and analysis of a multicenter project, - the second to create and study preliminarily a new tool to evaluate daily life capacities and performances in CP patients.AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

COMPÉTENCES PSYCHOSOCIALES ET ÉDUCATION THÉRAPEUTIQUE DU PATIENT DIABÉTIQUE DE TYPE 1 : UNE REVUE DE LA LITTÉRATURE

International audienceEn éducation thérapeutique, il est établi que les compétences psychosociales doivent être renforcées chez les patients pour les aider à mieux gérer leur maladie et les traitements associés. Actuellement, ce travail est difficilement réalisable en raison de questions conceptuelles, méthodologiques et opérationnelles qui restent en suspens. En particulier, se posent celles de l'identification et de l'évaluation des compétences psychosociales pertinentes à développer. Objectifs : Il s'agissait de réaliser un inventaire des compétences psychosociales ciblées par les interventions d'éducation et d'identifier les critères utilisés pour objectiver l'acquisition de ces compétences. Méthode : Une revue de la littérature a été réalisée auprès de 60 articles portant sur l'évaluation d'une intervention d'éducation de patients diabétiques. Résultats : Les compétences ont été identifiées dans le quart des articles. Elles renvoyaient à la communication et aux relations interpersonnelles, à la prise de décision et à l'esprit critique, et à la gestion de soi. Les articles utilisent davantage de critères d'évaluation de nature médicale que de nature psychosociale. Discussion : Les compétences psychosociales sont peu explicitées et peu évaluées. Souvent pensées à travers une approche biomédicale, les interventions se focalisent davantage sur les compétences d'autosoin. L'article conclut sur l'intérêt de développer une approche psychosociale pour une meilleure conceptualisation de la notion de compétence sociale

Les compétences psychosociales en éducation thérapeutique du patient : des enjeux pour la pratique du psychologue

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“Behave like a responsible adult” – Relation between social identity and psychosocial skills at stake in self-management of a chronic disease

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COMPÉTENCES PSYCHOSOCIALES ET ÉDUCATION THÉRAPEUTIQUE DU PATIENT DIABÉTIQUE DE TYPE 1 : UNE REVUE DE LITTÉRATURE

International audienceIntroduction: It has been established that the psychosocial skills of patients need to be strengthened in the context of therapeutic patient education, to help them to more effectively manage their disease and the associated treatments. This intervention is barely feasible at the present time because of unresolved conceptual, methodological and operational problems, particularly problems concerning the identification and evaluation of the psychosocial skills to be developed. Objectives: This study established an inventory of psychosocial skills targeted by educational intervention, and identified the criteria used to demonstrate acquisition of these skills. Method: A systematic review of the literature was performed on 60 articles dealing with evaluation of educational intervention in patients with diabetes. Results: Skills were identified in one quarter of these articles. They referred to communication and interpersonal relations, decision-making and critical thinking, and also to coping and self-management. These articles used more often used medical endpoints than psychosocial endpoints. Discussion: Psychosocial skills are poorly explained and poorly evaluated. Interventions, often based on a biomedical approach, focus more on self-care skills. The paper concludes on the importance of developing a psychosocial approach to provide a better conceptualization of the notion of social skills

Illness representations about schizophrenia and bipolar disorder held by French people without mental disorder

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