Psychometric properties of the expanded prostate cancer index composite - 26 instrument in a cohort of radical prostatectomy patients: theoretical and practical examinations.

BACKGROUND: Recently, the Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) was recommended for the assessment of adverse effects after the treatment of prostate cancer without clear reasons. This decision encouraged us to review the questionnaire development from the UCLA Prostate Cancer Index (UCLA-PCI) to the EPIC-16 CP with a focus on psychometric properties. We also reviewed PubMed for papers concerning such properties of the EPIC-26 since 2012 (latest review in 2011). Finally, we examined the psychometric properties of the EPIC-26 in a sample of Norwegian males treated with robot-assisted laparoscopic prostatectomy (RALP). METHODS: This study used three methods: (1) Comparison of the content of the UCLA-PCI, EPIC-50, EPIC-26, and EPIC-16 CP; (2) Review of EPIC-26 and EPIC-16 CP papers in PubMed from 2012 to 2016, identifying papers reporting on the psychometric properties of these questionnaires; and (3) Psychometric examination of the EPIC-26 rating in 651 Norwegian men treated with RALP at a mean of 3.2 years post-surgery. RESULTS: The questionnaire development showed a significant increase in bother versus function items, and the EPIC-26 contains eight function and 18 bother items. Twelve papers concerning the EPIC-26 available on PubMed since 2012 support the psychometric properties of the EPIC-26. The Norwegian EPIC-26 findings supported the psychometric properties of the EPIC-26, but suggested six subdomains both by exploratory and confirmatory factor analyses. CONCLUSIONS: In general our examinations supported the adequate psychometric properties of the EPIC-26, although the factor structure, construct and predictive validity of the instrument should be examined further.

"The impact of cancer scale" version 1: psychometric testing of the Norwegian translation in a heterogeneous sample of cancer survivors.

PURPOSE: The impact of cancer scale version 1 (IOC-1) from 2006 has only been tested psychometrically in a heterogeneous sample of 193 American long-term cancer survivors (LTSs). The Norwegian version of IOC-1 compares the psychometric findings of that study with those observed in a heterogeneous sample of 809 Norwegian LTSs. METHODS: We performed exploratory (EFA) and confirmatory (CFA) factor analyses, tests of internal consistency, correlational studies with various other tests and a change over time examination in order to test reliability and validity of the IOC-1. RESULTS: The American factor structure of the IOC-1 with 10 dimensions showed adequate fit with CFA in the Norwegian sample, but internal consistency was insufficient in 2 dimensions. EFA of the Norwegian sample found a 9 factor solution that also showed adequate fit on CFA, and with sufficient internal consistencies for all dimensions. The SF-36 dimensions, anxiety, depression, neuroticism, fatigue and body image all showed low correlations with the positive dimensions of the IOC-1, but higher correlations with the IOC-1 negative dimensions. The IOC-1 dimensions showed considerable stability over time. CONCLUSIONS: In our big heterogeneous sample of LTSs, the Norwegian version of the IOC-1 showed discriminant and concurrent validity, and reliability was supported.

A cross-sectional testing of The Iowa Personality Disorder Screen in a psychiatric outpatient setting.

BACKGROUND: Patients suspected of personality disorders (PDs) by general practitioners are frequently referred to psychiatric outpatient clinics (POCs). In that setting an effective screening instrument for PDs would be helpful due to resource constraints. This study evaluates the properties of The Iowa Personality Disorder Screen (IPDS) as a screening instrument for PDs at a POC. METHODS: In a cross-sectional design 145 patients filled in the IPDS and were examined with the SCID-II interview as reference. Various case-findings properties were tested, interference of socio-demographic and other psychopathology were investigated by logistic regression and relationships of the IPDS and the concept of PDs were studied by a latent variable path analysis. RESULTS: We found that socio-demographic and psychopathological factors hardly disturbed the IPDS as screening instrument. With a cut-off ≥4 the 11 items IPDS version had sensitivity 0.77 and specificity 0.71. A brief 5 items version showed sensitivity 0.82 and specificity 0.74 with cut-off ≥ 2. With exception for one item, the IPDS variables loaded adequately on their respective first order variables, and the five first order variables loaded in general adequately on their second order variable. CONCLUSION: Our results support the IPDS as a useful screening instrument for PDs present or absent in the POC setting.

Storing Information Electrically in Human Skin.

Human skin has been classified as a non-volatile memristor and it is shown that information can be stored within for at least three minutes. Here we investigate whether it is possible to store information up to 20 minutes. Furthermore, we investigate whether the information can be based on four different states, not just two (binary). We stored the information into the skin of the forehead of the test subjects under three different electrodes, which allows in principle for 64 different combinations (3 electrodes, 4 states) and one can think of numbers on the base of four. For this experiment, we decided on the numbers 1234 and 3024 (that correspond to numbers 27 and 50 in the decimal system). Writing of the different states was done by the application of DC voltage pulses that cause electro-osmosis in the sweat ducts (nonlinear electrical measurements). Based on our results, we were not able to distinguish between four different states. However, we can show that binary information storage in human skin is possible for up to 20 minutes.

