Search

Aim This study aimed to culturally adapt and psychometrically validate the PROMIS Social Relationships Short Forms (PROMIS‐SR) among Chinese patients with breast cancer. Design A cross‐sectional study. Method The PROMIS‐SR was translated into simplified Chinese by strictly adhering to the Functional Assessment of Chronic Illness Therapy translation method and was subsequently tested among patients with breast cancer (N = 965). Eligible patients filled out the demographic information questionnaire, the PROMIS‐SR, and the Functional Assessment of Cancer Therapy‐Breast. Results Confirmatory factor analysis (CFA) provided support for the original structure of the PROMIS‐SR. All instruments reported strong known‐group, cross‐cultural and convergent validity, as hypothesized. Correlation coefficients ranged from 0.67 to 0.85, and Cronbach's α of all items were high (0.90–0.94).

Purpose Mobile health (mHealth) application (app) targeted promoting physical activity (PA) demonstrates advantages in knowledge sharing, social connecting and tailored intervention for breast cancer (BC) patients. However, lacking of theoretical basis restricted sustainable benefits of these apps. We construct a theory-based mHealth PA intervention program and to determine whether this would improve PA behavior change during chemotherapy for BC patients.Methods Social cognitive theory, self-efficacy theory and the theory of planned behavior were referred to construct mHealth intervention strategies. Guided by agile development model, “Breast care” smartphone app based on above integrated theories was developed. Then, a three-month pre-post mHealth PA intervention delivered by the app was implemented. A mixed method was utilized to test the effectiveness of this remotely intervening. Results Twenty participants were recruited. Based on PA capability assessment and baseline PA evaluation, 12 patients were divided into active group, and 8 patients were grouped in sedentary lifestyle. Within three months, the average accumulated app usage time of each participant identified at portal site was 40 minutes a week. The total PA increased 945.70 metabolic equivalents (MET) -min/w with a significant improvement (P=.04) after 3 months. Walking displayed a significant improvement after intervention (904.20 MET-min/w) (P=.03). Qualitative results showed satisfaction and willingness of BC patients to use the app to manage PA and relevant health behaviors.Conclusion The theory-based mHealth PA intervention has great potential to enhance BC patients’ PA awareness and engagement, meanwhile to facilitate their PA behavior change.

Background Self-efficacy is a crucial variable that is related to quality of life. Patients who have high self-efficacy will exert sufficient effort and have better health outcomes and improved quality of life. Appropriate and precise measurement of self-efficacy can help promote better care. The Breast Cancer Survivor Self-efficacy Scale (BCSES) is designed to measure the perceived confidence of breast cancer patients in managing the tasks for self-management. Originally developed in America, it has not been used in China. Objectives The aims of this study were to translate BCSES into Chinese and assess its psychometric properties among Chinese patients. Methods In phase 1, the translation of BCSES closely followed the Principles of Good Practices. In phase 2, data on reliability and validity were evaluated in terms of internal consistency, item-total correlations, test-retest reliability, criterion validity, and construct validity. A total sample of 630 native Chinese-speaking patients from 5 hospitals in China participated, including a pilot sample of 182 and a validation sample of 448. Results Minor modifications in 5 items were recommended after translation. Both exploratory and confirmatory factor analyses suggested a 2-factor structure was more ideal than the original 1-factor model. Cronbach's α coefficient for the Chinese version of BCSES was .82, intraclass correlation coefficient was 0.97, and item-total correlations were from 0.61 to 0.76. Conclusions The Chinese version of BCSES appears to be culturally appropriate, reliable, and valid for assessing self-efficacy among patients with breast cancer in China. Implication for practice The Chinese version of BCSES could help measure the breast cancer patients' self-efficacy and provide evidence to develop culturally sensitive interventions for Chinese patients.

Background The diagnosis of breast cancer and the subsequent treatment undermine patients’ participation in social activities. This study aimed to carry out a cross-cultural adaption and analysis of the construct validity and reliability of the Chinese version of the PROMIS social function short forms in patients with breast cancer. Methods This study utilized a cross-sectional research design, and was registered in the Chinese Clinical Trial Registry (ChiCTR2000035439). After a standardized cross-cultural adaption process, a psychometric evaluation was performed of the Chinese version of the PROMIS social function short forms. Using convenience sampling, eligible patients with breast cancer from tertiary hospitals in China were enrolled from January 2019 to July 2020. Participants completed the sociodemographic information questionnaire, the PROMIS social function short forms, the Functional Assessment of Cancer Therapy-Breast, the PROMIS emotional support short form and the PROMIS anxiety short form. Results Data were collected from a sample of 633 patients whose mean age was 48.1 years. The measures showed an absence of floor and ceiling effects. Regarding construct validity, the results of confirmatory factor analysis supported the original two-factor structure of the PROMIS social function short forms. In addition, the measures were found to have acceptable known-group validity, measurement invariance, and convergent and discriminate validity. Regarding reliability, the Cronbach’s α was high for all items (> 0.70). Conclusion The Chinese version of the PROMIS social function short forms was demonstrated to be a valid and reliable measure for the assessment of social function in Chinese patients with breast cancer. Additional psychometric evaluation is needed to draw firm conclusions.

