New evidence on the reliability and validity of the pediatric oncology quality of life scale

Abstract

The present paper replicates and extends previous studies on the psychometric properties of the Pediatric Oncology Quality of Life Scale (POQOLS). The research questions were focused on (a) internal consistency; (b) relation with demographics; and (c) ability to discriminate between patient groups. Data were gathered in a Dutch-speaking Belgian sample of 73 pediatric oncology patients, drawn from the population of a university hospital. The parents completed the POQOLS, a 21-item parent-report inventory for the assessment of physical restriction, emotional distress and discomfort from medical treatment in pediatric oncology patients. The results support the psychometric quality of the POQOLS. Three of the core aspects of quality of life are tapped using sufficiently short and internally consistent subscales. The instrument is free from relations with demographics and shows good discriminant ability to differentiate between patient groups according to time since diagnosis, treatment status and diagnosis.     

Impact of organ transplantation in heart,lung and liver recipients: Assessment of positive life changes

Objective: The majority of psychological studies with organ transplant recipients have examined negative psychological effects. This study aimed to further investigate the positive effects of organ transplantation and to construct a specific measurement instrument.

Design: The initial pool of 14 items for the Positive Effects of Transplant Scale (PETS) was derived from organ recipient interviews. A cross-sectional postal study included 87 heart, 46 lung and 193 liver transplant recipients. The PETS was subjected to principal components analysis (PCA) using varimax rotation, and associations with other measures investigated.

Main outcome measures: PETS and an open-ended item about positive effects.

Results: Coding of the open-ended item revealed that the majority of recipients attributed positive life changes to the transplant experience. PCA of the PETS indicated three factors that accounted for 58.82% of the variance. The 12-item questionnaire assesses improvements in: (1) life philosophy, (2) gratitude and (3) health. The total PETS scores exhibited adequate internal consistency and validity.

Discussion: Most transplant patients report positive psychological effects, which suggests this may be an understudied area. The initial development of an assessment tool provides researchers and clinicians a way to assess the degree and nature of these life changes.     

A self-esteem measure for patients with cancer

Abstract

In assessing the quality of life of patients with cancer. :in important. though largely ignored. variable is self-esteem. The development of an instrument to measure self-esteem, using visual analogue scales, is described. This instrument was administered to 170 patients with newly diagnosed early breast cancer. Hodgkin's disease and non-Hodgkin's lymphoma three months and one year alter diagnosis. The instrument was acceptable to patients; internal consistency and test-retest reliability data are reported. Self-esteem scores were inversely correlated with depression and trait anxiety scores, and positively correlated with internal locus of control. Self-esteem was not significantly affected by tumour grade or stage. or by the extent to which patients felt disabled by the symptoms and side effects of their disease and treatment. The implications of these findings are discussed.     

Validation of a reflective thinking instrument for third-year undergraduate nursing students participating in high-fidelity simulation

Background: nursing students are required to think reflectively in both real and simulated clinical practice. Although the Reflective Thinking instrument is reliable in its measurement of reflective thinking, its validity is unknown. Method: confirmatory factor analysis was undertaken in an iterative manner within a non-equivalent control-group study to measure nursing students’ reflective thinking and satisfaction with high-fidelity simulation. The validity and reliability of the Reflective Thinking instrument was tested. Results: the resulting instrument consisted of 15 items across four factors. The final model was plausible as it demonstrated ‘goodness of fit’; however, it had neither convergent or discriminatory validity, nor reliability. Internal consistency was fair to reasonable for the four subscales. Conclusion: the testing of the Reflective Thinking instrument using confirmatory factor analysis is a vital initial step in the modification of this instrument. Further development using exploratory factor analysis will enhance the instrument’s relevance within high-fidelity simulation.     

The Paradoxes of Humor and the Burdens of Despair

SUMMARY

People today often express considerable despair about old age and the aging process. Older adults who experience frequent losses of connections with important persons can feel considerable despair in old age. Nevertheless, many older people retain hope in the face of situations that elicit despair and demonstrate what gerontologists call the “paradox of well being” in later life. Often, their hope is expressed in humor. This paper traces the connections among humor, hope, and religious faith in older adults. It argues that even persons who suffer from dementia can continue to express what Viktor Frankl called the “defiant power of the human spirit” through their humor.     

