Oncologists' psychological flourishing: A driving force for positive attitudes at work.

OBJECTIVE: Oncologists' psychological health is a major challenge due to the consequential concerning the quality of the care they provide. However, only critical states of their health have been really examined by scientists. This study sought to plug this gap by investigating the mediating role of psychological flourishing in the relationship between the perception of the professional social context (i.e., perceived workplace isolation and organizational support) and positive attitudes at work among oncologists (i.e., work engagement, task adjustment and empathy). METHODS: The study was a cross-sectional, including 541 French oncologists. Participants completed a self-report questionnaire. Structural Equation Modeling was employed to test the hypotheses. RESULTS: The analysis revealed that workplace isolation and organizational support perceptions were related to oncologists' work engagement, task adjustment and empathy. Additionally, psychological flourishing acted as a partial mediator between these perceptions of professional social context and oncologists' work-related attitudes. CONCLUSIONS: This research underlined the potential of enhancing the psychological flourishing of oncologists by improving organizational support and mitigating their sense of isolation, and in turn, to enhance some dimensions of their positive attitudes at work.

The place of the relative at the time of the announcement of cancer progression: BABEL - a mixed-methods study.

OBJECTIVES: This study aims to explore the place of the relative in these triadic consultations and how this influences communication. METHODS: A mixed-methods research strategy was used. Triadic consultations for the announcement of cancer progression were recorded and following the 3 participants completed questionnaires comprising mirror-items. Recordings and answers were further investigated in a few semi-structured interviews. Comparison of quantitative responses (questionnaires) used Wilcoxon's test for matched series. Qualitative analyses (consultations, interviews) used grounded theory. Patients were over 18, followed for cancer in palliative phase, excluding brain tumors and malignant hemopathies, and presented renewed disease progression. Relatives were over 18 and authorized by the patient to participate. RESULTS: 47 consultations (audio-recordings, answers to questionnaires) and 12 interviews conducted separately with 4 triads were collected. Half the relatives, while remaining in the background, nevertheless contributed to the discussion. For patients, the presence of a relative was considered beneficial and for oncologists it facilitated the announcement. However, symptoms perceived as intimate or private appeared difficult to express for some patients, and for relatives, prognosis was a difficult subject to broach. Although their relationship with time and their expectations may differ, patients and relatives found consultations positive. Oncologists appeared to underestimate the patient's level of understanding (P<0.001) and perceptions of the seriousness of the disease (P=0.009) but not those of relatives. They did not evaluate the relative's state of health and check what the dyad had retained. SIGNIFICANCE OF RESULTS: Training via simulation sessions should be adapted to communication involving relatives.

Bullying, supervisor support, relaxation, and personal and work outcomes: Testing a moderated mediation model.

AIM: To test a mediated moderation model in which bullying and supervisor support interact to predict nurses' personal and work outcomes with relaxation during off-job time mediating these effects. BACKGROUND: Bullying is a pervasive problem in the nursing profession. We integrate and extend past research addressing the question of how bullying and perceived supervisor support affect nurses' functioning. METHOD: Cross-sectional data were collected from a sample of 290 nurses who completed measures of bullying, perceived supervisor support, relaxation, need for recovery, sleeping problems, job satisfaction, emotional exhaustion and work performance. RESULTS: Results revealed that bullying was significantly linked to job satisfaction, sleeping problems, need for recovery and emotional exhaustion through relaxation, but only among nurses who perceived high levels of supervisor support. CONCLUSION: These results revealed that high supervisor support may be detrimental for nurses adding up to a negative cycle of stressors to maladaptive outcomes through lack of relaxation. IMPLICATIONS FOR NURSING MANAGEMENT: Health care organisations and managers should consider addressing work environment factors, such as bullying, in addition to supervisor support in their efforts to facilitate the positive effects of nurses' relaxation during non-work time.

R-CHOP 14 with or without radiotherapy in nonbulky limited-stage diffuse large B-cell lymphoma.