Aim To identify subgroups of cancer patients with distinct self-care self-efficacy profiles and to explore factors that can be used to predict those at risk of low self-efficacy. Design A secondary analysis of data pooled from two cross-sectional surveys was performed. Methods In total, 1,367 Chinese cancer survivors were included in the analysis. Latent profile analysis (LPA) was performed to categorize participants into latent subgroups with distinct self-efficacy profiles. Multinomial logistic regression was conducted to identify predictors of self-care self-efficacy subgroup classification. Results We identified three distinct subgroups: low, medium and high self-care self-efficacy. Patients with the "low" profile, which was characterized by a low education level, single marital status, complications, late cancer stage and a lower level of social support, had the poorest self-care behaviour.

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.

To provide effective end-of-life care education for health professions students, it is important to understand students' views of death in addition to their perceptions of educational needs and preferences. However, there is a lack of studies addressing interindividual variability in perceptions of end-of-life care educational needs among health professions students.This study aimed to identify latent profiles of perceptions of end-of-life care educational needs among health professions students and examine whether the demographic characteristics, death-related events, death attitude, and death anxiety differed by need subgroup.Through convenience sampling, health professions students from three universities in China were recruited between March 2020 and June 2020. Data were collected using a demographic information and death-related experience questionnaire, the End-of-Life Care Curriculum Needs Questionnaire, the End-of-Life Care Educational Needs Questionnaire, the Death Attitudes Profile-Revised, and the Templer's Death Anxiety Scale.A total of 1048 students completed the survey. Two classes of perceptions of end-of-life care educational needs were identified: approximately 29.80% of students belonged to a medium-need group class (1), and 70.20% belonged to a high-need group class (2). Being female and having knowledge of end-of-life care significantly increased the probability of membership in class 2. Students with the two latent profiles reported having varied curriculum needs. In addition, a positive attitude toward death and low death anxiety increased the probability of membership in class 1.Two classes of perceptions of end-of-life care educational needs were identified, and these classes were significantly associated with sex and death-related knowledge (P0.05). Interindividual variability should be considered in the future development of end-of-care curricula.

Aims To describe and synthesize diverse empirical evidence regarding physical activity (PA) in the context of advanced breast cancer (ABC). Design Integrative review guided by the work of Whittemore and Knafl (2005). Data sources Six electronic databases were systematically searched to identify relevant literature published between January 2007-June 2019. Review methods Abstracts of papers that met the inclusion criteria were reviewed by two researchers and full texts of eligible papers were assessed. Data were extracted by two independent researchers and inter-rater reliability of data extraction established. Quality of papers was evaluated using the Mixed Methods Appraisal Tool. Data were organized according to comprehensive thematic analysis and the biobehavioural model for the study of exercise interventions. Results Of the 532 abstracts, 18 studies met the inclusion criteria which included six randomized controlled trials, one quantitative non-randomized study, seven quantitative descriptive studies, three mixed method studies and one qualitative study. Results from studies enrolled fell into four domains: PA performance and its influence on survival; barriers and preferences for PA; interventions to enhance PA; perceived benefits of PA from qualitative feedback. Conclusion Evidence suggests that ABC patients are physically inactive. Main barriers of PA are less aerobic fitness and heavy symptom burden. Simple, tailored and specialist-supervised PA is preferred by ABC patients. Form of joint self-instructed and group accompanying is advocated as well. PA intervention programmes identified in this review vary on type, intensity, duration and frequency, while generally, are found to be feasible, safe and beneficial to patients' physical and psychosocial well-being. Impact The results propose tailored, supervised, group-based PA programmes are in urgent need for ABC patients. Clinical professionals should manage more feasible and safer PA interventions to help improve patients' overall health. More research with rigorous methodology design is warranted to explore PA's effect on long-term health outcomes.