Subjectivity,health and gender: an approach to chronified pain through the Psychosocial Gender Diagnostic methodology / Subjetividad,salud y género: una aproximación al dolor cronificado mediante la metodología del Diagnóstico Psicosocial de Género

Abstract

This paper bases itself on a psychological perspective to make a theoretical and methodological proposal that shifts the concept of health towards the crossing point between biomedical and social sciences. To that end, it is suggested that the concept of Subjectivity should be placed at the centre of the discipline of psychology, understanding it from the theoretical perspective that intersects between post-structuralism, psycho-dynamic theory and gender. The objective of the article is to make this proposal through a case study about chronic pain without organic cause, an emerging, contemporary, controversial malaise that is becoming increasingly common, called Fibromyalgia in the biopsychomedical field, and which affects mainly — but not only — women. In order to pursue this goal, a new methodological instrument was developed: the psychosocial gender diagnostic, oriented toward capturing the dynamics of chronic pain. This methodology facilitates the integration of the connections between subjectivity, gender and health, while at the same time problematizes the excessive medicalization of modern day life.     

Spirituality,quality of life,and depression in older people with dementia

ABSTRACT

This study aimed to observe dementia’s role in the relationship between spirituality, quality of life, and depression in aging. The sample included 61 participants between 65 and 98 years old, separated into two groups: participants diagnosed with dementia (N = 31) and control participants (N = 30). There was no significant difference in spirituality between demented and control participants; however, different patterns of correlation were observed between spirituality, depression, and quality of life in these groups. Although the level of spirituality did not differ despite dementia, this pathology would appear to play a role in the relationship between spirituality, quality of life, and depression.     

The role of anxiety sensitivity in the relationship between posttraumatic stress symptoms and negative outcomes in trauma-exposed adults

Background: The development of posttraumatic stress symptoms (PTSs) following a trauma is related to impairment, diminished quality of life, and physical health issues. Yet it is not clear why some trauma-exposed individuals experience negative outcomes while others do not. The purpose of this study was to determine the role of several influential factors related to PTS severity and negative outcomes. Methods: One hundred and twenty-two trauma-exposed adults were administered the following self-report measures: the Posttraumatic Stress Disorder Checklist-Civilian, the Trauma History Questionnaire-Short, the Anxiety Sensitivity Index-3, Depression and Anxiety Stress Scale 21, Sheehan Disability Scale, World Health Organization Quality of Life-BREF, and an abbreviated Patient Health Questionnaire. Primary Results: PTS severity was positively correlated with depressive symptom severity (r = 0.54, p < 0.001), chronicity of the most distressing trauma (r = 0.21, p = 0.017), and number of traumas (r = 0.22, p = 0.012). Main effects were found for PTS severity (β = ?0.38, p < 0.01) and anxiety sensitivity (AS; β = ?0.39, p < 0.01) on quality of life. No interaction was found between PTS severity and AS with any negative outcome. PTS severity mediated the relationship between AS and physical health issues (0.05; 95% CI: 0.02–0.08). Conclusion: This study helps clarify the role of various factors in the relationship between trauma and negative outcomes. Clinical and research implications are discussed.     

Sexual quality of life in patients undergoing coronary artery bypass graft surgery

Objectives: Despite improvements in many domains of functioning, sexual quality of life often remains impaired following coronary artery bypass graft (CABG) surgery. This study examined associations among sexual quality of life, fear of sexual activity and receiving information from providers about sexual activity in CABG patients.

Methods: Participants completed a survey assessing sexual activity, mental health and physical health at baseline (3–5-day post-surgery; n?=?60) and 2-month post-surgery (n?=?42).

Results: Sexual quality of life showed moderate difficulties at baseline and did not improve by follow-up (p values ≥0.09). At follow-up, greater patient fear was associated with lower sexual quality of life in some domains; receiving information was related to lower fear (p values ≤0.03) and greater sexual satisfaction and interest (p values ≤0.04). Suggestive of mediation, there was a significant indirect effect of information on patient fear and of patient fear on sexual interest (p?=?0.05).

Conclusions: Though data were cross-sectional, findings suggest that fears of sexual activity may play a role in lowering CABG patients’ motivation for sexual activity and that receiving information from a medical provider may assist in hastening sexual rehabilitation. Prospective and intervention studies are needed to support findings.     

Mental health and quality of life in non-binary transgender adults: a case control study

Abstract

Background: The social challenges that non-binary people experience, due in part to social intolerance and the lack of validation of non-binary gender identities, may affect the mental health and quality of life of this population. However, studies that have distinguished between non-binary and binary transgender identities are lacking.

