Validation of the Mexican version of the EORTC QLQ-CR29 in patients with colorectal cancer.

BACKGROUND: The evaluation of the quality of life (QoL) of patients with colorectal cancer (CRC) is an essential measure to measure the impact of the disease and treatments on the lives of patients. However, in Latin America there is no validated and reliable instrument to assess this construct. OBJECTIVES: This study aims to validate the EORTC QLQ-CR29 instrument in the Mexican population with CRC. METHODS: This study aims to validate the EORTC QLQ-CR29 instrument in the Mexican population with CRC. The study used an instrumental design and a nonprobabilistic sample due to availability, made up of 251 patients with CRC, with an average age of 54.7 ± 12.28 years. Exploratory and confirmatory factor analyses were performed, as well as concurrent validity tests. RESULTS: The exploratory factorial analysis yielded 4 factors that explained 51.64% of the variance, with a Cronbach reliability coefficient of .766 and an Omega index of .725. The confirmatory factor analysis indicated that the proposed theoretical model fits the data almost perfectly, with an error close to 0, which shows that it is a balanced and parsimonious instrument to measure the QoL of the patients with CRC. SIGNIFICANCE OF RESULTS: The EORTC QLQ-CR29 instrument proved to be a valid and reliable instrument for use in clinical care and research directed at patients with CRC in Mexico. Its use is recommended by multidisciplinary health teams in oncology in Mexico, since it allows knowing the patient's perspective on the impact of CRC on their life, guiding therapeutic decision-making and being a primary outcome measure.

Quality of life, adherence to voice rehabilitation therapy and psychological variables in patients with head and neck cancer / Calidad de vida, adherencia al tratamiento de rehabilitación de voz y variables psicológicas en pacientes con cáncer de cabeza y cuello

Introduction: Voice problems can affect quality of life (QoL), other psychological aspects, and the adequate adherence to voice rehabilitation therapy. Objective: To determine the association between QoL and treatment adherence (TA) to voice rehabilitation with symptoms of anxiety, depression, and coping strategies. Method: A longitudinal study was conducted with 97 participants with head and neck cancer (H&N) who were attending voice rehabilitation therapy. Instruments: EORTC QLQ-C30 and QLQ-H&N35, Treatment Adherence Checklist, Cancer Coping Questionnaire and HADS. Results: The mean overall QoL was 83.33, and mean TA was 8.80. Lower overall QoL and emotional functioning scores, as well as higher dry mouth scores were associated with higher levels of anxiety. Greater problems with social contact and lower TA were associated to higher depression scores. Conclusion: Consistent with the literature, TA and QoL were associated to depression and QoL was also correlated to anxiety. These results are among the first to explore such aspects in Latino patients and emphasize the importance of multidisciplinary care for H&N cancer patients in voice rehabilitation therapy, given that during their treatment they may encounter psychological barriers that could hinder their progress in voice quality and QoL.(AU)

Introducción: Los problemas de la voz pueden afectar la calidad de vida (CV) y otros aspectos psicológicos, así como la adecuada adherencia a la terapia de rehabilitación de voz. Objetivo: Determinar la relación entre la CV y la adherencia al tratamiento (AT) de rehabilitación de voz con síntomas de ansiedad, depresión y estrategias de afrontamiento. Método: Se realizó un estudio longitudinal en 97 participantes con cáncer de cabeza y cuello (CyC) que asistían a terapia de rehabilitación de voz. Instrumentos: EORTC QLQ-C30 y QLQ-H&N35, Lista de Verificación de Adherencia al Tratamiento, la Escala de Afrontamiento al Cáncer y la HADS. Resultados: La CV global promedio fue de 83.33 y el puntaje promedio de AT fue de 8.80. La calidad de vida global, la función emocional y boca seca se asociaron con la ansiedad. La dimensión de la CV contacto social y la AT tuvieron relación con la depresión. Conclusiones: Consistente con la literatura la AT y la CV tuvieron relación con la depresión y solo la CV se relacionó con la ansiedad. Los resultados presentados son de los primeros en explorar estos aspectos en pacientes latinos y enfatizan la importancia de la atención multidisciplinaria a pacientes con cáncer de CyC en terapia de rehabilitación de voz, dado que en el curso de sus tratamientos pueden encontrar barreras psicológicas que obstaculicen la mejora en la calidad de la voz y la CV.(AU)

Factors associated with the presence of fear of contagion and burnout syndrome in nursing personnel during the COVID-19 pandemic.