The benefit of radiotherapy (RT) after chemotherapy in limited-stage diffuse large B-cell lymphoma (DLBCL) remains controversial. We conducted a randomized trial in patients with nonbulky limited-stage DLBCL to evaluate the benefit of RT after rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Patients were stratified according to the modified International Prognostic Index, including lactate dehydrogenase, Eastern Cooperative Oncology Group performance status, age, and disease stage. The patients received 4 or 6 consecutive cycles of R-CHOP delivered once every 2 weeks, followed or not by RT at 40 Gy delivered 4 weeks after the last R-CHOP cycle. All patients were evaluated by fluorodeoxyglucose-positron emission tomography scans performed at baseline, after 4 cycles of R-CHOP, and at the end of treatment. The primary objective of the trial was event-free survival (EFS) from randomization. The trial randomly assigned 165 patients in the R-CHOP arm and 169 in the R-CHOP plus RT arm. In an intent-to-treat analysis with a median follow-up of 64 months, 5-year EFS was not statistically significantly different between the 2 arms, with 89% ± 2.9% in the R-CHOP arm vs 92% ± 2.4% in the R-CHOP plus RT arm (hazard ratio, 0.61; 95% confidence interval [CI], 0.3-1.2; P = .18). Overall survival was also not different at 92% (95% CI, 89.5%-94.5%) for patients assigned to R-CHOP alone and 96% (95% CI, 94.3%-97.7%) for those assigned to R-CHOP plus RT (P = not significant). R-CHOP alone is not inferior to R-CHOP followed by RT in patients with nonbulky limited-stage DLBCL. This trial was registered at www.clinicaltrials.gov as #NCT00841945.

Hypercalcemia is associated with a poor prognosis in lymphoma a retrospective monocentric matched-control study and extensive review of published reported cases.

The prognostic significance of hypercalcemia in lymphoma has only been studied on small series to date. We conducted a retrospective, monocentric, matched-control study that aimed to compare the outcome of patients diagnosed with any histological subtype of lymphoma associated with hypercalcemia, at diagnosis or relapse, with a group of controls matched for histological and prognostic factors. Sixty-two and 118 comparable patients treated between 2000 and 2016 were included in hypercalcemia and control cohorts, respectively. Hypercalcemia was found mainly at diagnosis (71%) in higher-risk patients (prognosis scores ≥ 3, 76%) and those with diffuse large B cell lymphoma (67.7%), stage III/IV disease (91.9%), and elevated LDH (90.3%). Two-year progression-free survival (PFS) was shorter in the hypercalcemia than control cohort [30.1% (95% confidence interval (95% CI) 18.3-41.9) vs 63.9% (95% CI 5.1-72.7), p < 0.001]. Two-year overall survival (OS) was 40.6% (95% CI 28.1-53.1) and 77.7% (95% CI 70.1-85.3) in the hypercalcemia and control cohorts, respectively (p < 0.001). Hypercalcemia was independently associated with poor PFS [HR = 2.5 (95% CI 1.4-3.5)] and OS [HR = 4.7 (95% CI 2.8-7.8)] in multivariate analysis. Among the 40 patients who received autologous stem cell transplantation (ASCT), hypercalcemia was still associated with shorter OS [2-year OS: 65% (95% CI 40.1-89.9) vs 88.0 (95% CI 75.3-100), p = 0.04]. Hypercalcemia may be associated with chemo-resistance, given its impact on PFS and OS. Hence, these data suggest that alternate strategies for lymphoma patients with hypercalcemia should be developed.

The effects of job demands on nurses' burnout and presenteeism through sleep quality and relaxation.

