Factors contributing to the ceiling effect of the EQ-5D-5L: an analysis of patients with prostate cancer judged “no-problems”

Abstract Purpose The goal of the present study was to determine factors related to a ceiling effect (CE) on the EQ-5D-5L among Japanese patients with prostate cancer (PC). Methods An existent cross-sectional observational study dataset was used. Patients were ≥ 20 years of age and diagnosed with PC. For CE determinants on the EQ-5D-5L, we excluded possible “full-health” patients flagged by the EQ-VAS (score = 100) and/or FACT-P (score = 156) instruments. We then divided them into binary variables: A CE group (EQ-5D-5L score = 1) and others (< 1). The associations between CE, sociodemographic and medical characteristics, and FACT-P subscale scores were examined using a multivariate LASSO selection followed by a binomial logistic regression analysis performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results A total of 362 patients were analyzed. The LASSO selection variables, including all obtained variables, were as follows: age, palliative treatment, FACT-P physical well-being, and PC subscale score. Statistically significant variables predicting CE were palliative treatment (OR 0.23; 95% CI 0.09–0.60), physical well-being (OR 1.54; 95% CI 1.34–1.76), and PC subscale (OR 1.08; 95% CI 1.03–1.14). Conclusions This study revealed that palliative treatment and two FACT-P physical well-being and PC subscale scores were positively related to CE on the EQ-5D-5L. To our knowledge, this is the first study to examine predictors of CE on the EQ-5D-5L. The present results may be helpful for facilitating the consideration of “bolt-on” studies from the standpoint of PC patients.

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Pride, shame and health among adolescents – a cross-sectional survey

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2016-0107 ◽

2017 ◽

Vol 30 (6) ◽

Cited By ~ 1

Author(s):

Eva Randell ◽

Junia Joffer ◽

Renée Flacking ◽

Bengt Starrin ◽

Lars Jerdén

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Identity Development ◽

Logistic Regression Analysis ◽

Strong Predictor ◽

Well Being ◽

Multivariable Logistic Regression Analysis ◽

Protective Mechanism ◽

Cross Sectional Survey ◽

Cross Sectional

Abstract Background Pride and shame are important emotions known to influence identity development and psychological well-being in adolescence. Research evidence indicates that self-rated health (SRH) is a strong predictor of future health. This cross-sectional study, conducted during 2008–2009, aimed to investigate the associations between pride, shame and SRH among adolescent boys and girls. Methods The study sample comprised 705 adolescents in Sweden aged 17–18 years (318 boys and 387 girls) who completed a questionnaire that included items on SRH, shame and pride (participation rate 67%). Logistic regression analyses (univariable and multivariable) were used to investigate the associations between pride and shame as separate and combined constructs on SRH, adjusting for potential confounders (country of birth, parental educational level, school experience, having enough friends, mood in family and being active in associations). Results Pride and shame separately were significantly associated with SRH in both genders. Logistic regression analysis of the pride-shame model showed that the odds of having lower SRH were highest in boys and girls with lower pride-higher shame. In a multivariable logistic regression analysis of the pride-shame model the odds of having lower SRH remained significant in boys and girls with lower pride-higher shame [boys: odds ratio (OR) 3.51, confidence interval (CI) 1.40–8.81; girls: OR 2.70, CI 1.22–5.96] and in girls with lower pride-lower shame (OR 2.16, CI 1.02–4.56). Conclusion The emotions of shame and pride are associated with SRH in adolescence. Experiencing pride seems to serve as a protective mechanism in SRH in adolescents exposed to shame. We believe that this knowledge should be useful in adolescent health promotion.

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Factors Contributing to the Ceiling Effect Among Patients with Prostate Cancer who Were Judged to Have “Full-Health” by EQ-5D-5L

Value in Health ◽

10.1016/j.jval.2017.08.285 ◽

2017 ◽

Vol 20 (9) ◽

pp. A448-A449

Author(s):

H Murasawa ◽

Y Matsuoka ◽

N Tanaka ◽

Y Takeda ◽

S Uchikawa ◽

...

