Screening for Distress and Unmet Needs in Patients With Cancer: Review and Recommendations

2012 ◽  
Vol 30 (11) ◽  
pp. 1160-1177 ◽  
Author(s):  
Linda E. Carlson ◽  
Amy Waller ◽  
Alex J. Mitchell
Keyword(s):  
Quality Of Life ◽  
Psychometric Properties ◽  
Unmet Needs ◽  
Assessment Tools ◽  
Screening Tools ◽  
Distress Screening ◽  
Screening Programs ◽  
Patients With Cancer ◽  
Screening For Distress

Purpose This review summarizes the need for and process of screening for distress and assessing unmet needs of patients with cancer as well as the possible benefits of implementing screening. Methods Three areas of the relevant literature were reviewed and summarized using structured literature searches: psychometric properties of commonly used distress screening tools, psychometric properties of relevant unmet needs assessment tools, and implementation of distress screening programs that assessed patient-reported outcomes (PROs). Results Distress and unmet needs are common problems in cancer settings, and programs that routinely screen for and treat distress are feasible, particularly when staff are supported and links with specialist psychosocial services exist. Many distress screening and unmet need tools have been subject to preliminary validation, but few have been compared head to head in independent centers and in different stages of cancer. Research investigating the overall effectiveness of screening for distress in terms of improved recognition and treatment of distress and associated problems is not yet conclusive, but screening seems to improve communication between patients and clinicians and may enhance psychosocial referrals. Direct effects on quality of life are uncertain, but screening may help improve discussion of quality-of-life issues. Conclusion Involving all stakeholders and frontline clinicians when planning screening for distress programs is recommended. Training frontline staff to deliver screening programs is crucial, and continuing to rigorously evaluate outcomes, including PROs, process of care, referrals, and economic costs and benefits is essential.

scholarly journals Food-Related Quality of Life in Cancer Patients: Development and Validation of a Questionnaire

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 273-273
Author(s):  
Catherine Mercier ◽  
Kenza Drareni ◽  
Anestis Dougkas ◽  
Fadila Farsi ◽  
Pamela Funk-Debleds ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Healthy Volunteers ◽  
Cancer Patients ◽  
Assessment Tools ◽  
Life Assessment ◽  
Life Questionnaire ◽  
Patients With Cancer ◽  
Item Questionnaire ◽  
Related Quality

Abstract Objectives Monitoring psychosocial, emotional, and hedonic aspects of food behavior is important to understand cancer patients’ distress and help to reduce risks of malnutrition. However, to date, there is no specific tool to measure the impact of diet, eating behavior, and chemotherapy side effects on patients’ food-related quality of life during cancer and its treatments. The objective was to develop and validate a questionnaire that aims to assess the food-related quality of life in cancer patients undergoing chemotherapy. Methods Relevant items from the existing food-related quality of life assessment tools were selected to compose the present 46-item questionnaire. The validation of the questionnaire was conducted in 276 healthy volunteers and 173 cancer patients. Exploratory Factor Analysis (EFA) was performed in both groups, construct and discriminant validity, and test-retest reliability were calculated. Results The questionnaire was perceived as clear and required less than14 minutes for completion (93% complete responses) in a pre-test (n = 156). The EFA allowed the inclusion of 9 dimensions in the food-related quality of life questionnaire. Common patterns between patients and healthy volunteers (factor loadings ≥ 0.4 in both groups) were used to calculate scores by dimension. Scores in the dimensions of adapting diet and sensorial discomfort (taste/odor) were higher in cancer patients, whilst scores in the dimension of discomfort in satiety were higher in healthy volunteers. Among patients with cancer, the total scores in sensorial discomfort, digestive discomfort, and discomfort in satiety were higher under chemotherapy than no treatment. Reproducibility after one week was in increasing order; digestive discomfort 0.6, adapting diet 0.61, products’ quality 0.67, cooking 0.75, healthy diet 0.76, eating and pleasure 0.80, discomfort in satiety 0.82, and sensorial discomfort 0.85. Conclusions This 46-item questionnaire can discriminate cancer patients versus healthy volunteers, and patients receiving vs those not receiving chemotherapy. A good to very good reproducibility was found for the most important factors of food-related quality of life of patients with cancer, i.e, eating and pleasure, sensorial discomfort, and discomfort in satiety. Funding Sources This study is funded by La Région Auvergne Rhône-Aples and La Métropôle de Lyon.