AIMS AND OBJECTIVES: The main aim of this study was to investigate the indirect effects of emotional dissonance and workload on presenteeism and emotional exhaustion through sleep quality and relaxation. BACKGROUND: Numerous investigations have found that job demands are related to employees' health and behaviours, but additional studies are needed among nurse samples. Specifically, little is known about the relationships between nurses' emotional dissonance and workload on one hand, and presenteeism and emotional exhaustion on the other hand. Moreover, research is needed to further explore the psychological mechanisms underlying these relationships. DESIGN: We used a cross-sectional design. Our study was carried out between October 2015-February 2016. Precisely, we asked nurses from various French healthcare centres to fill out a questionnaire survey. We ensured to meticulously follow the STROBE guidelines for cross-sectional research in designing and reporting this study. METHOD: An empirical study with a sample of 378 nurses was conducted. RESULTS: In line with our hypotheses, our findings revealed that emotional dissonance and workload were negatively linked to sleep quality and relaxation, which were, in turn, related to lower levels of presenteeism and emotional exhaustion. Workload and emotional dissonance were also directly and positively related to emotional exhaustion, while emotional dissonance was associated with higher levels of presenteeism. Finally, the indirect effects of emotional dissonance and workload on emotional exhaustion through sleep quality as well as the indirect effects of emotional dissonance on emotional exhaustion through relaxation were significant and positive. CONCLUSIONS: Overall, our results provide insight into the effects of emotional dissonance and workload on presenteeism and emotional exhaustion through recovery processes. RELEVANCE TO CLINICAL PRACTICE: The present findings have some practical implications for reducing nurses' emotional exhaustion and presenteeism. Specifically, managers and organisations should try to design and craft jobs to decrease the presence of negative work characteristics (i.e., workload and emotional dissonance). Our results also suggest that recovery processes may be important factors to focus on.

The Forest and the Trees: Investigating the Globality and Specificity of Employees' Basic Need Satisfaction at Work.

This research assessed the underlying psychometric multidimensionality and nomological validity of 523 employees' responses to the Work-related Basic Need Satisfaction (W-BNS) scale using bifactor-exploratory structural equation modeling (bifactor-ESEM). Our results first showed the superiority of a bifactor-ESEM representation when compared to alternative representations of the data. Thus, employees' ratings of psychological need satisfaction simultaneously reflected a global need satisfaction construct, which coexisted with specific autonomy, competence, and relatedness needs satisfaction. Importantly, our findings also supported the nomological validity of employees' ratings of psychological need satisfaction in relation to measures of positive affect, negative affect, job satisfaction, perceived organizational support, organizational citizenship behaviors, work engagement, and burnout. In addition, our results also supported the presence of indirect (mediated) effects between perceived organizational support and some of the outcome variables as mediated by employees' levels of need satisfaction.

Nonlinear pharmacokinetics of rituximab in non-Hodgkin lymphomas: A pilot study.

AIMS: Rituximab is an anti-CD20 monoclonal antibody approved in non-Hodgkin lymphoma (NHL). This study aimed to assess the relationship between antigen mass and nonlinear pharmacokinetics of rituximab in NHL patients. METHODS: In a retrospective cohort of 25 NHL patients treated with rituximab, antigen mass was assessed at baseline by measuring metabolic tumour volume (MTV) by positron emission tomography. Rituximab pharmacokinetics was described using a semimechanistic 2-compartment model including a latent target antigen. Rituximab target-mediated elimination was described as irreversible binding between rituximab and it target. Histology (follicular or diffuse large B-cell lymphomas), initial MTV and body weight were tested as covariates on pharmacokinetic parameters. RESULTS: The model allowed a satisfactory description of rituximab serum concentrations. Target-mediated elimination was maximum at the beginning of treatment and became negligible towards the end of follow-up. The second-order elimination of rituximab due to target binding and complex elimination increased with baseline MTV. Central volume of distribution increased with body weight (P = .022) and baseline MTV (P = .005). CONCLUSIONS: This study quantified for the first time the target-mediated elimination of rituximab in NHL patients and confirmed rituximab retention by antigen mass.

The effects of work factors on nurses' job satisfaction, quality of care and turnover intentions in oncology.

AIMS: We examined the effects of perceived supervisor support, value congruence and hospital nurse staffing on nurses' job satisfaction through the satisfaction of the three psychological needs for autonomy, competence and relatedness. Then, we examined the links between job satisfaction and quality of care as well as turnover intentions from the workplace. BACKGROUND: There is growing interest in the relationships between work factors and nurses' job satisfaction. However, minimal research has investigated the effects of perceived supervisor support, value congruence and staffing on nurses' job satisfaction and the psychological mechanisms by which these factors lead to positive outcomes. DESIGN: A cross-sectional questionnaire was distributed in 11 oncology units between September 2015 - February 2016. METHOD: Data were collected from a sample of 144 French nurses who completed measures of perceived supervisor support, value congruence, staffing adequacy, psychological need satisfaction, job satisfaction, quality of care and turnover intentions. RESULTS: The hypothesized model was tested with path analyses. Results revealed that psychological need satisfaction partially mediated the effects of perceived supervisor support, value congruence and hospital nurse staffing on job satisfaction. Moreover, job satisfaction was positively associated with quality of care and negatively linked to turnover intentions. CONCLUSION: Overall, these findings provide insight into the influence of perceived supervisor support, value congruence and staffing on nurses' attitudes and behaviours.