Keyword(s):

Prostate Cancer ◽

Ceiling Effect ◽

Full Health

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Screening Patients With Metastatic Breast Cancer for Psychiatric Disease: a Cross Sectional Study

10.21203/rs.3.rs-946803/v1 ◽

2021 ◽

Author(s):

Raquel Basto ◽

Cecília Caramujo ◽

Inês Ferreira Gomes ◽

Teresa Fraga ◽

Joana Correia Magalhães ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Psychiatric Disorders ◽

Palliative Treatment ◽

Metastatic Breast ◽

Subscale Score ◽

Psychiatric Disease ◽

Cross Sectional ◽

Ovarian Function Suppression ◽

Female Patients

Abstract Objective: To evaluate the prevalence of psychiatric disorders in a sample of Portuguese patients with metastatic breast cancer and assess the relationship between these disorders and the characteristics of the oncological disease.Methods: Cross-sectional, single-center study with female patients diagnosed with metastatic breast carcinoma and under palliative treatment between November 2020 and May 2021. Psychiatric disorders were screened by applying and filling-out the MMSE, HADS, BSI, and WHOQoL-Bref instruments at the outpatient daycare unit when patients were present for treatmen. Results: A total of 91 female patients were included, median age 59.79 years. None of the patients had cognitive impairment (MMSE). HADS scale: 18.7% of the patients scored for anxiety and 17.6% for depression. The anxiety subscale score of > 8 (HADS) was related to ovarian function suppression (p<0.001), neoadjuvant therapy (p<0.001), and type of second-line of palliative treatment (p=0.024). The depression subscale score >8 (HADS) was related to the type of surgery performed (p= 0.022), molecular subtype of the tumor (p=0.020), and occurrence of grade 3-4 toxicities in the first (p=0.018), and third-line treatments (p=0.031).Conclusion: The screening of psychiatric disorders through the application of these scales by the medical oncology team may be able to aid in diagnosis and potentially lead to psychiatric referral and intervention at an earlier stage.

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Psychological distress, social function and financial burden of cancer patients receiving treatment in an African setting.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e19048 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e19048-e19048

Author(s):

Musliu Adetola Tolani ◽

Peter Pase Abur ◽

Muhammad Daniyan ◽

Stanley Emeka Nwabuoku ◽

Aisha Mustapha ◽

...

Keyword(s):

Psychological Distress ◽

Cancer Treatment ◽

Palliative Treatment ◽

Financial Burden ◽

Well Being ◽

Social Function ◽

Cross Sectional Study ◽

Clinicopathologic Characteristics ◽

Cross Sectional ◽

Female Ratio

e19048 Background: The improvement in the quality of cancer treatment is key to increasing survival. However, the functional well-being of these patients is equally important. This study aimed to assess the degree of psychological distress, social function and financial burden in patients undergoing cancer treatment in our center. Methods: A cross-sectional study was designed to prospectively recruit patients in our teaching hospital between December 2019 to February 2020. Those with cancer, aged 18 years and above, who had surgery, chemotherapy and (or) radiotherapy for treatment were included while those who had not commenced cancer treatment were excluded. Information on their clinicopathologic characteristics was obtained. The degree of psychological distress was assessed using a distress thermometer (DT) based on an 11-point scale. Social function was assessed using validated SCARF social functioning index (SSFI) (Cronbach's alpha = 0.818) which has 4-domains, each with scores ranging from 0 (very poor) to 4 (very good). Financial burden (FB) was assessed on a 5-point Likert scale. SPSS was used for data analysis with p < 0.05 considered significant. Results: Seventy-two patients were analyzed with a mean age of 50.3 ± 13.7 years and male to female ratio of 0.8:1.0. The median time from diagnosis was 6.0 (2.5 – 16.0) months and 51 (70.8%) were on palliative treatment. The median psychological distress score was 6.0 (4.0 – 8.0) while the mean SSFI score was 12.0 ± 3.3. Relationship with immediate family (3.4 ± 0.7) had a significantly higher sub-score than two other domains (occupational role: 2.3 ± 1.4, p < 0.001; self-concern/care: 3.0 ± 1.0, p < 0.001). Fifty patients (69.4%) had heavy or extreme financial burden with 34 (47.2%) admitting to income reduction since onset of therapy. Female sex (p < 0.001, 95% CI: 1.246 – 3.597), higher ECOG score (p = 0.033, 95% CI: 0.061 – 1.383) and palliative treatment (p = 0.038, 95% CI: 0.084 – 2.768) were independent predictors of psychological distress. Conclusions: Despite the marked psychological distress and huge financial burden in patients receiving cancer treatment in this setting, they still maintained a relatively normal status in most of the social function domains.

