Item response theory and factor analysis as a mean to characterize occurrence of response shift in a longitudinal quality of life study in breast cancer patients.

International audienceBACKGROUND: The occurrence of response shift (RS) in longitudinal health-related quality of life (HRQoL) studies, reflecting patient adaptation to disease, has already been demonstrated. Several methods have been developed to detect the three different types of response shift (RS), i.e. recalibration RS, 2) reprioritization RS, and 3) reconceptualization RS. We investigated two complementary methods that characterize the occurrence of RS: factor analysis, comprising Principal Component Analysis (PCA) and Multiple Correspondence Analysis (MCA), and a method of Item Response Theory (IRT). METHODS: Breast cancer patients (n = 381) completed the EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires at baseline, immediately following surgery, and three and six months after surgery, according to the "then-test/post-test" design. Recalibration was explored using MCA and a model of IRT, called the Linear Logistic Model with Relaxed Assumptions (LLRA) using the then-test method. Principal Component Analysis (PCA) was used to explore reconceptualization and reprioritization. RESULTS: MCA highlighted the main profiles of recalibration: patients with high HRQoL level report a slightly worse HRQoL level retrospectively and vice versa. The LLRA model indicated a downward or upward recalibration for each dimension. At six months, the recalibration effect was statistically significant for 11/22 dimensions of the QLQ-C30 and BR23 according to the LLRA model (p ≤ 0.001). Regarding the QLQ-C30, PCA indicated a reprioritization of symptom scales and reconceptualization via an increased correlation between functional scales. CONCLUSIONS: Our findings demonstrate the usefulness of these analyses in characterizing the occurrence of RS. MCA and IRT model had convergent results with then-test method to characterize recalibration component of RS. PCA is an indirect method in investigating the reprioritization and reconceptualization components of RS

Assessment of coping: a new french four-factor structure of the brief COPE inventory

International audienceBackground: The Brief Coping Orientation to Problems Experienced (Brief COPE) inventory is the most usual measure to identify the nature of coping strategies implemented by individuals and explore 14 coping strategies. The availability of a structure with fewer factors rather than the initial 14-factor structure may be of interest for both healthcare professionals and researchers. We report the validation process of a 4-factor structure of the French version of the Brief COPE in a French sample of individuals facing a singular life event, such as cancer, including patients and their caregivers. Methods: The cross-sectional study included cancer patients and their caregivers. Self-administered data were collected including: socio-demographic (age, gender, marital status, employment status, and education level), coping strategies using the French version of the Brief COPE, quality of life (QoL) using the French version of the short form health survey questionnaire (SF36). Construct validity, internal consistency, reliability, and external validity were tested

Age-related hearing loss in individuals and their caregivers: effects of ă coping on the quality of life among the dyads

International audienceObjectives: Age-related hearing loss (ARHL) impacts the daily living and ă quality of life (QoL) of affected individuals and the functioning of ă family caregivers. In the specific context of voluntary medical ă checkups, we examined sample dyads (ARHL individual and the caregiver) ă to determine whether QoL of patients and caregivers is influenced by ă coping strategies implemented either by themselves or their relatives. ă Methods: This was a cross-sectional study with a descriptive/correlative ă design performed in a French preventive health center (Regional ă Institute for Prevention of Aging, Marseille, France) for the ă beneficiaries of pension funds of private sector employees. The samples ă included beneficiary-caregiver dyads. The beneficiaries had bilateral ă (mild to moderately severe) ARHL. Self-reported data were collected as ă follows: QoL using the World Health Organization Quality of Life ă questionnaire, coping strategies using the Brief Coping Orientation to ă Problems Experienced Scale, and anxiety and mood using visual analog ă scales. ă Results: The final sample comprised 44 beneficiaries and 44 caregivers. ă The caregiver was the partner of the beneficiary in 73% of cases. The ă QoL scores of the social dimension were significantly lower for ă beneficiaries and caregivers compared with French age-and sex-matched ă controls. Among beneficiaries and caregivers, coping strategies based on ă problem solving were the most commonly used strategies. The use of ă positive thinking strategies was associated with higher QoL scores. The ă more one member of the dyad used an avoidance coping strategy, the more ă the other member used a positive thinking strategy. ă Conclusion: This study emphasizes that QoL of individuals with ă age-related hearing impairment and their natural caregivers is related ă to the coping strategies that they use. This finding suggests that ă targeted interventions should be offered to help individuals who ă experience emotional difficulties to implement more efficient coping ă strategies