[Infections of implantable ports in haematology patients]. / Infections des chambres à cathéter implantables chez les patients atteints d'une hémopathie.

From 2010 to 2015, a study analysed the infections of implantable ports in haematology patients. Communication, collaboration and diligence were some of the main issues raised.

Decisional early interim (18)F-fluoro-2-deoxy-D-glucose positron emission tomography after two cycles of chemotherapy in de novo Hodgkin lymphoma.

BACKGROUND/AIMS: An early evaluation with positron emission tomography (FDG-PET) has been demonstrated to be a valuable tool in the prediction of Hodgkin lymphoma's outcome. Herein we report a retrospective study on the outcome of Hodgkin lymphoma treated in accordance with interim FDG-PET results. METHODS: 48 patients with de novo Hodgkin lymphoma were treated with 2 cycles of chemotherapy. According to the interim FDG-PET (PET2) evaluation, pre-established treatment was continued if PET2 was considered negative. Patients with a positive PET2 result underwent a salvage therapy. Progression-free survival (PFS) and overall survival (OS) were chosen as end points. RESULTS: PET2 scan results were negative for 37 patients and positive for 11 patients. After salvage therapy, 7/11 patients were in complete remission and 4 patients had stable disease and were considered for third-line therapy. After a median follow-up of 5.2 years, 46 patients were still alive. The 4-year PFS were 84.5 and 45.4% for PET2-negative and PET2-positive patients, respectively (p = 0.007). In multivariate analysis, PET2 scan and extranodal disease remained relevant on PFS (p = 0.001 and 0.009, respectively). No difference was seen in OS. CONCLUSION: Our retrospective study suggests that salvage therapy for non-responder Hodgkin lymphoma using interim FDG-PET could improve the PFS of this group of patients.

Interferon alpha with or without rituximab achieves a high response rate and durable responses in relapsed FL: 17 years' experience in a single centre.

Maintenance interferon alpha (IFN-α) immunotherapy after induction chemotherapy prolongs progression-free survival (PFS) in untreated follicular lymphoma (FL). Little information is available about IFN-α use in relapsed FL. This study aims to evaluate the benefit of IFN-α as a treatment of low-burden FL relapse. This single-centre retrospective study identified 20 patients treated in 27 cases with IFN-α. We analysed all cases of IFN-α treatment in patients with low-burden FL in clinical relapse (11), partial response (5) or only with molecular minimal residual disease (MRD; 5). The treatment schedule was 3MIU IFN-α three times a week alone (16) or combined with four weekly rituximab (R; 11), according to the institution's policy. Except for the molecular relapses, responses were evaluated according to the IWG 1999 criteria. MRD was defined as a repeatedly detectable BCL2-IgH rearrangement in peripheral blood or bone marrow. In 22 cases of clinical relapses or partial responders, overall response rate was 68 %, with 55 % complete responses. Median PFS was 20.9 months (95 % confidence interval (95 % CI), 0-64.9) with 20.9 and 48.7 months in the IFN and R-IFN groups, respectively (p = 0.4). The median PFS of the five MRD cases was 133 months (95 % CI, 103-165). The Follicular Lymphoma International Prognostic Index score calculated at initiation of IFN-α treatment was predictive of time to relapse (p = 0.036). These results compare favourably with previous reports of the efficacy of R alone, and of R with IFN-α in relapse. Further research is required to explore the role of IFN-α in the management of FL.

A phase 1 dose escalation study of idarubicin combined with methotrexate, vindesine, and prednisolone for untreated elderly patients with primary central nervous system lymphoma. The GOELAMS LCP 99 trial.

