Motivational interviewing appears to be a promising strategy for modifying dietary behavior, and Black churches are an excellent setting to implement and evaluate health promotion programs.

This report summarizes findings related to the psychometric properties (internal consistency and construct validity) of the Pittsburgh Sleep Quality Index (PSQI) and discusses issues related to its use based on data from two clinical studies with diverse samples of cancer patients. Subjects completed a questionnaire that included the PSQI, the Schwartz Cancer Fatigue Scale, and specific demographic, disease, and treatment variables. There were complete data on 170 (of 214) cases in Study 1 and 249 (of 259) cases in Study 2. The Cronbach's alpha for the Global Sleep Quality scale was 0.81 in Study 1 and 0.77 in Study 2 A comparison of Global Sleep Quality in two contrasting groups with low and high fatigue yielded statistically significant differences in both samples. Psychometric evaluation supports its internal consistency reliability and construct validity. However, the scoring is rather cumbersome and raises questions regarding level of measurement and appropriate analysis techniques.

Abstract:Cancer patients may experience multiple concurrent symptoms caused by the cancer, cancer treatment, or their combination. The complex relationships between and among symptoms, as well as the clinical antecedents and consequences, have not been well described. This paper examines the literature on cancer symptom clusters focusing on the conceptualization, design, measurement, and analytic issues. The investigation of symptom clustering is in an early stage of testing empirically whether the characteristics defined in the conceptual definition can be observed in cancer patients. Decisions related to study design include sample selection, the timing of symptom measures, and the characteristics of symptom interventions. For self-report symptom measures, decisions include symptom dimensions to evaluate, methods of scaling symptoms, and the time frame of responses. Analytic decisions may focus on the application of factor analysis, cluster analysis, and path models. Studying the complex symptoms of oncology patients will yield increased understanding of the patterns of association, interaction, and synergy of symptoms that produce specific clinical outcomes. It will also provide a scientific basis and new directions for clinical assessment and intervention. Key Words: Symptoms, symptom clusters, symptom management, quality of life Article: INTRODUCTION Typical symptoms associated with cancer and its treatment include fatigue, nausea-vomiting, pain, depression, and difficulty sleeping. In cancer care, these symptoms can be caused by cancer, cancer treatment, or the combination of cancer and cancer treatment. Despite the knowledge that individuals undergoing cancer therapy are likely to experience multiple concurrent symptoms, most research on symptoms in cancer has examined individual symptoms.1 The relationship between and among cancer symptoms and the impact on quality of life have not been evaluated systematically. The purpose of this paper is to examine critical research issues related to the conceptualization, design, measurement, and analysis of multiple concurrent symptoms or symptom clusters in oncology. The Concept of a Symptom ClusterRecently, Dodd et al .2 called for consideration of the "symptom cluster" in oncology research to capture the complexity of the cancer symptom experience. The term "symptom cluster" has not

The internal consistency, validity, and factor structure of the Shacham shortened version (37 items) of the 65-item profile of mood states (POMS) were examined with a sample of 428 cancer patients who were awaiting bone marrow transplantation. Cronbach's alphas ranging from 0.78 to 0.91 were obtained for each of the six subscales of the POMS-short form (POMS-SF) and for the total 37-item scale. Correlations with the CES-D, the Self-Rated Karnofsky, the MOS SF-20 Physical Functioning, and the Bradburn Positive and Negative Affect Scales provided evidence of the convergent and discriminant validity of the POMS-SF. Results of a confirmatory factor analysis were supportive of the 6-factor interpretation of the POMS items in the 37-item version of the POMS.

Genetic counseling is conceptualized as having both "teaching" and "counseling" functions; however, little is known about how these functions are articulated in routine practice. This study addresses the question by documenting, on videotape, the practices of a national sample of prenatal and cancer genetic counselors (GCs) providing routine pre-test counseling to simulated clients (SCs). One hundred and seventy-seven GCs recruited at two annual conferences of the National Society of Genetic Counselors (NSGC) were randomly assigned to counsel one of six female SCs of varying ethnicity, with or without a spouse, in their specialty. One hundred and fifty-two videotapes were coded with the Roter Interaction Analysis System (RIAS) and both GCs and SCs completed evaluative questionnaires. Two teaching and two counseling patterns of practice emerged from cluster analysis. The teaching patterns included: (1) clinical teaching (31%) characterized by low psychosocial, emotional and facilitative talk, high levels of clinical exchange, and high verbal dominance; and (2) psycho-educational teaching (27%) characterized by high levels of both clinical and psychosocial exchange, low levels of emotional and facilitative talk, and higher verbal dominance. The counseling patterns included: (1) supportive counseling (33%) characterized by low psychosocial and clinical exchange, high levels of emotional and facilitative talk, and low verbal dominance; and (2) psychosocial counseling (9%) with high emotional and facilitative talk, low clinical and high psychosocial exchange, and the lowest verbal dominance. SCs ratings of satisfaction with communication, the counselor's affective demeanor, and the counselor's use of non-verbal skills were highest for the counseling model sessions. Both the teaching and counseling models seem to be represented in routine practice and predict variation in client satisfaction, affective demeanor, and nonverbal effectiveness.