Purpose
The aim of this study was to analyze the internal structure of the EORTC QLQ-C30, to examine the validity and normative data for cancer patients.
Method
Exploratory and Confirmatory factor analyses were conducted to explore the scale’s dimensionality and test for strong measurement invariance across sex and tumor site. All the analyses were based on a multicenter cohort of 931 patients who completed the Brief Symptom Inventory (BSI-18) and the EORTC QLQ-C30.
Results
Our findings indicate that the EORTC QLQ-C30 has acceptable psychometric properties and an internal structure that is well accounted for a bifactor model: a general factor that evaluates quality of life and a group factor that would analyze physical health that would be defined by physical function, role function, and fatigue. The result of the multi-group CFA revealed a strong invariance according to sex, tumor, and over time. Reliability of the EORTC exceeding 0.86 and the simple sum of the items of the scale was a good indicator of oncology patients’ quality of life. Both factors correlate closely with depression, anxiety, and psychological distress and are sensitive to change, especially the quality of life, with a significant decrease in the post-test.
Conclusion
The Spanish version of the EORTC QLQ-C30 proved to be a valid, reliable instrument to appraise quality of life in cancer patients. The normative data collected from this study may be useful for the early detection of initial symptoms of deterioration of quality of life in oncology patients.
Purpose of reviewTo summarize the current literature on the psychological impact of COVID-19 on patients with cancer, both in terms of the impact of the virus itself and of changes in the healthcare system; and to describe current recommendations for supporting patients with cancer during the pandemic.
Recent findingsMultiple studies have shown that patients with cancer experience high levels of psychological distress during COVID-19. Factors of greater vulnerability have been described as: being young, being female, low socioeconomic status, lower educational level, having low levels of hope or optimism, lower social support, and having cancer with curative intent. The severe acute respiratory syndrome-coronavirus-2pandemic has accelerated the healthcare digitization process. All departments involved in the diagnosis and treatment of cancer have made contingency plans to minimize the impact on patients.
Background
The study assessed quality of life, psychological distress, and their associations with socio-demographic and clinical factors in patients with advanced cancer before systemic treatment initiation.
Methods
The NEOetic-SEOM study, a cross-sectional, prospective, observational, and multicenter research, involved patients with advanced cancer confirmed through histology. We collected socio-demographic details, psychological distress (BSI-18), and quality of life (EORTC-QLQ-C30) data through questionnaires. Multivariate analysis was used to construct models, and forest plots were generated to represent the proportions of patients undergoing psychological and functional difficulties.
Results
The analysis included 507 patients (mean age 64.8 years, 54% male) with prevalent cancers being lung (29%), colorectal (16%), and pancreatic (11%). The majority underwent chemotherapy (79%) and targeted or immunotherapy (38%). 71% reported moderate/severe psychological distress correlating with functional (55%) and symptom problems (87%) (p = 0.001). Depression and anxiety rates were 71% and 63%. Males and good performance status patients showed higher functional scales, while older individuals, adenocarcinoma histology, and poor ECOG had increased symptoms. Lower education correlated with higher anxiety, depression, and psychological distress, mostly in younger patients. No associations were found between clinical variables (cancer stage or site) and quality of life or distress.
Conclusion
In summary, our investigation elucidates the distinct experiences of advanced cancer patients concerning sex, age, performance status, histological subtype, and education in relation to quality of life and psychological distress. These insights underscore the necessity for personalized therapeutic approaches to cater to the multifaceted requirements of patients with advanced malignancies.
The therapeutic alliance is an important factor in successful cancer treatment, particularly for those with advanced cancer. This study aims to determine how the therapeutic alliance relates to prognostic preferences and satisfaction with the physician and medical care among patients with advanced cancer. We conducted a cross-sectional study to explore the therapeutic relationship, trust, satisfaction with healthcare, and prognostic preferences among 946 patients with advanced cancer at 15 tertiary hospitals in Spain. Participants completed questionnaires with self-reported measures. Most were male, aged > 65 years, with bronchopulmonary (29%) or colorectal (16%) tumors and metastatic disease at diagnosis. Results revealed that 84% of patients had a good therapeutic alliance. Collaborative and affective bond was positively associated with a preference to know the prognosis and satisfaction with care and decision. There was no difference in a therapeutic alliance based on clinical or sociodemographic factors. The therapeutic alliance between patient and physician is essential for successful treatment outcomes and better overall satisfaction. Therefore, it is vital for healthcare providers to focus on establishing and maintaining a strong relationship with their patients. To achieve this, transparency and care should be prioritized, as well as respect for the preferences of patients regarding the prognosis of their illness.
Background. The purpose of this study was to investigate the sociodemographic factors related to psychological distress, spirituality, and resilience, and to examine the mediating role of spirituality with respect to psychological distress and resilience in patients with advanced, unresectable cancer during the Covid-19 pandemic.Methods. A prospective, cross-sectional design was adopted. Data were collected from 636 participants with advanced cancer at 15 tertiary hospitals in Spain between February 2019 and December 2021. Participants completed self-report measures: Brief Resilient Coping Scale (BRCS), Brief Symptom Inventory (BSI-18), and Spiritual well‐being (FACIT-Sp). Hierarchical linear regression models were used to explore the mediating role of spirituality. Results. Spirituality was significantly different according to the person’s age and marital status. Psychological distress accounted for 12% of the variance in resilience (β =-0.32, p<0.001) and spirituality, another 15% (β =0.48, p<0.001). Spirituality acted as a partial mediator in the relationship between psychological distress and resilience in individuals with advanced cancer.Conclusions. Both psychological distress and spirituality played a role in resilience in cases of advanced cancer. Spirituality can help promote subjective well-being and increased resilience in these subjects.
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