A study of coping in long-term testicular cancer survivors.

The primary objective of this study was to explore approach and avoiding coping strategies in long-term testicular cancer survivors (TCSs) as self-rated by the brief approach/avoidance coping questionnaire (BACQ). As the BACQ is a new instrument, the second objective was to examine critical psychometric properties of the instrument. The third objective was to examine the correlation between the BACQ and established self-rating instruments commonly used in psychosocial oncology to explore if the BACQ added an additional perspective to the characterization of TCSs. In this cross-sectional questionnaire study, 1326 Norwegian TCSs at a mean of 11.3 years (SD 4.2, median 10.7, range 5-21 years) after diagnosis gave information about their medical and social situation, distress, fatigue, quality of life, self-esteem, and neuroticism. The BACQ ratings of the TCSs were compared to those of a control sample of men from the general population (N = 566; NORM). Among TCSs 84% (95% CI 82-86%) used more approach coping, and this proportion did not differ significantly from 86% among NORM (95% CI 83-89%). The mean BACQ approach/avoidance score of TCSs were similar to that observed in NORM adjusted for age and work status (p = 0.33). The BACQ approach/avoidance score showed only moderate associations with established instruments used in psychosocial oncology. TCSs with more avoidance coping (N = 216) differed significantly from TCSs with more approach coping (N = 1110) by showing a lower proportion in paired relations and in paid work, more somatic and mental morbidity, more fatigue and poorer quality of life and self-esteem. In multivariate analyses lower self-esteem, higher cancer-related avoidance, more depression and neuroticism were most strongly associated with avoidant coping. In conclusion, we found that TCSs used similar coping patterns as NORM, avoidant coping was associated with significantly more problems than observed among TCSs who used more approach coping.

The Norwegian version of the Experiences in Close Relationships measure of adult attachment: psychometric properties and normative data.

BACKGROUND: Self-report questionnaires have facilitated attachment research, and validation of these instruments in different languages and cultures has become of importance. The Experiences in Close Relationships measure (ECR) is a well-established and suitable tool for cross-cultural comparisons of adult attachment. AIMS: The aim of this study was to assess the psychometric properties of the Norwegian version of the ECR and to develop a shorter version. We also investigated the associations between socio-demographic characteristics and attachment styles as measured by the ECR on the anxiety and avoidance subscales. METHODS: Data were anonymously collected by a mailed questionnaire to young adults aged 30, 40 and 45 years. With a response rate of 29%, 437 individuals were included. Exploratory factor analysis was performed and confirmatory factor analysis was done by structural equation modelling. RESULTS AND CONCLUSIONS: The psychometric properties of the Norwegian version of the ECR were satisfying and comparable with the properties reported by other translations. Individuals who scored low on both avoidance and anxiety scales were more likely to live in paired relations, have paid work, rate themselves with good health and in general be more satisfied with their lives. A new 12 item short version of the ECR showed good psychometric properties and similar associations to socio-demographic variables. Taking into account its brevity and feasibility further research on attachment style with ECR in clinical samples should be performed.

The Norwegian versions of the Chronic Pain Acceptance Questionnaire CPAQ-20 and CPAQ-8 - validation and reliability studies.

PURPOSE: The aim of this study was to test the validity and reliability of the translated Norwegian version of the Chronic Pain Acceptance Questionnaire (CPAQ-20) and the shorter version CPAQ-8 based on the same data. METHOD: The sample consisted of 120 women with chronic widespread musculoskeletal pain (CWP). The respondents completed CPAQ-20 and visual analogue scales (pain, fatigue, sleep problems and depression), General Health Questionnaire-12, The Pain Catastrophizing Scale, Fibromyalgia Impact Questionnaire and SF-8. Confirmatory factor analyses were performed on a one-factor baseline model, the previous validated CPAQ-20 and CPAQ-8 models, as well as an exploratory generated model based on the current sample. RESULTS: The two-factor model of CPAQ-20 and a two-factor model of CPAQ-8 obtained adequate model fit and outperformed the baseline model. The exploratory factor, analysis-generated two-factor model obtained only a marginally better fit, supporting the two-dimensional model of CPAQ-20. CPAQ-20 and CPAQ-8 had Cronbach's alphas between 0.75 (Pain Willingness subscales both versions) and 0.85. Both scales correlated significantly in the hypothesised direction with all the other scales. CONCLUSION: The Norwegian versions of CPAQ-20 and CPAQ-8 are reliable assessment tools with good construct validity for measurement of acceptance. Future studies should validate the scales in other Norwegian samples. Implication for Rehabilitation CPAQ-20 and CPAQ-8 are valid Norwegian instruments for measuring acceptance of pain. Acceptance of pain is an important process in the rehabilitation of persons with chronic widespread pain. Treatment models supporting acceptance can now be developed and measured further in Norway.