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Psychosocial impact of prostate cancer surgery on sexual intimacy

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e20685 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e20685-e20685

Author(s):

T. L. Krupski ◽

V. Mouraviev ◽

J. Mayes ◽

T. Polascik

Keyword(s):

Prostate Cancer ◽

Cancer Treatment ◽

Well Being ◽

Self Esteem ◽

Sexual Relationships ◽

Sexual Intimacy ◽

Emotional Status ◽

Prostate Cancer Treatment ◽

Cross Sectional ◽

Partnership Quality

e20685 Background: Prostate cancer survivors live with the day-to-day consequences of the disease and its treatment. Prostate cancer, has been labeled a “relationship disease” because it impacts both partners. Traditional research does not include psychosocial aspects of sexual well-being. We designed a retrospective survey asking patients’ and their partners’ about the physiologic and psychosocial changes experienced after prostate cancer treatment. Methods: The study design is a cross sectional retrospective mailing sent to men treated surgically for prostate cancer. Questions related to physiologic changes centered around foreplay, libido, erection, orgasm and ejaculation while emotional status, relationship/partnership quality, self image, and social support comprised the psychological questions. Of the total 47 items, 18 items assessed the above concepts in binary fashion while the remaining 29 used a Likert scale. Results: After obtaining IRB approval, we mailed consents to 368 men. Only 65 men acknowledged receiving the information and 51 consented to participate. The participants were a median age of 59.6, predominantly Caucasian (80%), and treated by prostatectomy or cryotherapy. In terms of emotional status, 20% were diagnosed with depression and 10% with anxiety since their prostate cancer diagnosis and of those 32% felt it affected their sexual status. One third of the men rated their overall sexual relationship with their partner as “poor.” Of those men, 44% also perceived their partner was supportive. Over 80% felt their partnership quality was “stable,” “strong,” and “happy.” Almost half (43%) of the men experienced a decrease in self-esteem while 16% were unhappy with their physical appearance. While few men (4%) availed themselves of support groups, 18% found the advice of other patients helpful in coping with their sexuality. The side effects were unexpected in nearly half (43%) of the men. Conclusions: These preliminary findings suggest that prostate cancer treatment may be associated with psychosocial problems related to depression, anxiety, and self- esteem that impact sexual relationships. Although prospective validated questionnaires are needed to confirm these findings, better counseling through the disease trajectory may help combat these emotional issues. No significant financial relationships to disclose.

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Prevalence of bullying in the nursing workplace and determinant factors: a nationwide cross-sectional Polish study survey

BMJ Open ◽

10.1136/bmjopen-2019-033819 ◽

2019 ◽

Vol 9 (12) ◽

pp. e033819 ◽

Cited By ~ 2

Author(s):

Lena Izabela Serafin ◽

Bożena Czarkowska-Pączek

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Workplace Bullying ◽

Online Survey ◽

Working Hours ◽

Well Being ◽

Cross Sectional Study ◽

Bachelor's Degree ◽

Cross Sectional

ObjectivesIn the present study, we aimed to investigate the prevalence of bullying among Polish nurses, and to identify the most common negative acts, as well as individual and work-related risk factors for workplace bullying.MethodsCross-sectional study designed using an online survey. The total study sample was 404 nurses, each having over 6 months of working experience. Data were collected using the Polish version of the Negative Act Questionnaire-Revised. Linear stepwise regression analysis and logistic regression analysis were performed to assess predictors of greater reporting of perceived workplace bullyingResultsBullying was experienced by 65.84% of participants. Perceived workplace bullying was associated with sex (p=0.043), age (p=0.003), seniority (p=0.006), number of working hours per week (p=0.010) and position (p=0.029). Logistic regression analysis with the dependent variable of bullying according to Leymann’s rigorous criteria revealed that the model could include four variables: age from 50 to 59, seniority of 11–15 years,>45 working hours per week and a bachelor’s degree in nursing.ConclusionsAn alarming percentage of nurses were victims of bullying. Among all variables included in the regression model, the most significant predictors of perceived workplace bullying were age, seniority, work overtime and bachelor’s degree education. Bullying prevention and improvement of well-being at work must be addressed as part of an overall strategy to deal with turnover.

