Assessing the needs of patients with breast cancer and their families across various treatment phases using a Latent Dirichlet Allocation model: a text-mining approach to online health communities.

PURPOSE: This study aimed to assess the different needs of patients with breast cancer and their families in online health communities at different treatment phases using a Latent Dirichlet Allocation (LDA) model. METHODS: Using Python, breast cancer-related posts were collected from two online health communities: patient-to-patient and patient-to-doctor. After data cleaning, eligible posts were categorized based on the treatment phase. Subsequently, an LDA model identifying the distinct need-related topics for each phase of treatment, including data preprocessing and LDA topic modeling, was established. Additionally, the demographic and interactive features of the posts were manually analyzed. RESULTS: We collected 84,043 posts, of which 9504 posts were included after data cleaning. Early diagnosis and rehabilitation treatment phases had the highest and lowest number of posts, respectively. LDA identified 11 topics: three in the initial diagnosis phase and two in each of the remaining treatment phases. The topics included disease outcomes, diagnosis analysis, treatment information, and emotional support in the initial diagnosis phase; surgical options and outcomes, postoperative care, and treatment planning in the perioperative treatment phase; treatment options and costs, side effects management, and disease prognosis assessment in the non-operative treatment phase; diagnosis and treatment options, disease prognosis, and emotional support in the relapse and metastasis treatment phase; and follow-up and recurrence concerns, physical symptoms, and lifestyle adjustments in the rehabilitation treatment phase. CONCLUSION: The needs of patients with breast cancer and their families differ across various phases of cancer therapy. Therefore, specific information or emotional assistance should be tailored to each phase of treatment based on the unique needs of patients and their families.

Psychometric properties of the Chinese version of the functional assessment of chronic illness therapy-fatigue (FACIT-F) among patients with breast cancer.

BACKGROUND: Fatigue is the most frequent and distressing symptom affecting the physical, cognitive, and affective domains of breast cancer patients. The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) has been widely used in patients with chronic diseases and has shown satisfactory reliability and validity. This study aimed to examine the psychometric properties of the FACIT-F among Chinese patients with breast cancer. METHODS: Using a convenience sampling method, a cross-sectional survey (January 2020 and September 2022) was used with patients recruited from two tertiary hospitals in Shanghai, Mainland China, and a total of 597 patients completed a demographic information questionnaire, the FACIT-F and the Functional Assessment of Cancer Therapy for Breast Cancer (FACT-B). Convergent validity was estimated by calculating the Pearson correlation coefficient of the FACIT-F with the FACT-B. Measurement invariance across age was performed by examining differential item functioning (DIF) across age groups (≤ 60 and > 60 years). The internal consistency and split-half reliability were performed for reliability analysis. Unidimensionality of the scale was evaluated by the principal component analysis by Rasch analysis. Additionally, Rasch analysis was performed for item difficulty levels, and an item-person map was used. RESULTS: No floor/ceiling effects were observed for the FACIT-F. Moderate correlations were found between FACIT-F and FACT-B (r = - 0.342, p < 0.01). Most items showed an absence of DIF regarding age, except for one item. In addition, the FACIT-F showed acceptable internal consistency. Principal component analysis of Rasch residuals showed that the proportion of variance explained by the FACIT-F was 53.3%, and the outfit mean square statistics for the items ranged from 0.68 to 1.90 and the infit MNSQ from 0.63 to 1.73. Additionally, an acceptable response between items and persons was found. CONCLUSIONS: The findings indicate that the Chinese version of the FACIT-F is a valid tool for the measurement of fatigue in breast cancer patients.

Pain Reported by Chinese Children During Cancer Treatment: Prevalence, Intensity, Interference, and Management.