Treatment of primary central nervous system lymphoma (PCNSL) in elderly patients remains unsatisfactory. To develop a new high-dose methotrexate (HD-MTX)-based regimen including idarubicin, a phase 1 multicenter dose escalation study was conducted to determine the maximum-tolerated dose (MTD) of idarubicin. Thirty-five immunocompetent patients with PCNSL were enrolled. The median age was 65 years (range, 60-70 years). MTX and vindesine (VDS) were given at the fixed dose of 3 g/m(2) (6-hr intravenous [IV]) and 3 mg/m(2) IV on day 1, respectively. Prednisolone (PRED) was given at the fixed dose of 60 mg/m(2) (IV or orally) on days 1-5. Idarubicin was escalated in increments of 2 mg/m(2) with doses ranging from 12-18 mg/m(2) IV on day 1. Treatment was repeated three times every 3 weeks. Dose-limiting toxicity (DLT) was defined as grade 4 neutropenia for more than 7 days, thrombocytopenia grade 4 or nonhaematological toxicity more than grade 2. The MTD of idarubicin was reached at 16 mg/m(2) . At this level, the main haematological toxicities were thrombocytopenia grade 4: 5% and neutropenia grade 3 or 4 (52%); the main nonhaematological toxicities were grade 3 or 4 infectious disease (5%) and grade 2 renal failure (9%). For the study population, median overall and progression-free survival were 19 and 13 months, respectively. Our study suggests that the MTD of idarubicin in combination with HD-MTX, VDS, and PRED, should be 16 mg/m(2) . Further studies will be necessary to challenge a standard treatment in elderly patients with PCNSL.

A randomized study of interferon α-2b versus no treatment as consolidation after high dose therapy and autologous stem cell transplantation for patients with relapsed lymphoma.

Patients with lymphoma who have experienced a first relapse or progression and have disease deemed sensitive to salvage chemotherapy nevertheless have a high likelihood of having a second relapse. To decrease the likelihood of a second relapse after high-dose therapy (HDT) and autologous stem cell transplantation (ASCT), interferon (IFN) α-2b was given in a prospective randomized international trial. Methods. In this trial, 221 patients with varying histologic diagnoses (8 small lymphocytic, 37 follicular, 9 mantle, 90 diffuse large B-cell, 20 peripheral T-cell, 3 high-grade B-cell non-Hodgkin lymphoma, and 54 Hodgkin lymphoma) were randomly assigned to receive no further treatment (arm A: 117 patients) or IFNα-2b, 3 MU three times weekly, for 18 months (arm B: 104 patients). Results. In arm B, 21 patients (20%) did not receive IFNα-2b because of early progression or absence of hematologic recovery, 29 patients (28%) completed the 18 months of treatment, and 54 patients (52%) interrupted treatment because of progression (23%) or toxicity (29%). Event-free survival and overall survival were not different between the two arms on an intent-to-treat analysis and also if analysis was restricted to patients who were alive and had not experienced disease progression three months after transplantation. The study was not sufficiently powered to evaluate effects in histologic subtypes. Conclusion. In this trial, post-autograft IFNα-2b did not improve outcomes in a heterogeneous group of patients with lymphoma.

Procedural justice, supervisor autonomy support, work satisfaction, organizational identification and job performance: the mediating role of need satisfaction and perceived organizational support.

AIM: To test a model linking procedural justice, supervisor autonomy support, need satisfaction, organizational support, work satisfaction, organizational identification and job performance. BACKGROUND: Research in industrial and organizational psychology has shown that procedural justice and supervisor autonomy support lead to positive outcomes. However, very little research related to this subject has been conducted in healthcare settings. Moreover, few studies have examined mechanisms that could account for these positive relationships. DESIGN: A cross-sectional correlational design was used. METHOD: Convenience sampling was used and a sample of 500 nurses working in haematology, oncology and haematology/oncology units in France was surveyed in 2011. The final sample consisted of 323 nurses (64.6% response rate). The hypothesized model was tested using structural equation modelling. RESULTS: Procedural justice and supervisor autonomy support significantly and positively influenced need satisfaction and perceived organizational support, which in turn positively predicted work satisfaction, organizational identification and job performance. CONCLUSION: Organizations could deliver training programmes for their managers aimed at enhancing the use of fair procedures in allocating outcomes and developing their autonomy-supportive behaviours to improve nurses' work satisfaction, organizational identification and job performance.