Aim: To compare the mental health and quality of life of a community sample of non-binary transgender adults with controls (binary transgender people and cisgender people) matched on sex assigned at birth.

Method: A total of 526 participants were included. Ninety-seven were classified as non-binary and were compared with two control groups: 91 people classified as binary and 338 cisgender people. Only transgender people not on gender affirming hormone treatment or who had not undergone gender affirming surgery were included. Participants were invited to complete an online survey that included mental health and quality of life measures.

Results: Non-binary people reported significantly better mental health than binary transgender people, but worse than cisgender people. Overall, there were no significant differences in quality of life between non-binary and binary transgender participants assigned male at birth and transgender females, but non-binary assigned males at birth had better scores on the psychological and social domains of quality of life than transgender males. Quality of life was better across all domains in cisgender people than transgender groups.

Conclusion: There is an inequality with regard to mental health and quality of life between non-binary (and binary) transgender people and the cisgender population that needs to be addressed. The better mental health scores in non-binary people may reflect lower levels of body dissatisfaction among the non-binary population. Mental health problems and poor quality of life are likely to have social causes and hence legislative measures and broader government-led inclusive directives should be put in place to recognize and to validate non-binary identifying people.     

Executive Dysfunctions Across Adulthood: Measurement Properties and Correlates of the DEX Self-Report Questionnaire

ABSTRACT

Difficulties in executive processes can disturb daily life functioning. Using data obtained from two independent community-dwelling samples (n ₁?=?468, n ₂?=?669, 18–97 years), we examined the factor structure of the Dysexecutive Functioning Questionnaire (DEX) and explored the frequencies and potential correlates of self-reported executive difficulties. Our results revealed that executive problems are parsimoniously described with one underlying factor. Everyday executive dysfunctions were moderately frequent throughout adulthood. Reports of executive problems were associated with individual difference characteristics including age, subjective health, personality, affect, and cognition. We also found that, although executive functions are known to decline with advancing adult age, younger age groups reported more problems than older groups, an effect that was partially mediated by a negative affect factor. We discuss implications for the validity of the instrument as well as directions for future research on executive functioning difficulties in everyday life.     

Coping strategies and quality of life in women with advanced breast cancer and their family caregivers

Abstract

This study examines the effects of personal resources of both heart patients and their close social partners on patients' coping and quality of life. Generalized personal resources (self-efficacy beliefs, dispositional optimism, self-regulation competence) and outcomes were assessed by questionnaire 1–3 days before surgery (n = 122) and again six months later (n= 50). Outcome variables were coping styles, social resources (social support and social integration), emotional states, and further measures of quality of life. Patients' personal resources were dominant in the prediction of most of the outcomes. Partners' resources were uniquely related to social support, social integration, and quality of life as perceived by the patients. Further, partners' personality resources predicted changes in patients' loneliness and energy levels during the six-month interval.     

Follow-up effects of social comparison information on the quality of life of cancer patients: The moderating role of social comparison orientation

Objective: To examine how social comparison orientation (SCO) moderates the effects of three types of social comparison information on the global quality of life of cancer patients 2 weeks and 3 months later. Design: Cancer patients (n?=?226) were provided with social comparison information just prior to undergoing radiation therapy, using audiotapes. Each participant was confronted with one of three tapes: (1) focusing on procedural aspects, (2) focusing on emotional reactions and (3) focusing on coping strategies. Main outcome measures: Quality of life as measured with the Cantril self-anchoring scale [Cantril, H. (1965). The pattern of human concerns. New Brunswick, NJ: Rutgers University Press]. Results: With increasing SCO, a lower quality of life was reported after listening to the emotion tape, while a higher quality of life was reported after listening to the coping tape. These effects were found 2 weeks as well as 3 months after the radiation therapy had ended. Conclusion: Social comparison information may have longitudinal effects on quality of life, but these effects are to an important extent dependent on the nature of the information and individual differences in SCO.     