BACKGROUND Physical activity (PA), known as a modifiable protective factor, provides an approach to sustain physical and psycho-social health for breast cancer patients both during and after treatment. Mobile health (mHealth) application targeted promoting health behaviors demonstrates advantages in behavior tracking, knowledge sharing and social connecting and tailored intervention. However, process of mHealth application (App) development is lack of theoretical basis, restricting its sustainable benefits to cancer survivors. OBJECTIVE To construct a theory-based mHealth PA intervention program, and to determine whether this intervention would improve PA behavior change during chemotherapy for breast cancer patients, thus to capture their perspectives and experiences when participate it. METHODS Social cognitive theory (SCT), self-efficacy theory (SET) and the theory of planned behavior (TPB) are referred to construct mHealth intervention strategies. Smartphone application was chosen to implement a pre-post three-month PA intervention. A mixed method was utilized to test the preliminary effectiveness of MPAP. Quantitative results from online records and self-reported questionnaires were collected after intervention. Qualitative feedback through telephone interviewing was recorded to explore patients’ using experiences. RESULTS “Breast care” smartphone application was developed to improve self-management of breast cancer patients including PA. In the end, five main pages covering 6 functions (information delivering, disease tracking, events reminding based on calendar, online interaction, health behavior recording and self-reported assessment) were displayed in the app. In the preliminary evaluation process, twenty participants were recruited. Based on PA capability assessment and baseline PA evaluation, 12 patients were divided into active group, and 8 patients were grouped in sedentary lifestyle. Within three months, participants’ usage behavior identified at portal site indicated the accumulated app usage time is 40 minutes a week, and average login time of each participant was three times a week. The total PA increased 945.70 MET-min/w with a significant improvement(p=0.040) after 3 months. Walking displayed a significant improvement after intervention (904.20 MET-min/w) (p=0.030). Sedentary mean time declined 210 mins/w. Qualitative results showed satisfaction and willingness of breast cancer patients to use app to manage PA and relevant health behaviors. CONCLUSIONS The theory-based mHealth PA intervention has great potential to enhance breast cancer patients’ PA awareness and engagement, meanwhile to facilitate their PA behavior change.

Background Self-management plays an important role in improving quality of life among patients with breast cancer. Self-management behaviors change with treatment periods, and the trajectory varies in patients with different demographic and psychosocial characteristics. However, the trajectory patterns and the predictive factors have not been fully studied. Objectives The aim of this study was to identify the trajectory patterns of self-management behaviors in Chinese patients with breast cancer and their predictive factors. Methods A total of 128 patients with breast cancer were recruited. Demographic and disease-related information, self-management behaviors, self-efficacy, coping modes, emotional distress, and social support were investigated across 5 time points. Growth mixture modeling was used to identify the trajectory patterns of self-management behaviors. Logistic regression was used to determine the predictors for membership. Results The best-fit growth mixture modeling revealed a 2-class model; model fit indices were all in acceptable ranges. Class 1 and 2 were named as the group of "stable" (34.38%) and the group of "sharply decreased" (65.62%), respectively, based on the tendency of change. Modified radical mastectomy, avoidance coping mode, anxiety, and low self-efficacy level were predictors of the patients' membership to the sharply decreased group. Conclusion Our study proved the heterogeneity of self-management behaviors and the influencing effect of treatment and psychosocial factors on the development of self-management behaviors in Chinese patients with breast cancer. Implications for practice Health professionals should pay more attention to patients who are at higher risk of developing a poor self-management pattern. Targeted interventions should be developed across subpopulations and treatment periods accordingly.

BackgroundAcute lymphoblastic leukemia (ALL) is the most common childhood malignancy. Caring for children with ALL is challenging for parents. A mobile health (mHealth) supportive care intervention was developed to meet parents’ needs. ObjectiveThis study aims to evaluate the potential effectiveness of this mHealth supportive care intervention on emotional distress, social support, care burden, uncertainty in illness, quality of life, and knowledge. MethodsWe conducted a quasi-experimental pre- and postdesign study from June 2015 to January 2016. In total, 101 parents were enrolled in the study, with 50 in the observation group and 51 in the intervention group. Parents in the observation group received the standard health education and were observed for 3 months. Parents in the intervention group received the mHealth supportive care intervention, in addition to the standard health education. The intervention consisted of 2 parts—an Android smartphone app “Care Assistant (CA)” and a WeChat Official Account. The CA with 8 modules (Personal Information, Treatment Tracking, Family Care, Financial and Social Assistance, Knowledge Center, Self- Assessment Questionnaires, Interactive Platform, and Reminders) was the main intervention tool, whereas the WeChat Official Account was supplementary to update information and realize interaction between parents and health care providers. Data of parents’ social support, anxiety, depression, care burden, uncertainty in illness, quality of life, their existing knowledge of ALL and care, and knowledge need were collected before and after the 3-month study period in both groups. For the intervention group, parents’ experience of receiving the intervention was also collected through individual interviews. ResultsOverall, 43 parents in the observation group and 49 in the intervention group completed the study. Results found that the intervention reduced parents’ anxiety (Dint(Post-Pre)=−7.0 [SD 13.1], Dobs(Post-Pre)=−0.4 [SD 15.8], t90=−2.200, P=.03) and uncertainty in illness (Dint(Post-Pre)=−25.0 [SD 8.2], Dobs(Post-Pre)=−19.8 [SD 10.1], t90=−2.761, P=.01), improved parents’ social function (Dint(Post-Pre)=9.0 [SD 32.8], Dobs(Post-Pre)=−7.5 [SD 30.3], t90=2.494, P=.01), increased parents’ knowledge of ALL and care (Dint(Post-Pre)=28.4 [SD 12.4], Dobs(Post-Pre)=17.2 [SD 11.9], t90=4.407, P

