Patient‐reported outcome measures for emotional functioning in cancer patients: Content comparison of the EORTC CAT Core, FACT‐G, HADS, SF‐36, PRO‐CTCAE, and PROMIS instruments

Article

Author: Giesinger, Johannes M. ; Holzner, Bernhard ; Rothmund, Maria ; Pilz, Micha J. ; Petersen, Morten Aa. ; Egeter, Nathalie ; Schmidt, Heike ; Lidington, Emma ; Young, Teresa ; van Leeuwen, Marieke ; Grønvold, Mogens ; Piccinin, Claire ; Arraras, Juan I.

AbstractBackgroundCancer and its treatment can have substantial impact on patients' emotional functioning. Several patient‐reported outcome measures (PROMs) assessing emotional functioning are available, but differences in content limit the comparability of results. To better understand conceptual (dis)similarities, we conducted a content comparison of commonly used PROMs.MethodsWe included emotional functioning items, scales, and item banks from the EORTC CAT Core, EORTC QLQ‐C30, FACT‐G, Hospital anxiety and depression scale (HADS), SF‐36, PRO‐CTCAE, and PROMIS (item banks for anxiety, depression, and anger). Item content was linked to the International Classification of Functioning, Disability, and Health (ICF) and a hierarchical framework established for PROMIS. Single items could be coded with more than one ICF category but were solely assigned to one facet within the PROMIS framework.ResultsThe measures comprise 132 unique items covering the ICF components ‘Body functions’ (136/153 codings, 88.9%) and ‘Activities and participation’ (15/153, 9.8%). Most ICF codings (112/153, 73.2%) referred to the third‐level category ‘b1528 Emotional functions, other specified’. According to the PROMIS framework 48.5% of the items assessed depression (64/132 items), followed by anxiety (41/132, 31.1%) and anger (26/132, 19.7%). The EORTC measures covered depression, anxiety, and anger in a single measure, while the PROMIS inventory provides separate item banks for these concepts. The FACT‐G, SF‐36, PRO‐CTCAE and HADS covered depression and anxiety, but not anger.ConclusionOur results provide an in‐depth conceptual understanding of selected PROMs and important qualitative information going beyond psychometric evidence. Such information supports the identification of PROMs for which scores can be meaningfully linked with quantitative methods.

01 Nov 2022·Psycho-Oncology

Psychosocial characteristics of chronic pain in cancer survivors referred to an Australian multidisciplinary pain clinic

Article

Author: Costa, Daniel J. ; Nicholas, Michael K. ; Glare, Paul A.

AbstractObjectiveTo describe the clinical and psychosocial characteristics of chronic pain in cancer survivors referred to one Australian hospital's ambulatory pain clinic over a 7‐year period (2013‐19), and to compare cancer treatment‐related pain with comorbid non‐malignant pain.MethodRetrospective chart review including responses to standardized self‐report questionnaires (Brief Pain Inventory, Depression Anxiety Stress Scale, Pain Self‐Efficacy Questionnaire, Pain Catastrophizing Scale), routinely collected in all patients referred to pain clinics at Australian and New Zealand hospitals.ResultsOf 3510 new referrals during the study period, 267 (7.5%) had a history of cancer and 176 (5.0%) met the study's eligibility criteria. Their average age was 63 ± 13 years, with 55% female. Breast cancer survivors were commonest, followed by hematological, prostate, melanoma, and colorectal, a median of 3 years post‐diagnosis. Pain was attributed to cancer treatment in 87 (49%), surgery being the commonest modality. Multimodal treatment (n = 89, 58%) was significantly commoner in the treatment‐related pain group (p < 0.001). Average pain severity was moderate, as was pain‐related disability and distress. Pain cognitions were often maladaptive (low pain self‐efficacy, high pain catastrophizing), predicted by pre‐existing anxiety and depression. Associations between pain cognitions and outcomes were medium‐to‐large. Differences between treatment pain and comorbid pain were small‐to‐medium. Their scores were similar to Australian pain clinic norms.ConclusionCancer treatment causes tissue damage, but pain‐related distress and disability in survivors is associated with maladaptive pain cognitions. Survivors with poor pain outcomes should be evaluated for unhelpful thoughts and beliefs especially when they have pre‐existing depression or anxiety.

01 Aug 2017·International Journal of Clinical OncologyQ3 · MEDICINE

Patient perceptions of symptoms and concerns during cancer chemotherapy: ‘affects my family’ is the most important

Q3 · MEDICINE

Article

Author: Takamatsu, Y ; Mogi, A ; Sasaki, H ; Ikari, Y ; Naito, Y ; Nakashima, Y ; Tamura, K ; Masaki, M ; Tanaka, T ; Ogata, K

BACKGROUNDCancer chemotherapy is associated with a variety of side effects/adverse events. It is very important that patients adhere to the planned chemotherapy regimen, which necessitates a minimum of side effects and that these side effects be kept under control. We have investigated patients' concerns and symptoms during chemotherapy with the aim to seek solutions that will improve patients' quality of life during chemotherapy.METHODSForty-nine patients with malignant diseases on parenteral antineoplastic agents were sequentially enrolled in this study. These patients completed a questionnaire consisting of 42 items related to non-physical concerns and 52 items of physical symptoms related to chemotherapy. Each patient was also asked to select the three items among these 94 items which affected him/her the most.RESULTSThe median age of the cancer patients was 62 years and the male-to-female ratio was 18:31. Among the non-physical concerns, the most frequently chosen concern was 'affects my family or partner,' followed by anxiety related to treatment. Regarding the physical symptoms, the most frequent complaints were fatigue, alopecia and constipation, while the most troublesome symptoms were nausea, poor taste and paresthesia. Overall, the most frequently expressed concerns were 'affects my family or partner' and anxiety related to treatment. Male patients suffered most from fever, fatigue and nausea, and female patients complained more of poor taste and gastrointestinal problems.CONCLUSIONPatient perceptions of adverse events associated with cancer chemotherapy apparently have changed from physical symptoms to non-physical concerns. In our patient cohort 'affects my family or partner' was the most important concern. One important point to note is that female patients often complained of poor taste because this meant they were unable to cook well.

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