The evaluation of the postoperative quality of life in patients undergoing radical gastrectomy for esophagogastric junction cancer using the Postgastrectomy Syndrome Assessment Scale-45: a nationwide multi-institutional study.

PURPOSE: This retrospective nationwide survey investigated the quality of life (QOL) of patients with esophagogastric junction cancer after gastrectomy using the Postgastrectomy Syndrome Assessment Scale-45. METHODS: The Postgastrectomy Syndrome Assessment Scale-45 comprises 45 questions classified into symptoms, living status, and QOL domains. A total of 1950 gastrectomized patients with upper-third gastric or esophagogastric junction cancer returned the completed forms. Among them, 224 eligible patients with esophagogastric junction cancer were selected, including 86, 120, and 18 patients who underwent total gastrectomy, proximal gastrectomy (reconstruction-esophagogastrostomy: 56; double-tract method: 51), and other procedures, respectively. RESULTS: The postoperative period was significantly shorter (47 ± 30 vs. 34 ± 30 months, p = 0.002), and the rates of early-stage disease and minimally invasive approaches significantly higher (both p < 0.001) in the proximal gastrectomy group than in the total gastrectomy group. Despite advantageous background factors for proximal gastrectomy, the postoperative QOL did not differ markedly between the groups. Compared to patients who underwent reconstruction with the double-tract method, patients who underwent esophagogastrostomy had significantly larger remnant stomachs but a similar QOL. CONCLUSION: Even with total gastrectomy, a postoperative QOL comparable to that with proximal gastrectomy can be maintained. Clarifying the optimal reconstruction methods for proximal gastrectomy for esophagogastric junction cancer is warranted. TRIAL REGISTRATION: This study was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR; registration number: 000032221).

Psychometric properties of the Assessment of Positive Occupation 15 final version in individuals with mental illness.

AIMS: This study was to test the reliability and validity of the Assessment of Positive Occupational 15 (APO-15) for individuals experiencing mental illness. METHODS: A sample of 408 people experiencing mental illness living in communities or admitted to hospitalized was recruited. The sample has completed demographic information, the Assessment of Positive Occupation 15 (APO-15), the Japanese version of the Self-identified Stage of Recovery Part-B (SISR-B), the Japanese version of the Recovery Assessment Scale (RAS), the General Health Questionnaire 12 (GHQ-12). APO-15 is a measure of how engaged one is in occupations that promote well-being. The final version of the APO-15 was developed by assessing the validity and reliability by mainly using confirmatory factor analysis (CFA), item response theory (IRT). RESULTS: This study indicated satisfactory the validity and reliability of APO-15 in a group of individuals experiencing mental illness. CFA showed acceptable values for all indices of fit, namely comparative fit index (CFI), Tucker-Lewis index (TLI) (i.e., greater than .90), and the value of root mean square error of approximation (RMSEA) was .087, which was acceptable. The IRT showed satisfactory responses for the item slope parameter (α) and item difficulty parameter (ß) in APO-15. DISCUSSION: APO-15 was demonstrated good psychometric properties in measuring involvement in the occupation to promote well-being in individuals experiencing mental illness. In conclusion, the APO-15 is an important tool to enable occupational therapists to assess clients who are not engaged in well-being promoting occupations and thus enable them to participate in such occupations.