Relationships between the characteristics of oncohematology services providing palliative care and the sociodemographic characteristics of caregivers using health indicators: social support, perceived stress, coping strategies, and quality of work life.

OBJECTIVE: The aim of this study was to analyze the relationships between the characteristics of the management of oncohematology services and the psychosocial determinants of caregivers' health at work including social support, stress, and coping strategies. DESIGN: Investigation using questionnaires was carried out about nurses and nurse aides in hematology and oncology services. SETTING: All hematology and oncology services of Western France were requested. Five questionnaires concerning sociodemographic characteristics, measurements of quality of work life, of social support, of perceived stress, and of coping strategies and quality of work life were delivered among health professionals. PARTICIPANTS: Five hundred seventy-four questionnaires from 53 different services were analyzed. There were 57.4% nurses and 42.6% nurse aides. Some 94.1% were female and 33.5% were older than 40 years. RESULTS: Several characteristics of oncohematology services were significantly linked to health indicators, as the need for time and recognition, the importance of training (in palliative care, pain management, and help relationship), the care of patients and their families, the interdisciplinary efficiency, and external interventions (psychologists and volunteers). We showed that participative management which includes implementation of service projects and of multidisciplinary staff influence the quality of work life of health professionals. We showed also how much the characteristics of services organized around an effective social support (need for recognition) favor a better quality of work life among caregivers, influencing their perceived stress and their coping strategies. CONCLUSION: To our knowledge, it is the first study showing a relationship between participative management (including multidisciplinary staffs, approach with a service project, and internal training) and the quality of work life in the domain of health care. The implementation of this model should be promoted in health care services.

Investigating a Participatory Intervention in Multidisciplinary Cancer Care Teams Using an Integrative Organizational Model: A Study Protocol.

Multidisciplinary teams encounter many challenges that can lead to higher levels of distress and burnout. This trend is acutely prevalent among multidisciplinary cancer care teams who frequently contend with increased task complexity and numbers of patients. Resilience is emerging as a critical resource that may optimize team members' psychological health and wellbeing, work efficiency, and organizational agility, while reducing burnout. Accordingly, the proposed study aims to implement and evaluate a promising participatory interventional approach that fosters team resilience. Specifically, the effects of the intervention on participating team members will be compared to a control group of non-participating team members. This intervention's core components include skills training, patient-centered meetings, talking spaces, and an agile problem-solving approach. The proposed study also seeks to determine whether enhanced resilience improves team mental health status and organizational outcomes. A participatory interventional approach will be implemented and assessed at three-time intervals [i.e., pre-intervention deployment (N = 375), 12 months post-deployment (N = 236), and 24 months post-deployment (N = 146)] across five cancer care teams in three Quebec healthcare institutions. A mixed methods design will be used that includes observations, semi-structured interviews, focus groups, and self-report questionnaires. Direct observation will document team functioning and structural resources (e.g., meetings, conflict management, and leadership). Semi-structured interviews will explore participants' experience with activities related to the participatory interventional approach, its perceived benefits and potential challenges. Focus groups will explore participants' perceptions of their team's resilience and the effectiveness of the intervention. Questionnaires will assess support, recognition, empowerment, organizational justice, individual resilience, psychological safety, work climate, team resilience, workplace burnout, engagement, quality of work life, wellbeing, and organizational citizenship behaviors, and sociodemographic variables. Moreover, objective measures including absenteeism and staff turnover will be obtained via human resource records. Structural equation modeling will be used to test the study's hypotheses. The proposed protocol and related findings will provide stakeholders with quantitative and qualitative data concerning a participatory interventional approach to optimize team effectiveness. It will also identify critical factors implicated in favorable organizational outcomes in connection with multidisciplinary cancer care teams. Expected results and future directions are also presented herein.