BACKGROUND: Pain is a frequently reported and distressing symptoms during cancer treatment. However, there is limited evidence on pain reported by Chinese children with cancer. OBJECTIVES: This study aimed to investigate the prevalence, intensity, interference, and management of pain reported by Chinese children during cancer treatment and explore the predictors of pain interference. METHODS: We conducted a cross-sectional survey to investigate the pain intensity, pain interference, co-occurring symptoms (anger, anxiety, depression, fatigue), and pain management strategies reported by children 8 years and older undergoing active cancer treatment in 4 Chinese hospitals. RESULTS: Data were analyzed for 187 children. The prevalence of moderate to severe pain (≥4/10) was 38.50%, with an average pain interference score of 52.97 out of 100. Approximately 24% of children were prescribed pain medicine. Pain interference and pain intensity were marginally correlated (r = 0.047, P < .01) and were both positively correlated with pain duration and co-occurring symptoms and negatively correlated with perceived pain alleviation (all P < .01). Multiple regression analyses suggested that severe pain intensity (B = 2.028, P = .003) and fatigue (B = 0.440, P < .001) significantly predicted higher levels of pain interference (R2 = 0.547, F = 23.102, P < .001). CONCLUSION: Chinese children with cancer reported a low pain intensity score but a relatively high level of pain interference. According to the children's reports, pain has not been sufficiently addressed through Chinese pediatric oncology supportive care. IMPLICATIONS FOR PRACTICE: There is an urgent requirement for comprehensive pain assessment and standardized, targeted interventions in Chinese pediatric oncology pain management.

Attitudes toward and Perceptions of Educational Needs for End-of-Life Care among Health Professions Students: A Cross-Sectional Study in China.

CONTEXT: 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. OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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 (P < 0.05). Interindividual variability should be considered in the future development of end-of-care curricula.

Chinese Version of Pediatric Patient-Reported Outcomes Measurement Information System Short Form Measures: Reliability, Validity, and Factorial Structure Assessment in Children With Cancer in China.

BACKGROUND: The Pediatric Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to measure symptoms and functions of children with a variety of chronic diseases. As the Chinese version of pediatric PROMIS (C-Ped-PROMIS) measures was developed, the measurement properties of C-Ped-PROMIS have not been demonstrated. OBJECTIVE: The aim of this study was to examine the reliability, validity, and factorial structure of the C-Ped-PROMIS measures in children with cancer in China. METHODS: A total of 272 children and adolescents were recruited from 3 hospitals in China. The 8 C-Ped-PROMIS measures and Pediatric Quality of Life Inventory General Core Module and Cancer Module were administered in a cross-sectional design. Known-group validity, concurrent validity, and item and scale reliability of these 8 measures were examined by using SPSS 21.0, and factorial structures were tested by using confirmatory factor analysis with Mplus 7.1. RESULTS: All 8 C-Ped-PROMIS measures showed good known-group validity as hypothesized (P < .05) and good concurrent validity measured by significant correlations with the Pediatric Quality of Life Inventory General Core Module and Cancer Module; the correlation coefficients ranged from r = 0.519 to r = 0.655, except for peer relationship with r = 0.255 and r = 0.136, respectively. The Cronbach's α of C-Ped-PROMIS ranged from .758 to .910, and model-estimated scale reliabilities ranged from 0.740 to 0.905. The confirmatory factor analysis models of each measure fit data very well. CONCLUSIONS: All 8 C-Ped-PROMIS measures have a valid factorial structure as theoretically defined with good reliability and validity. IMPLICATIONS FOR PRACTICE: The C-Ped-PROMIS can be readily used to measure symptoms and functions of children and adolescents with cancer in China.

Developing "Information Assistant": A Smartphone Application to Meet the Personalized Information Needs of Women with Breast 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.

The patient-provider discordance in patients' needs assessment: a qualitative study in breast cancer patients receiving oral chemotherapy.

