Objective This study aimed to synthesize the available knowledge of symptom trajectories in patients with breast cancer and identify predictors associated with these trajectories. Methods Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in four databases (PubMed, Embase, Web of Science, and CINAHL). The retrieved articles’ publication time was limited to 2010 to 2020, and only peer-reviewed English articles were included. Results Twenty-seven articles were included. The findings of the relevant studies were analyzed using thematic analysis. They were grouped into two themes: symptom trajectories of patients with breast cancer (symptom trajectories in patients with breast cancer, in patients who underwent surgery, and in patients who received cancer-related treatment) and associated factors (socioeconomic factors, health characteristics, cancer-related treatment characteristics) . Newly diagnosed patients tended to report high trajectories of depression and persistent sleep disturbance. Most patients who underwent surgery reported significant sleep disturbance and anxiety shortly after surgery. For patients who received cancer-related treatment, only a small proportion had a high level of physical activity after cancer-related therapy over time. A high body mass index, a low relationship quality, parental responsibilities, insufficient social support, a low educational background, and an unhealthy lifestyle may increase the risk of negative symptom trajectories in patients with breast cancer. Additionally, old patients were more likely to report cognitive impairment after chemotherapy, while young patients tended to report trajectories of persistent sexual dysfunction. Concurring symptoms and poor health status also contributed to adverse symptom trajectories. Conclusion The findings of this review add to the body of knowledge of the interindividual variability of symptom trajectories in patients with breast cancer. Despite the overall similarity in appraisal at baseline, the patients reported varied symptom trajectories over time. It is recommended that nurses consider sociodemographic, clinical and cancer-related treatment characteristics and perform targeted early preventive interventions for patients with breast cancer.
BACKGROUND The main goal for the healthcare of children and adolescents with cancer is to cure and better manage the distress caused by the multiple symptoms that may manifest during chemotherapy. Patient-reported outcomes (PROs) are considered to be the best way to obtain a subjective measure of symptoms. As such, it is crucial to select appropriate pediatric PROs tools, taking advantage of technologies to develop a suitable platform, and assess and manage symptoms over long-term cancer treatment. OBJECTIVE This study aimed to develop and test a smartphone application's usability, known as the WeChat mini-program. It enables children and adolescents with cancer aged 5 to 17 years old and their parent proxies to assess pediatric patients' quality of life-related symptoms using Pediatric Patient-reported Outcome Measurement Information System (PROMIS) profile-25. METHODS A focus group interview among researchers, clinical professionals, and software engineers, as well as personal qualitative interviews with pediatric patients and proxies, were conducted to form the development proposal. The iterative method was used to develop and assure the quality of the mini-program. The usability test was performed based on the standards of ISO 9241-11 among target users. Effectiveness and efficiency were based on usability tasks, satisfaction was measured with the Post-Study System Usability Questionnaire (PSSUQ), and additional qualitative interviews were conducted following all tests. Further modifications and tests would be performed to improve the mini-program based on feedback. RESULTS The WeChat mini-program 'PROMIS Assessment' included demographic and clinical information and the profile-25 questionnaire (which assesses and collects data on depressive symptoms, anxiety, fatigue, physical activity-mobility, peer relationships, pain interference, and pain intensity). Functions such as voice assistance, a reward system, data visualization, and reminders were added to improve accessibility and compliance. A total of 16 target users participated in the first round of usability tests. The completion rate of the three tasks ranged from 80.0% (for the proxy task of 'search and open') to 100.0%, and most users could complete tasks quickly. Satisfaction scores of the four dimensions of PSSUQ ranged from 6.2 to 6.8 (out of 7.0). In qualitative interviews, most participants thought the mini-program was convenient, easy to use, and helpful. Disadvantages were mainly problems with searching, expressions, and interaction with reality. The revised mini-program gained positive feedback during the second round of usability tests. CONCLUSIONS The 'PROMIS Assessment' and its administration website were developed and proved to have good usability. It can be used both inside and outside hospitals by children and adolescents with cancer and their proxies during treatment to assess their quality of life and offer significant patient-reported data to assist clinical decisions.
Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) has been proven to be an effective and efficient measurement tool and has entered its global promotion phase. Our research team was authorized by the PROMIS Health Organization to translate five adult Patient-Reported Outcomes Measurement Information System (PROMIS) physical function short forms (4a, 6b, 8b, 8c, and 8c 7-Day) to ensure the conceptual and semantical equivalence to the source and pretest them in a Chinese population for cultural adaptation.Methods: The translation was conducted following the Functional Assessment of Chronic Illness Therapy (FACIT) methodology, which mainly includes forward translation, reconciliation, back-translation, expert reviews, cognitive testing, and linguistic validation, etc. And cognitive interview was used to pretest the translated items in Chinese patients with cancer and a healthy population.Results: The translation process was relatively smooth, except for some translated versions that slightly altered some word choices or sentence structures. Subsequent pre-testing of the Simplified Chinese short forms showed that clarifying or laying emphasis on the time frame in the instructions was needful, and two sets of response categories and one item stem needed some slight revisions due to cultural or language discrepancies.Conclusion: The translation and linguistic validation of five adult PROMIS physical function short forms into Simplified Chinese have been completed, and field testing, calibration, and psychometric testing are pending.
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