Domains of quality of life freely expressed by cancer patients and their caregivers: contribution of the SEIQoL

Abstract Background The purposes of this study, performed on a large sample of cancer patient-caregiver dyads, were: i) to simultaneously investigate, using an individualized quality of life (QoL) measure (Schedule for the Evaluation of Individual QoL, SEIQoL), the QoL domains freely expressed by cancer patients and their caregivers, and ii) to explore overlapping between the SEIQoL assessment and QoL assessment using traditional instruments. Methods The study employed a cross-sectional design including cancer patients who were going to receive chemotherapy treatment and their caregivers. Quality of life was assessed using condition-specific questionnaires (EORTC QLQ-C30 and CarGOQoL), generic health-related questionnaire (SF-36), and open individualized measure (SEIQoL). Results The final sample included 205 patient-caregiver dyads. From the SEIQoL, Family, Health, and Leisures were the most freely expressed QoL domains by patients and caregivers, but reported with different weights. Love life and financial issues were less spontaneously mentioned. The SEIQoL index was moderately correlated to the condition-specific QoL questionnaires (R lower than |0.40|) and to SF-36 (correlation coefficients: R ranging from 0.17 to 0.31). Conclusion Individualized QoL measures allow individuals to spontaneously express important, non-predefined domains. This study highlights the need to explore QoL using a combination of individualized questionnaires and standardized questionnaires, capturing complementary facets that patients consider important in their life

Dyadic effects of coping strategies, time perspectives, and personality on the quality of life of cancer patients and their caregivers

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Coping strategies and quality of life: a longitudinal study of high-grade glioma patient-caregiver dyads

International audienceAmong a sample of patient-informal caregiver dyads in the specific context of new diagnoses of high-grade glioma in the time-frame between diagnosis and the third month following diagnosis, we examine whether the coping strategies implemented by the patients and their caregivers influenced their own quality of life (QoL) and the QoL of their relatives

Additional file 1: of Assessment of coping: a new french four-factor structure of the brief COPE inventory

Replication on patient and caregiver subsamples. Table S1. Characteristics of patients and caregivers. Table S2. Dimensions’ characteristics of Brief COPE for patients and caregivers. Table S3. Relationships between Brief COPE and sociodemographics and quality of life for patients and caregivers. (DOCX 53 kb

Lymph node thyroglobulin in the diagnosis of metastases of thyroid carcinoma with the thyroid in situ: A prospective intraoperative study

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Time to health-related quality of life score deterioration as a modality of longitudinal analysis for health-related quality of life studies in oncology: do we need RECIST for quality of life to achieve standardization?

International audiencePurposeLongitudinal analysis of health-related quality of life (HRQoL) remains unstandardized and compromises comparison of results between trials. In oncology, despite available statistical approaches, results are poorly used to change standards of care, mainly due to lack of standardization and the ability to propose clinical meaningful results. In this context, the time to deterioration (TTD) has been proposed as a modality of longitudinal HRQoL analysis for cancer patients. As for tumor response and progression, we propose to develop RECIST criteria for HRQoL.MethodsSeveral definitions of TTD are investigated in this paper. We applied this approach in early breast cancer and metastatic pancreatic cancer with a 5-point minimal clinically important difference. In breast cancer, TTD was defined as compared to the baseline score or to the best previous score. In pancreatic cancer (arm 1: gemcitabine with FOLFIRI.3, arm 2: gemcitabine alone), the time until definitive deterioration (TUDD) was investigated with or without death as event.ResultsIn the breast cancer study, 381 women were included. The median TTD was influenced by the choice of the reference score. In pancreatic cancer study, 98 patients were enrolled. Patients in Arm 1 presented longer TUDD than those in Arm 2 for most of HRQoL scores. Results of TUDD were slightly different according to the definition of deterioration applied