AIMS AND OBJECTIVES: To explore the differing perspectives of patients and providers and their assessment of supportive care needs in breast cancer patients receiving oral chemotherapy. BACKGROUND: The patient-provider concordance in patients' needs assessment is critical to the effective management of cancer. Self-administered oral chemotherapy greatly shifts responsibilities for side-effect monitoring, symptom management and dose adjustments from the provider to the patient. Home-based care plans will be central to the effective management of these patients. DESIGN: A descriptive qualitative design was used. METHODS: A purposive sample of nine breast cancer patients, four oncologists and four oncology nurses were recruited in Shanghai, China. Semi-structured and in-depth interviews were conducted to collect data. A qualitative content analysis aimed at finding manifest and latent meanings of data was applied to analyse the information. RESULTS: Four themes of needs emerged from the interviews with patients and providers: information/knowledge, communication, social support and symptom management, but patients and providers only agreed on the assessment of symptom and side-effects management needs. Patients want more positive encouraging information from providers, but providers think patients need more information of efficacy and safety. Patients appreciate support from other peer patients with similar experiences, but providers think the support from families and friends are readily available to them. Patients discussed their spiritual needs, while oncologists see the need to improve patient adherence to medication. CONCLUSION: Breast cancer patients differed from their providers in assessment of healthcare needs. Further investigation of the relationships between patient-provider discordance and patient outcomes may guide interventions to improve care for cancer patients receiving oral chemotherapy. RELEVANCE TO CLINICAL PRACTICE: Oncology nurses should develop a holistic home-based care plan by exploring and integrating the discordance of needs assessment of both patients and health providers.

Factorial structure of a scale: Strategies Used by People to Promote Health--Chinese version.

BACKGROUND: The Strategies Used by People to Promote Health (SUPPH) is an instrument used to measure self-reported self-efficacy in patient populations. Self-efficacy has a major impact on quality of life and psychological well-being. Previous findings of dimensionality of the SUPPH vary, and cultural differences exist suggesting the need for further investigation and psychometric testing to establish construct validity of the SUPPH in different cultures. OBJECTIVE: The purpose of this study was to examine the factorial structure of the Chinese version of the SUPPH (C-SUPPH). METHODS: Using reports from 764 oncology patients in China, the factorial structure of the C-SUPPH was assessed via 2 analytical strategies. First-order confirmatory factor analysis (CFA) models were used to examine the dimensionality of the C-SUPPH; a second-order CFA was used to determine the existence of a factorial structure hierarchy of the C-SUPPH. RESULTS: Compared with the 2- and 4-factor solutions, the 3-factor CFA of the C-SUPPH had a better fit with the data (comparative fit index = 0.94, Tucker-Lewis index = 0.94, root-mean-square error of approximation = 0.05, the close-fit test P = .565, and standardized root-mean-square residual = 0.04). Our findings confirmed the 3-scale structure: Positive Attitude, Stress Reduction, and Making Decisions; together, the 3 factors represent an underlying higher-order factor, that of general self-care self-efficacy. CONCLUSIONS: The C-SUPPH has a valid factorial structure and can be readily applied to studying self-efficacy in Chinese patients who are diagnosed with cancers. IMPLICATIONS FOR PRACTICE: Our findings provide support for a culturally sensitive, reliable, and valid self-efficacy measure (the C-SUPPH) of Chinese adult cancer patients' self-care self-efficacy.

Testing measurement invariance of the Chinese version of the Strategies Used by Patients to Promote Health among patients with cancer.

BACKGROUND AND PURPOSE: The Chinese version of the Strategies Used by Patients to Promote Health (C-SUPPH) is a self-report instrument used to measure self-efficacy among patients with cancer. The purpose of this article is to examine measurement invariance of C-SUPPH using data of 764 cancer patients recruited in China. METHODS: Multigroup confirmatory factor analysis (CFA) models were applied across the selected sociodemographic groups of gender, age, education, and monthly income levels. RESULTS: The factorial structure and factor loadings (relationships between items and their underlying factors) of C-SUPPH were invariant across all sociodemographic groups. CONCLUSIONS: The findings showed that the C-SUPPH measures the same latent constructs/factors in the same way when administered to different sociodemographic groups and thus can be readily applied to studying self-efficacy of cancer patients in China.

Smartphone interventions for long-term health management of chronic diseases: an integrative review.