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Associations of Autism Traits With Obsessive Compulsive Symptoms and Well-Being in Patients With Obsessive Compulsive Disorder: A Cross-Sectional Study

Frontiers in Psychology ◽

10.3389/fpsyg.2021.697717 ◽

2021 ◽

Vol 12 ◽

Author(s):

Satomi Doi ◽

Yuki Kobayashi ◽

Yoshitake Takebayashi ◽

Eriko Mizokawa ◽

Atsuo Nakagawa ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Social Skill ◽

Well Being ◽

Subscale Score ◽

Autism Spectrum ◽

Autism Spectrum Quotient ◽

Obsessive Compulsive ◽

Cross Sectional ◽

Compulsive Disorder ◽

Autism Traits

The aim of this study is to examine the association of autism traits with long-term obsessive compulsive disorder (OCD) symptoms and well-being levels in patient with OCD. Participants comprised 18 outpatients from a tertiary hospital and 100 adults who were registered in a large Japanese internet marketing research company and met OCD criteria by the Mini-International Neuropsychiatric Interview and were between the ages of 20 and 65 years. Clinical characteristics, autism trait assessed using the Autism Spectrum Quotient (AQ), OCD symptoms assessed using Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and well-being assessed using the Flourishing Scale were assessed. Multiple regression analyses showed that a greater total score of AQ, a greater subscale score “imagination” was associated with a greater score of Y-BOCS. Greater total score of AQ, a greater subscale score “social skill,” and “imagination” were associated with lower well-being score. Autism traits, especially lack of imagination, were associated with more severe OCD symptoms. Further, autism traits, especially social skill problems and lack of imagination, were associated with lower levels of well-being. Assessment of autism traits before treatment and a strategy designed for OCD patients with autism traits may be warranted.

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Does Chronic Stress Moderate Age Differences in Emotional Well-Being? Testing Predictions of Strength and Vulnerability Integration

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa174 ◽

2020 ◽

Author(s):

Martin J Sliwinski ◽

Sara Freed ◽

Stacey B Scott ◽

Giancarlo Pasquini ◽

Joshua M Smyth

Keyword(s):

Boundary Condition ◽

Life Satisfaction ◽

Regression Analysis ◽

Negative Affect ◽

Chronic Stress ◽

Emotional Distress ◽

Age Differences ◽

Well Being ◽

Positive And Negative Affect ◽

Cross Sectional

Abstract Objectives The Strength and Vulnerability Integration (SAVI) theory posits boundary conditions, such as chronic stress, which place constraints on positive emotional aging. We examine SAVI’s prediction that higher levels of chronic stress will attenuate favorable age gradients for multiple indices of well-being. Methods We used cross-sectional data from a diverse systematic probability sample of adults (n = 260, ages 25–65). Multiple regression analysis was used to examine age gradients and test age × chronic stress interactions on 5 measures of well-being relevant for SAVI’s prediction: positive and negative affect, life satisfaction, emotional distress, and rumination. Results Age was unrelated to well-being unless individual differences in health limitations were statistically controlled, in which case older age was associated with more favorable levels of well-being. Chronic stress significantly interacted with age for negative affect, emotional distress, rumination, and life satisfaction; examination of the interactions indicated that age was no longer associated with more favorable levels of well-being at higher levels of chronic stress. Discussion Our findings support a key prediction of SAVI by demonstrating that high levels of chronic stress present a boundary condition for favorable age gradients on well-being. We discuss the implications of these findings for understanding the “paradox” of well-being.