[French translation and adaptation of the "Return to Work Self-Efficacy' Scale - 11 items" in patients diagnosed with a cancer]. / Traduction et adaptation française du « Return to Work Self-Efficacy' scale ­ 11 items ¼ chez des patients diagnostiqués d'un cancer.

INTRODUCTION: The self-efficacy to return to work is a major psychological factor of the return to work of patients diagnosed with a cancer. However, french investigations in this field do not take this dimension into account due to the lack of a suitable tool for its assessment. The objective of this study was to provide a french translation and adaptation of the "Return to Work Self-Efficacy' scale - 11 items" (RTWSE-11), validated in dutch language in its original version. METHODS: After translation-back translation steps, completed by experts' consensus meetings, interviews were conducted with thirteen patients diagnosed with cancer in order to evaluate the degree of clarity, simplicity and ambiguity or the various elements of the french version of the RTW-SE-11. RESULTS: The main modifications inherent to the french adaptation of the questionnaire concerned the modalities of the Likert scale and the inversion of three negative items into positive items. DISCUSSION: The french translation and adaptation of the RTWSE-11 was particularly faithful to the semantic, idiomatic, functional, experiential, conceptual and operational aspects of the original version. Future work can therefore focus on the psychometrics evaluations of the questionnaire. However, this tool can already be used in clinical practice to establish an initial assessment of the ability of patients diagnosed with cancer to return to work.

High-dose therapy followed by autologous purged stem cell transplantation and doxorubicin-based chemotherapy in patients with advanced follicular lymphoma: a randomized multicenter study by the GOELAMS with final results after a median follow-up of 9 years.

Autologous stem cell transplantation (ASCT) as first-line therapy for follicular lymphoma (FL) remains controversial. The multicenter study randomized 172 patients with untreated FL for either immunochemotherapy or high-dose therapy (HDT) followed by purged ASCT. Conditioning was performed with total body irradiation (TBI) and cyclophosphamide. The 9-year overall survival (OS) was similar in the HDT and conventional chemotherapy groups (76% and 80%, respectively). The 9-year progression-free survival (PFS) was higher in the ASCT than the chemotherapy group (64% vs 39%; P = .004). A PFS plateau was observed in the HDT group after 7 years. On multivariate analysis, OS and PFS were independently affected by the per-formance status score, the number of nodal areas involved, and the treatment group. Secondary malignancies were more frequent in the HDT than in the chemotherapy group (6 secondary myelodysplastic syndrome/acute myeloid leukemia and 6 second solid tumor cancers vs 1 acute myeloid leukemia, P = .01). The occurrence of a PFS plateau suggests that a subgroup of patients might have their FL cured by ASCT. However, the increased rate of secondary malignancies may discourage the use of purged ASCT in combination with TBI as first-line treatment for FL. This trial has been registered with ClinicalTrials.gov under identifier NCT00696735.

An explanatory model of authentic leadership, flourishing and work-family balance of nurses in French hospitals.

PURPOSE: This study aims to investigate the relationship between a positive leadership style [i.e. authentic leadership (AL)] and nurses' psychological health (i.e. nurses' flourishing and satisfaction with work-family balance), including psychological capital (PsyCap) as a mediational variable. DESIGN/METHODOLOGY/APPROACH: A cross-sectional study was conducted with a self-report questionnaire including 1,076 nurses from public and private hospitals in France. FINDINGS: Structural equation modeling results revealed that AL is related to nurses' flourishing and satisfaction with work-family balance and that PsyCap acted as a partial mediator between this leadership style and positive outcomes. PRACTICAL IMPLICATIONS: This research indicated that hospitals can enhance nurses' psychological health not only in their work but also in their lives in general by improving leaders' authentic management style and developing PsyCap (e.g. staffing, training and development). ORIGINALITY/VALUE: An original feature of this paper concerns its focus on the mediating role of PsyCap in the relationship between AL and these positive outcomes. Moreover, this study underlined the influence of leadership style on nurses' psychological health beyond occupational health. The research makes a valuable contribution to the existing AL literature by establishing a new explanatory model of AL and nurses' psychological health in the French context. It also highlights the interest in developing this leadership style in health-care settings.