INTRODUCTION: Long-term health management is challenging for the rapidly growing number of patients with chronic diseases. Smartphone interventions offer promising solutions. This article presents features of smartphone interventions for long-term chronic condition management, illustrating how these applications benefit patients with chronic diseases. MATERIALS AND METHODS: Systematic searches for smartphone health interventions were conducted in five publication databases. Articles were included only if (1) the smartphone application (app) was exclusively developed for patients with chronic diseases and (2) the article incorporated a defined outcome measurement to evaluate the effects of the implemented intervention. Sixteen articles were included in the final review, including studies in diabetes, mental health problems, overweight, cancer, and chronic obstructive pulmonary disease. RESULTS: These studies found that the smartphone intervention was a completely or at least partially effective tool to assist in managing some chronic diseases. With the help of health-related smartphone apps, patients with chronic conditions (1) felt secure in the knowledge that their illnesses were closely monitored, (2) participated in their own health management more effectively, and (3) felt that they had not been forgotten by their doctors and were taken good care of even outside the hospital/clinic. CONCLUSIONS: However, there are limited smartphone apps for the long-term health management of chronic diseases. More smartphone apps need to be developed to help people manage chronic diseases.

Self-efficacy difference among patients with cancer with different socioeconomic status: application of latent class analysis and standardization and decomposition analysis.

INTRODUCTION: Although the relationship between partial socioeconomic status (SES) and self-efficacy has been studied in previous studies, few research have examined self-efficacy difference among patients with cancer with different SES. METHODS: A cross-sectional survey involving 764 patients with cancer was completed. Latent class analysis (LCA) was applied to identify distinct groups of patients with cancer using four SES indicators (education, income, employment status and health insurance status). Standardization and decomposition analysis (SDA) was then used to examine differences in patients' self-efficacy among SES groups and the components of the differences attributed to confounding factors, such as gender, age, anxiety, depression and social support. RESULTS: Participants were classified into four distinctive SES groups via using LCA method, and the observed self-efficacy level significantly varied by SES groups; as theorized, higher self-efficacy was associated with higher SES. The self-efficacy differences by SES groups were decomposed into "real" group differences and factor component effects that are attributed to group differences in confounding factor compositions. CONCLUSION: Self-efficacy significantly varies by SES. Social support significantly confounded the observed differences in self-efficacy between different SES groups among Chinese patients with cancer.

A Chinese version of the City of Hope Quality of Life-Ostomy Questionnaire: validity and reliability assessment.

BACKGROUND: The City of Hope Quality of Life-Ostomy Questionnaire is a widely accepted scale to assess quality of life in ostomy patients. However, the validity and reliability of the Chinese version (C-COH) have not been studied. OBJECTIVE: The objective of the study was to assess the validity and reliability of the C-COH among ostomy patients sampled from Shanghai from August 2010 to June 2011. METHODS: Content validity was examined based on the reviews of a panel of 10 experts; test-retest was conducted to assess the item reliabilities of the scale; a pilot sample (n = 274) was selected to explore the factorial structure of the C-COH using exploratory factor analysis; a validation sample (n = 370) was selected to confirm the findings from the exploratory study using confirmatory factor analysis (CFA). Statistical package SPSS version 16.0 was used for the exploratory factor analysis, and Amos 17.0 was used for the CFA. RESULTS: The C-COH was developed by modifying 1 item and excluding 11 items from the original scale. Four factors/subscales (physical well-being, psychological well-being, social well-being, and spiritual well-being) were identified and confirmed in the C-COH The scale reliabilities estimated from the CFA results for the 4 subscales were 0.860, 0.885, 0.864, and 0.686, respectively. CONCLUSIONS: Findings support the reliability and validity of the C-COH. IMPLICATIONS FOR PRACTICE: The C-COH could be a useful measure of the level of quality of life among Chinese patients with a stoma and may provide important intervention implications for healthcare providers to help improve the life quality of patients with a stoma.

An international comparative study of professional development in research.

In 2005, a group of researchers in China decided to compare the development of research in China with that of other countries. This article describes the process the authors used and the prevalent topics for trends and developments. Further ideas for their own professional development in research are defined.