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Psychological attachment in the new normal working context: Influence of career navigation and career well-being attributes

African Journal of Career Development ◽

10.4102/ajcd.v3i1.48 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Ingrid L. Potgieter ◽

Melinde Coetzee ◽

Nadia Ferreira

Keyword(s):

Social Support ◽

Regression Analysis ◽

South African ◽

Well Being ◽

Cross Sectional ◽

Convenience Sample ◽

New Normal ◽

Adoption Of Technology ◽

Working Space ◽

Managerial Employees

Background: The new normal working context, characterised by fast changes, rapid upskilling, adoption of technology, and remote working, requires employees to remain psychologically attached to their organisations. More insight is needed regarding how career navigation (as an attribute of career agility) and career well-being attributes explain the psychological attachment of employees in order to invest in their career development amidst the chaos and demands driven by the new normal working context.Objective: The study explored career navigation and career well-being attributes (i.e. positive career effect, career networking/social support, and career meaningfulness) as potential explanatory mechanisms of individuals’ psychological attachment.Method: The study used a cross-sectional research design, which involved a convenience sample (n = 177) of national and international employees (mean age = 34 years; standard deviation [SD] = 10.14), represented by 39% managerial employees, 38% staff, and 23% professional consultants. Most of the participants (72%) were employed by South African organisations.Results: Multiple regression analysis revealed that career navigation explains higher levels of psychological attachment (including affective, normative, and continuous attachment). Positive career effects significantly predicted continuous attachment, whereas social support/career networking positively predicted overall psychological attachment and affective and normative attachment. Career meaningfulness was found to explain higher levels of overall and affective psychological attachment.Conclusion: The findings contribute new insights into the construct of career navigation and career well-being attributes and extend research on the antecedents of psychological attachment in the new normal working space, characterised by remote working and technology.

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Investigating the Added Value of the EQ-5D-5L With Two Bolt-On Items in Patients With Hemophilia

Frontiers in Medicine ◽

10.3389/fmed.2021.707998 ◽

2021 ◽

Vol 8 ◽

Author(s):

Richard Huan Xu ◽

Dong Dong ◽

Nan Luo ◽

Renchi Yang ◽

Junshuai Liu ◽

...

Keyword(s):

Regression Analysis ◽

Multiple Regression Analysis ◽

Multiple Regression ◽

Ceiling Effect ◽

Discriminatory Power ◽

Added Value ◽

Life Questionnaire ◽

Vas Scores ◽

The Impact ◽

Eq Vas

Objective: This study examined the impact of adding two condition-specific bolt-on items to the EQ-5D-5L and assessed their psychometric properties in patients with hemophilia.Methods: The data were obtained from a nationwide cross-sectional online survey of patients with hemophilia in China. Self-reported and proxy-reported data were analyzed separately. Ceiling effect, informativity, and discriminatory power of the EQ-5D-5L with two bolt-on items, dignity (DG), and bleeding (BL), were examined. Spearman's rank correlation (rho) was used to assess the associations of the EQ-5D-5L and two bolt-on items with the Hemophilia Quality of Life Questionnaire for Adults (Haem-A-QoL) and SF-12. Multiple regression analysis was performed to evaluate the explained variance of the EQ-5D-5L and bolt-on items in predicting EQ-VAS scores.Results: A total of 895 patients and 222 caregivers completed the questionnaire. The ceiling effect decreased from 1.9 to 0.6% and 5.9 to 0.9% when using the EQ-5D-5L and the EQ-5D-5L with two bolt-on items among participants with both self- and proxy-completed questionnaires. Both DG and BL were strongly correlated with Haem-A-QoL sum score [rho: DG = 0.64 (patient) vs. 0.66(proxy); BL = 0.49 (patient) vs. 0.31 (proxy)], SF-12 mental component [rho: DG = −0.36 (patient) vs. −0.41 (proxy); BL = −0.53 (patient) vs. −0.57(proxy)], and SF-12 physical component [rho: DG = −0.61 (patient) vs. −0.61 (proxy); BL = −0.35 (patient) vs. −0.39 (proxy)]. Known-group comparisons confirmed that the two bolt-on items had satisfactory discriminatory power. Multiple regression analysis indicated that adding two bolt-on items significantly increased the ability to predict EQ-VAS scores. The adjusted R2 increased by 8.2 and 8.8% for reports completed by the patients or patients' proxy respondents, respectively.Conclusion: Adding the DG and BL bolt-on items can increase performance on the EQ-5D-5L in patients with hemophilia. A future valuation study will be carried out.

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