Construction and Validation of a Biodata Selection Instrument

Abstract

Biodata instruments can be used in selection for several purposes (including screening, prediction, analysis of decision strategies). This article is concerned with the construction and validation of a biodata instrument for the selection of intermediaries by a profit-making employment agency in the Netherlands. The instrument was constructed according to the sample approach and measures work experiences with regard to relevant tasks and job dimensions. A field study gathered biodata scores from applicants (n £ 300) and present employees (n £ 70), interview ratings from the applicants, and ratings of job performance for the employees. The results obtained indicated that the instrument was a potentially useful selection device. The homogeneity of scale scores was sufficient and the scores show little overlap with other selection devices (interview ratings). In addition, particular scores correlate at a statistically significant level (P < 0.01) with ratings of job performance of present employees (r £ 0.30 to 0.40). Estimates of the utility (financial gains) of using the instrument in selection revealed that the instrument may yield considerable pay-offs. It is concluded that the construction and validation of the instrument yielded several positive results, and that the sample approach in constructing biodata selection instruments is an option worth considering.     

Spiritual Inquiry and Well-Being in Life-Limiting Illness

ABSTRACT

Introduction: End of life, as a developmental phase, is accompanied by inner resources as well as losses. Spirituality is a potential inner resource for integrating illness that often occurs during this time. Despite the increase in spirituality research, how spiritual perspectives are used in life-limiting illness remains under-investigated. Better knowledge about this process may be useful for health care providers, family caregivers and patients themselves to enhance well-being at end of life. This study describes the process of how patients and family care-givers use their spiritual resources to facilitate well-being at the end of life.

Method: A qualitative study was designed, based upon the grounded theory method, that entails theoretical sampling of concepts (not sampling of people as in quantitative designs), and the analytic technique of constant comparison of the data until conceptual categories are saturated with supporting data and a theory can be identified. The sample consisted of 12 respondents: 6 dyads of elderly patients with a life-limiting illness and family caregivers. Interviews occurred over a 2-year period.

Results: Data analysis generated a theory about a process called “transcending life-limiting illness,” which derived from two related themes: spiritual inquiry and end-of-life dimensions.

Conclusion: The results expand existing knowledge about how people, either as patients or as family caregivers of persons facing end of life, live with life-limiting illness. The process of transcending life-limiting illness goes beyond merely coping to tap resources for well-being. This resource is expressed through an ongoing dialectic process of spiritual inquiry about life and death as supported by six critical life dimensions.     

Cognition,daily living,and health-related quality of life in 85-year-olds in Sweden

ABSTRACT

This study investigates how cognition influences activities of daily living and health-related quality of life in 85-year-olds in Sweden (n?=?373). Data collection included a postal questionnaire comprising demographics and health-related quality of life measured by the EQ-5D. The ability to perform personal activities of daily living (PADL) was assessed during a home visit that included administering the Mini Mental State Examination (MMSE). Cognitive impairment was shown in 108 individuals (29%). The majority were independent with respect to PADL. A larger number of participants with cognitive impairment reported that they needed assistance in instrumental activities of daily living (IADL) compared to the group without cognitive impairment. Impaired cognition was significantly related to problems with IADL. Significant but low correlations were found between cognition and health-related quality of life – higher ratings on perceived quality of life correlated with higher results on the MMSE.     

Self-efficacy and quality of life in adults who stutter

PurposeSelf-efficacy has emerged as a potential predictor of quality of life for adults who stutter. Research has focused primarily on the positive relationship self-efficacy has to treatment outcomes, but little is known about the relationship between self-efficacy and quality of life for adults who stutter. The purpose of this mixed- methods study is to determine the predictive value of self-efficacy and its relationship to quality of life for adults who stutter.MethodThe Self-Efficacy Scale for Adult Stutterers and the Overall Assessment of the Speaker’s Experience with Stuttering were administered to 39 adults who stutter, aged 18– 77. Percentage of syllables stuttered was calculated from a conversational speech sample as a measure of stuttered speech frequency. Qualitative interviews with semi-structured probes were conducted with 10 adults and analyzed using thematic analysis to explore the lived experience of adults who stutter.ResultsSelf-efficacy emerged as a strong positive predictor of quality of life for adults living with a stuttered speech disorder. Stuttered speech frequency was a moderate negative predictor of self-efficacy. Major qualitative themes identified from the interviews with the participants were: encumbrance, self-concept, confidence, acceptance, life-long journey, treatment, and support.ConclusionResults provide clarity on the predictive value of self-efficacy and its relationship to quality of life and stuttered speech frequency. Findings highlight that the unique life experiences of adults who stutter require a multidimensional approach to the assessment and treatment of stuttered speech disorders.