Validation and optimization of the French Generic Adherence for Chronic Diseases Profile (GACID-P) using classical test and item response theory.

BACKGROUND: The Generic Adherence for Chronic Diseases Profile is a French generic scale (GACID-P) developed to measure adherence in several disease areas such as cardiology, rheumatology, diabetes, cancer and infectiology. METHOD: We aimed to study the measurement invariance of the Generic Adherence for Chronic Diseases Profile by an item response model, optimize the new instrument version from item response model and qualitative content analyses results, and validate the instrument. The metric properties of the optimized version were studied according to classical test theory and item response model analysis. RESULTS: A sample of 397 patients consulting at two French hospitals (in diabetes, cardiology, rheumatology, cancerology and infectiology) and in four private practices was recruited; 314 (79%) patients also completed the questionnaire 15 days later. Factor analyses revealed four dimensions: "Forgetting to take medication", "Intention to comply with treatment", "Limitation of risk-related consumer habits" and "Healthy lifestyle". The item response model and content analyses optimized these four dimensions, regrouping 32 items in four dimensions of 25 items, including one item conditioned on tobacco use. The psychometric properties and scale calibration were satisfactory. One score per dimension was calculated as the sum of the items for the dimensions "Forgetting to take medication" and "Intention to comply with treatment" and as a weighted score according to the item response model analysis for the two other dimensions because of differential item functioning found for two items. CONCLUSION: Four adherence profile scores were obtained. The instrument validity was documented by a theoretical approach and content analysis. The Generic Adherence for Chronic Diseases Profile is now available for research targeting adherence in a broad perspective.

Adherence to oral antineoplastic agents by cancer patients: definition and literature review.

Since the 1990s, oral chemotherapy has been gaining ground as cancer treatment. This therapy seems to have few toxic effects and offers patients good quality of life. However, in addition to the fears the therapy might generate in patients, oral treatment raises a new issue, which, until now, has been marginal in this field: therapeutic observance or adherence. We investigated the research into adherence to oral chemotherapy among cancer patients published between 1990 and July 2013. Studies showed considerable diversity in terms of both the definition and measurement of adherence. As well, adherence to antineoplastic therapy is affected by the patient's understanding of the treatment and ability to remember information provided by the physician, treatment length and psychological distress. Our review of the few studies on adherence to anticancer drug treatment raises some questions that could be pursued in future research. In light of our findings, patients should receive 'therapy education' to help them and their support groups better understand the disease and its treatment and to achieve optimal health management and improved treatment effectiveness.

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.