scholarly journals Prevalence and Prognostic Value of Malnutrition Among Elderly Cancer Patients Using Three Scoring Systems

2021 ◽  
Vol 8 ◽  
Author(s):  
Qi Zhang ◽  
Liang Qian ◽  
Tong Liu ◽  
Jia-Shan Ding ◽  
Xi Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Scoring Systems ◽  
Assessment Tools ◽  
Life Questionnaire ◽  
Advanced Tumor Stage ◽  
Patients With Cancer ◽  
All Cause Mortality

Background: Malnutrition is common in patients with cancer and is associated with adverse outcomes, but few data exist in elderly patients. The aim of this study was to report the prevalence of malnutrition using three different scoring systems and to examine the possible clinical relationship and prognostic consequence of malnutrition in elderly patients with cancer.Methods: Nutritional status was assessed by using controlling nutritional status (CONUT), the prognostic nutritional index (PNI), and the nutritional risk index (NRI). Quality-of-life (Qol) was assessed during admission by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30. Performance status (PS) was assessed by using the Eastern Cooperative Oncology Group (ECOG) classification. The relationship between nutritional status and overall survival and Qol were examined.Results: Data were available for 1,494 elderly patients with cancer (63.65% male), the mean age was 70.76 years. According to the CONUT, NRI, and PNI, 55.02, 58.70, and 11.65% patients were diagnosed with malnutrition, respectively. Worse nutritional status was related to older, lower BMI, lower hand grip strength, and more advanced tumor stage. All malnutrition indexes were correlated with each other (CONUT vs. PNI, r = −0.657; CONUT vs. NRI scores, r = −0.672; PNI vs. NRI scores, r = 0.716, all P < 0.001). During a median follow-up of 43.1 months, 692 (46.32%) patients died. For patients malnourished, the incidence rate (events-per-1,000person-years) was as follows: CONUT (254.18), PNI (429.91), and NRI (261.87). Malnutrition was associated with increased risk for all-cause mortality (adjust HR [95%CI] for CONUT: 1.09 [1.05–1.13], P < 0.001; PNI: 0.98[0.97–0.99], P < 0.001; NRI: 0.98 [0.98–0.99], P < 0.001). All malnutrition indexes improved the predictive ability of the TNM classification system for all-cause mortality. Deterioration of nutritional status was associated with deterioration in Qol parameters and immunotherapeutic response (P < 0.001).Conclusions: Malnutrition was prevalent in elderly patients with cancer, regardless of the assessment tools used, and associated with lower Qol and the immunotherapy response.

scholarly journals A230 GAPS IN IDENTIFYING FOOD-RELATED QUALITY OF LIFE AND HYPERVIGILANCE IN AT-RISK INDIVIDUALS WITH IBD: REVIEW OF VALIDATED SCREENING TOOLS

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 106-107
Author(s):  
A N Sasson ◽  
L Targownik ◽  
K Vagianos ◽  
C N Bernstein
Keyword(s):  
Quality Of Life ◽  
Screening Tool ◽  
Assessment Tools ◽  
Screening Tools ◽  
Measurement Properties ◽  
Cochrane Library ◽  
Full Text Review ◽  
Health Related Qol ◽  
Related Quality

Abstract Background Inflammatory bowel disease (IBD) has a profound impact on psychosocial aspects of food and nutrition, thereby affecting food-related quality of life (QoL). While there is literature on associated prevalence of increased anxiety in individuals with IBD, there is limited data on its contribution to hypervigilance and orthorexia with food intake. Many patients with IBD have strong beliefs about dietary symptom triggers, which can lead to avoidance behaviors and decreased nutrient intake. This can exacerbate malnutrition and disordered eating, as well as increase disease-related stress and negatively impact coping. While there are validated scales evaluating anxiety-related, QoL-related and food-related behaviors in IBD, a combined screening tool to assess this comorbid axis is not well described. Aims To conduct a systematic review of existing literature in order to inform practice and facilitate development of an effective food-related hypervigilance and QoL evaluation in IBD patients Methods The literature was systematically searched through September 2019, using an electronic database querying Embase, PubMed, MEDLINE, Cochrane Library and PsycINFO. We searched original articles describing development, validation and measurement properties for screening tools on anxiety, QoL and food-related behaviors in IBD from 1975 to 2018. The primary outcome of interest was to evaluate the current measurements of the validated tools to identify whether a screening tool highlighting all above parameters exists for patients with IBD. Results Initial database search resulted in 5548 articles. After screening titles and abstracts, 168 were included. After full text review and deduplication, 23 validated scales were identified for use in IBD patients with respect to measuring anxiety, health-related QoL and food-related behaviors. There was substantial heterogeneity in IBD populations using the assessment tools (adult vs. pediatric, CD vs. UC, inpatient vs. outpatient). The breakdown of studies identified: 2 studies (8.6%) evaluated QoL and anxiety, 2 studies (8.6%) evaluated QoL and food-related behaviors. The remainder of studies individually assessed QoL, anxiety and food-related behaviors (47.8%, 26% and 8.6% respectively). None of the tools performed satisfactory to establish all three measurements in individuals with IBD. Conclusions Recent evidence suggests the presence of dietary hypervigilance in individuals with chronic GI conditions potentially leading to food restrictive behaviors impacting QoL. Screening models evaluating multivariable relations of anxiety in food-related behaviors and QoL in IBD is lacking. Efforts should be made to develop and validate a multi-assessment screening tool to aid in early identification of this prevalence in IBD patients to facilitate improved management outcomes. Funding Agencies None

