Impacts of COVID-19 on population well-being: Results of a web survey conducted in France during the first quarantine in 2020.

This study aimed to evaluate the impact of COVID-19 pandemic on mental well-being observed during the first quarantine implemented in France in 2020. This online survey included 1,876 French volunteer participants who completed data on lifestyle habits during the period of confinement and self-reported levels of resilience, optimism and psychological well-being. We observed that the score of participants' psychological well-being was considerably lower among single participants, students, the unemployed and those facing risk of financial insecurity. The results of the multivariate analysis showed that low levels of psychological well-being were significantly associated with single status and male gender. Higher scores for general peer support, optimism, resilience and confidence in information shared within immediate circles of friends of family were also significantly positively associated with better mental health. Taken together, the results from this study showed that quarantine measures impacted the psychological well-being of the participants in our sample, that the degree of impact was strongly linked with individual levels of resilience and optimism, and that general support together with confidence in one's immediate circle of friends or family also played an important role in overall mental well-being.

Optimizing DyNaChron instrument for assessing chronic nasal dysfunction symptoms by Rasch analysis.

BACKGROUND: The DyNaChron (Dysfonctionnement Nasal Chronique) questionnaire is a self-reporting 78-item instrument assessing six symptoms and their consequences of chronic nasal dysfunction. Patients complete items of a symptom domain only when it is present but in case the patient presents several or all symptoms, its length can limit its use. Here, we aimed to optimize, or shorten, the DyNaChron for clinical use. METHODS: A total of 640 patients in 14 rhinology outpatient clinics all over France completed the original DyNaChron questionnaire before the first rhinologic clinic and 15 days later. The optimization process involved Rasch analysis and then qualitative content analyses. Rasch analysis flagged items with a floor/ceiling effect or with important differential item functioning and an expert committee decided whether to retain the flagged items on the basis of clinical importance and statistical characteristics. The psychometric properties of the optimized version were studied according to classical test theory and Rasch analysis. RESULTS: Rasch analysis revealed 4 items with underfit, 6 with an extreme score, 2 that were highly locally dependent and 16 with differential item functioning which 5 of these 16 items were retained after content analysis. In total, 19 flagged items were removed. Factorial analysis confirmed the preservation of the initial instrument structure in the optimized scale; psychometrics properties and scale calibration were the same as or better than the original version. CONCLUSION: The shortened DyNaChron optimizes the quality of assessment by deleting redundant items and reduces the burden on respondents; the structure is preserved and the psychometrics properties are improved.

Cancer-related fatigue management: evaluation of a patient education program with a large-scale randomised controlled trial, the PEPs fatigue study.

BACKGROUND: To assess the efficacy of a patient educational program built according to guidelines that aims at reducing cancer-related fatigue (CRF). METHODS: Randomised controlled trial, multicentre, comparing a patient education program, vs the standard of care. Patients were adult cancer outpatients with any tumour site. The primary outcome was fatigue severity assessed with a visual analogical scale (VAS), between the day of randomisation and week 7. Secondary outcomes were fatigue assessed with other scales, health-related quality of life, anxiety and depression. The time to fatigue severity deterioration was assessed. Analyses were performed in a modified intent-to-treat way, that is, including all patients with at least one baseline and 1 week 7 score. RESULTS: A total of 212 patients were included. Fatigue severity assessment was made on 79 patients in the experimental group and 65 in the control group. Between randomisation and week 7, the fatigue (VAS) improved by 0.96 (2.85) points in the experimental group vs 1.63 (2.63) points in the control group (P=0.15). No differences with the secondary outcomes were highlighted between two groups. No other factors were found to be associated with fatigue severity deterioration. CONCLUSIONS: Despite rigorous methodology, this study failed to highlight the program efficacy in fatigue reduction for cancer patients. Other assessment tools should be developed to measure the effect of the program on CRF and behaviour. The implementation of the program should also be explored in order to identify its mechanisms and longer-term impact.

Factors correlated with fatigue in breast cancer patients before, during and after adjuvant chemotherapy: the FATSEIN study.

INTRODUCTION: Breast cancer is by far the most common form of cancer diagnosis in women. Cancer treatments are long, complex and often cumbersome with numerous side effects. Fatigue is now considered as the most distressing side effect of treatment. Fifty-eight percent to 94% of breast cancer patients experience fatigue during treatment with adjuvant chemotherapy. OBJECTIVE: The aim of this study is to identify the determinants of cancer-related fatigue, and the long-term effects of the different adjuvant treatments will be explored. RESEARCH DESIGN: A prospective longitudinal study in women diagnosed for the first time with stage I-IIIA breast cancer and who have undergone surgery, has been designed to meet the study aims. Recruitment began in September 2008 and target enrollment completion date is December 2010. (clinicaltrials.gov number, NCT01064427). The MFI-20 (Multidimensional Fatigue Inventory) and the EORTC QLQ-C30 (European Organization for Research and Treatment Quality of Life Questionnaire) will be completed, at several times. The follow-up is planned over a 24-month period. We studied adjuvant chemotherapy regimens with anthracyclines or with anthracycline/taxane combination. The LOR (Life Orientation Test) will be completed only at baseline to estimate the level of optimism of the patient and the STAI (State-Trait Anxiety Questionnaire) will be filled to measure a stable propensity to experience anxiety, and tendencies to perceive stressful situations as threatening. OUTCOMES: The knowledge of determinants should facilitate screening of fatigue, and its evaluation on consequences on the patients' quality of life would allow physicians better help patients cope with the management of fatigue according to the adjuvant regimen.