Background: The FACT-Lym was developed to address the disease-specific quality-of-life (QOL) issues for patients with non-Hodgkin’s lymphoma (NHL). Methods: Items for inclusion in the lymphoma subscale for the FACT instrument were generated from interviews with health care providers and published literature on NHL. Items were selected based on symptom relevance, disease-specificity and clinical relevance. Validation testing was conducted with NHL patients. Patients completed the FACT-Lym and other measures at three timepoints: baseline (T1), 3–7 days (T2), and 8–12 weeks (T3). These patients were also interviewed about item content. Results: From a pool of 69 items, 22 items were selected for testing based on relevance ratings of 17 experts. Items included B symptoms, sleep disturbance, anorexia, pruritus, pain, swelling, dyspnea, fatigue, emotional lability, worries, and uncertainty about the future. 75 NHL patients participated in validation testing (55% female, 59% with indolent disease, and 84% currently receiving treatment). Patient interviews confirmed item relevance and comprehensiveness. Item correlations, expert relevancy ratings, and patient input further reduced the subscale to 15 items. Internal consistency coefficients (alpha) for the 15–item subscale (.80, .86, .83) and test-retest stability (.85) suggest very good reliability. Correlations between the subscale and the SF-36 physical (r=.62) and mental (r=.47) summary scores reflect concurrent validity. Responsiveness to ECOG performance status rating and treatment status (on vs. off) equaled or exceeded that of the more established FACT subscale scores. From T1 to T3, subscale scores declined (−6.8, effect size= −0.86) in 14 patients who reported themselves as worsened, increased (3.9, effect size= 0.49) in 28 patients who reported themselves as improved, and did not change (−0.2, effect size= −0.02) in 18 patients who reported themselves as unchanged. Conclusions: The FACT-Lym addresses QOL concerns that are relevant to NHL patients and is reliable and valid for use in clinical research.
Cancer is the second most common cause of death among those aged 65 years, and is a major cause of morbidity. There is some evidence that screening, by detecting precancerous lesions in asymptomatic patients, is effective in reducing cancer-related morbidity and mortality among older men and women. The objectives of the current review article were to identify some of the barriers to and opportunities for research in cancer screening among older individuals. Using expert opinion, the authors developed a taxonomy of barriers to research among those aged 65 years at 3 levels: the macro (policy and population), the organi-
Few groups have investigated whether diets of breast cancer survivors comply with the Dietary Approaches to Stop Hypertension (DASH) guidelines. In a cross‐sectional study, 58 female breast cancer survivors (aged 53 ± 8 years) completed a 45‐ item questionnaire on knowledge of American Cancer Society dietary guidelines, risk perception for recurrence, and physical activity and an online food frequency questionnaire (Vioscreen, version 2.5, Viocare, Inc., Princeton, NJ) A 10‐item modified DASH score was calculated. Average DASH score was 4.1 ±1.5 with a range from 2 to 7. Vegetable (60%) and sweets (63%) had the highest proportion of perfect scores; legumes and nuts(10%) had the lowest. Those who were DASH accordant were more likely to report more vegetable servings/day (2.7 ±1.5 vs 1.6 ±1.3, p=0.01, accordant vs. non‐accordant), more fruit servings/day (3.1 ±1.1 vs 1.3 ±1.0, p<0.0001), more dietary fiber/day (28.4±10.1 vs 22.4 ±1.1 vs 9.9 g, p=0.05) and lower BMI (24.1±1.1 vs 29.2 ±7.1 kg/m2, p=0.01). Those with higher perceived risk for recurrence were less likely to be DASH accordant (p=0.004). Greater efforts to increase compliance to the DASH dietary guidelines are needed.
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