Psychometric properties of the EORTC head and neck–specific quality of life questionnaire in disease-free Greek patients with cancer of pharynx and larynx

2010 ◽  
Vol 19 (5) ◽  
pp. 761-768 ◽  
Author(s):  
Meri Nalbadian ◽  
Vasilios Nikolaidis ◽  
Agelos Nikolaou ◽  
Christos Themelis ◽  
Athanasios Kouloulas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychometric Properties ◽  
Head And Neck ◽  
Life Questionnaire ◽  
Quality Of Life Questionnaire ◽  
Patients With Cancer ◽  
Disease Free

Development and Validation of a Questionnaire to Assess Parent Reported Quality of Life Pre and Post Vision Therapy in a Population with Autism Spectrum Disorder

2019 ◽  
pp. 195-207
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Social Behavior ◽  
Psychometric Properties ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Visual Behavior ◽  
The Mean ◽  
Vision Therapy

Background: Autism spectrum disorder is characterized in part by atypical behavior in the communication, social, and visual domains. Success in vision therapy is judged not only by changes in optometric findings, but through improvement in quality of life involving communication, social behavior and visual behavior. It would therefore be beneficial to have a validated questionnaire to assess parent reported quality of life pre and post vision therapy specific to patients with autism spectrum disorder. To our knowledge, a questionnaire of this nature has not been previously published in the literature. Methods: Questionnaire items were generated through surveying medical literature based on symptoms in three different categories: visual behavior, social behavior and communication. A pool of 34 questions was developed initially and then with thorough discussion with other experts, a 20-point questionnaire was developed with each item reflected in the construct concept. A draft of 20 questions was then sent to 10 subject experts with clinical experience in the field for more than 20 years, to review the pooled items. Validity and reliability was established prior to assessing the psychometric properties of the ASD/QOL-VT. Prospective observational study was conducted for a duration of 18 months. The study included individuals undergoing vision therapy in the age range of 3 to 15 years who had been diagnosed with ASD. The questionnaire was administered to parents of these children prior to the start of vision therapy. All subjects completed a minimum of 60 vision therapy sessions. The questionnaire was readministered after completing 60 sessions of vision therapy. Results: Cronbach’s alpha value for this questionnaire was 0.93, which reflected very good internal consistency. Factorial analysis yielded four factors with an Eigen value exceeding 1.0 which accounted for 68% variation in the model. The Cronbach alpha value for subscales identified by factorial analysis is 0.97 indicating excellent internal reliability. The mean pre vision therapy social behavior, communication and visual behavior score was 12.0±3.21, 17.07±4.57 and 26.97±6.41 respectively. The mean post vision therapy scores for social behavior, communication and visual behavior was 8.27±4.16, 11.33±5.27 and 17.93±6.52 respectively. On paired t test, the mean difference in score was statistically significant with P<0.001 in all three subcategories. Conclusions: Our study presents the development of a valid and reliable parent questionnaire, the ASD/QOL-VT, that judges communication, social behavior, and visual behavior in autism. Results of the study conducted indicate that vision therapy can result in significant improvements in the quality of life of patients with ASD as judged by their parents. This is evidenced by statistically significant changes in psychometric properties of the ASD/QOL-VT in social behavior, communication and visual behavior.

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