Primary caregivers of cancer patients in the palliative phase: a path analysis of variables influencing their burden.

Research has shown that several variables influence the burden of primary caregivers of cancer patients staying at home in the palliative phase, but the associations between these variables have hardly been explored. The aim of this study was to examine the associations of theory-driven variables with the caregivers' burden by means of path analysis. The sample consisted of 96 caregivers of cancer patients in the palliative phase staying at home recruited from a hospital trust in Norway. The dimensions of burden from the Caregiver Reaction Assessment, namely self esteem, lack of family support, impact on finances, and impact on daily schedule, were used as the dependent variable. The following independent variables were tested in the models: the patients' levels of pain, fatigue, and nausea; and the caregivers' physical quality of life, anxiety and depression, and social support. The Partial Least Squares approach to structural equation modelling was used for the path analysis. Model 1 shows the direct associations between the independent variables and the dependent variable, explaining 16% of the variance in caregiver burden. Model 1 supports the finding that only caregivers' depression has a direct significant association with caregiver burden, and shows further that the effects of the other independent variables on burden are mediated through depression. In Model 2, anxiety and depression are mediating factors between three other independent variables and caregiver burden, and 12% of the variance is explained. Model 2 supports none of the independent variables as antecedents of burden. Testing of the models suggested that caregivers' depression was the main factor associated with caregiver burden, but also an important mediator of indirect associations of indirect associations of caregivers' anxiety and physical health.

Psychological distress related to BRCA testing in ovarian cancer patients.

An increasing demand for genetic testing has moved the procedure from highly selected at-risk individuals, now also including cancer patients for treatment associated testing. The heritable fraction of ovarian cancer is more than 10%, and our department has offered BRCA testing to such patients irrespective of family history since 2002. This study examined potential psychosocial distress associated with this procedure using The Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire and other patient-rated generic distress instruments. Patients were divided into four groups according to cancer risk: mutation carriers, own history of breast cancer and ovarian cancer, family history of breast cancer and/or ovarian cancer, and patients without family history. In a postal survey, 354 patients responded. Good acceptance of the MICRA was observed, and previously described good psychometric properties were confirmed. A significant association between MICRA total score and receiving a positive BRCA test result was found. No significant between-group differences were observed with generic distress instruments. Time since cancer diagnosis, test result, and survey showed no significant associations with MICRA scores. Internal consistencies of instruments were adequate. Exploratory and confirmatory factor analyses showed adequate fit indices for a three factor solution of the MICRA, but further refinement of the items should be considered. In conclusion, the specific types of worry and distress most relevant to receiving genetic testing irrespective of family history were not captured by the generic distress instruments. The MICRA was supported as a useful tool for detection of mental distress related to genetic testing and risk evaluation.

Does a parental history of cancer moderate the associations between impaired health status in parents and psychosocial problems in teenagers: a HUNT study.

Severe disease in a parent is associated with increased psychosocial problems in their children. However, moderating factors of such associations are less studied. In this cross-sectional population-based controlled study we examined the moderating effects of a history of parental cancer on the association between impaired health status in parents and psychosocial problems among their teenagers. Among families with both parents responding to the adult Health Survey of Nord-Trøndelag County of Norway (the HUNT-2 study) 71 couples were identified with primary invasive cancer in one parent. Their 81 teenage children took part in the Young-HUNT study. These families were compared to 322 cancer-free families with 328 teenagers. Based on self-report data the relations between three variables of parental impaired health and six psychosocial problems in teenagers were analyzed family wise by structural equation modeling. Significant associations between parental and teenagers' variables were observed in eight of 18 models. A history of parental cancer was a significant moderator which decreased four of eight significant associations. Such a history significantly weakened the associations between parental poor self-rated health and teenagers' anxiety/depression and school problems. A similar association of a history of parental cancer was found between psychological distress in parents and teenagers' feelings of loneliness and poor self-rated health. This study confirmed strong associations between impaired parental health and psychosocial problems in their teenagers. A history of parental cancer weakened several of the significant associations between parental impaired health variables and psychosocial problems in their teenagers.

Psychometric examination and normative data for the narcissistic personality inventory 29 item version.

The Narcissistic Personality Inventory (NPI) is commonly used in empirical studies of narcissism. Few population-based studies have been published. Our aim was to do a confirmatory factor analysis (CFA) of the NPI 29 item version with a four-factor structure, in two population-based samples and in a patient sample, and present normative population-based data. The NPI-29 was filled in by 324 respondents from the Norwegian population, 231 from the Swedish population and 167 Norwegian psychiatric patients. The four-factor structure of the NPI-29 with Leadership/Power, Exhibitionism/Self-admiration, Superiority/Arrogance and Uniqueness/Entitlement was reproduced in these samples. The CFA models showed good fit indices in all samples. Mean scores on the NPI-29 and four subscales hardly differed between the samples. For the NPI-29 total score and factors, few significant differences were observed. CFA of the samples supported the factor structure of the NPI-29 formerly identified by principal component analysis of the Swedish population sample.