Breast cancer patients showed low engagement in physical activity (PA) during chemotherapy. Evidence showed regular PA has potential to reduce mortality and risks of cancer recurrence, relieve psychological distress, manage symptoms and improve quality of life. Mobile health intervention displays a great advantage to deliver cancer care timely and remotely. A Mobile Physical Activity Program was constructed in a mobile phone application. The application contained 5 modes: information delivering, disease tracking, events reminders, online interaction, health behavior recording (daily walking steps, sleeping time and body weight) and self-reported assessment. Both applications and web-based administration portal were developed by engineers.

BACKGROUND Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. Caring for children with ALL is challenging for parents. A mobile health (mHealth) supportive care intervention was developed to meet parents’ needs. OBJECTIVE This study aims to evaluate the potential effectiveness of this mHealth supportive care intervention on emotional distress, social support, care burden, uncertainty in illness, quality of life, and knowledge. METHODS We conducted a quasi-experimental pre- and postdesign study from June 2015 to January 2016. In total, 101 parents were enrolled in the study, with 50 in the observation group and 51 in the intervention group. Parents in the observation group received the standard health education and were observed for 3 months. Parents in the intervention group received the mHealth supportive care intervention, in addition to the standard health education. The intervention consisted of 2 parts—an Android smartphone app “Care Assistant (CA)” and a WeChat Official Account. The CA with 8 modules (Personal Information, Treatment Tracking, Family Care, Financial and Social Assistance, Knowledge Center, Self- Assessment Questionnaires, Interactive Platform, and Reminders) was the main intervention tool, whereas the WeChat Official Account was supplementary to update information and realize interaction between parents and health care providers. Data of parents’ social support, anxiety, depression, care burden, uncertainty in illness, quality of life, their existing knowledge of ALL and care, and knowledge need were collected before and after the 3-month study period in both groups. For the intervention group, parents’ experience of receiving the intervention was also collected through individual interviews. RESULTS Overall, 43 parents in the observation group and 49 in the intervention group completed the study. Results found that the intervention reduced parents’ anxiety (Dint(Post-Pre)=−7.0 [SD 13.1], Dobs(Post-Pre)=−0.4 [SD 15.8], t90=−2.200, P=.03) and uncertainty in illness (Dint(Post-Pre)=−25.0 [SD 8.2], Dobs(Post-Pre)=−19.8 [SD 10.1], t90=−2.761, P=.01), improved parents’ social function (Dint(Post-Pre)=9.0 [SD 32.8], Dobs(Post-Pre)=−7.5 [SD 30.3], t90=2.494, P=.01), increased parents’ knowledge of ALL and care (Dint(Post-Pre)=28.4 [SD 12.4], Dobs(Post-Pre)=17.2 [SD 11.9], t90=4.407, P CONCLUSIONS The mHealth intervention in supporting parents of children with ALL is effective. This study is informative for other future studies on providing mHealth supportive care for parents of children with cancer.

Breast cancer presents specific challenges both physically and psychologically to women. Women living with breast cancer frequently do not receive adequate information support and they urgently need professional assistance that help them to cope and adjust to challenges. This paper documents the process of developing a smartphone application (app) "Information Assistant" for women with breast cancer in China. First, individual interviews were used to explore and understand the real experience of breast cancer patients and their diverse information needs during different stages of diagnosis and treatment. Next, expert working group discussions and the Delphi technique, including breast cancer care physicians, nurses and software engineers, were used to draft the structure and contents of the m-health based information support program. Then, these feedbacks were used to develop "Information Assistant" app. This app has five modules: personalized information recommendation, category knowledge center, headline information browsing, newest information browsing and information searching.