Introduction: During the COVID-19 pandemic, nursing personnel presented a higher prevalence of fear of contagion, anxiety symptoms, depression, and burnout syndrome. However, the variables associated with these conditions in Mexico are unknown. Objective: To determine the clinical, sociodemographic, and psychological variables associated with fear of contracting COVID-19 and burnout syndrome in nursing personnel. Methods: The study was a cross-sectional correlational study. It included 423 Mexican nursing professionals, working in public and private institutions, of different specialties aged 18-61 years (M = 36 years), the sampling was non-probabilistic by convenience. The instruments used were: COVID-19 fear scale, Maslach Burnout Inventory, Generalized Anxiety Disorder Scale-7 and Patient Health Questionnaire-9. Multinomial logistic regression models were used to analyse the results. Results: The factors associated with fear of contagion were anxiety symptoms (Odds Ratio [OR]: 7.806, p < 0.05), caring for patients with COVID-19 (OR: 5.460, p < 0.05, 0.001) and mild emotional exhaustion (OR: 5.181, p < 0.05). The syndrome dimensions were: depressive symptoms (OR: 12.062; 7.667, p < 0.05), fear of contagion (OR: 4.978; 4.913; 4.921; 4.921, p < 0.01), marital status (OR: 3.404; 3.219, p < 0.05) and young age (OR: 1.064; 1.084, p < 0.05). Conclusions: The factors associated with fear of contagion and burnout syndrome found were having clinical psychological symptoms, as well as being young, being single, being married and being in the health system caring for patients with COVID-19.

Evidencia psicométrica del Cuestionario sobre la Salud del Paciente (PHQ-9) y Escala de Ansiedad Generalizada (GAD-7) en pacientes con asesoramiento genético en Oncología / Psychometric evidence of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Scale (GAD-7) in patients with genetic counseling in Oncology

Introducción: Los síntomas de depresión y ansiedad en pacientes que reciben Asesoramiento Genético en Oncología (AGO), se encuentran dentro de las afectaciones psicológicas más prevalentes, por lo que su identificación de forma oportuna, valida y confiable es prioritaria. Objetivo: Determinar las propiedades psicométricas del Cuestionario sobre la Salud del Paciente, PHQ-9, y de la Escala de Ansiedad Generalizada, GAD-7, en pacientes con cáncer portadores de variantes patogénicas germinales en genes de alta susceptibilidad. Método: Se empleó un diseño instrumental, transversal con un muestreo no probabilístico. Se incluyeron 163 participantes con variantes patogénicas en BRCA1/BRCA2, asociadas a cáncer hereditario, entre 19 y 79 años, (48,2 ± 11,2 años). Resultados: La validez de constructo de cada instrumento se probó a través de un análisis factorial exploratorio y confirmatorio. La GAD-7 obtuvo un α = 0,899 y 62,3 % de la varianza explicada, por otro lado, el PHQ- 9 obtuvo un α = 0,896 y 54,8 % de la varianza explicada. El análisis factorial confirmatorio sugiere que los modelos teóricos de ambos instrumentos se ajustan a un solo factor, con una consistencia e índices de validez adecuados. Discusión y conclusión: El PHQ-9 y la GAD-7 son instrumentos parsimoniosos, breves, válidos y confiables para la detección de síntomas de depresión y ansiedad en pacientes que reciben AGO, en población mexicana. Se recomienda su uso en la atención clínica (al inicio, y durante el seguimiento), así como en investigaciones futuras (AU)

Introduction: The symptoms of depression and anxiety in patients receiving Genetic Counseling in Oncology (AGO) are among the most prevalent psychological affectations, so their timely, valid, and reliable identification is a priority. Objective: To determine the psychometric properties of the Patient Health Questionnaire, PHQ-9, and the Generalized Anxiety Scale, GAD-7, in cancer patients carrying germinal pathogenic variants in high susceptibility genes. Method: An instrumental, cross-sectional design was used with a non-probabilistic sampling. 163 participants with pathogenic variants in BRCA1/BRCA2, associated with hereditary cancer, between 19 and 79 years (48.2 ± 11.2 years) were included. Statistical analysis: The construct validity of each instrument was tested through an exploratory and confirmatory factor analysis. Results: The GAD-7 obtained α = 0.899 and 62.3% of the explained variance, on the other hand, the PHQ-9 obtained α = 0.896 and 54.8% of the explained variance. Confirmatory factor analysis suggests that the theoretical models of both instruments fit a single factor, with adequate consistency and validity indices. Discussion and conclusion: The PHQ-9 and the GAD-7 are parsimonious, brief, valid and reliable instruments for the detection of symptoms of depression and anxiety in patients receiving AGO, in the Mexican population. Its use is recommended in clinical care (at baseline, and during follow-up), as well as in future research (AU)

Use of telehealth for psychosocial oncology: A mixed methods study about barriers to and opportunities with Latino patients from Latin America, Spain, and the United States.

OBJECTIVES: Telehealth for mental healthcare expanded rapidly with the COVID-19 pandemic's onset; however, global access disparities emerged. Telehealth challenges and opportunities for Latino cancer patients from different geographical regions must be explored. METHODS: A cross-sectional online survey (March-July 2021) of mental health providers, serving Latino cancer patients in Latin America, United States, and Spain, contained close-ended questions related to the use of telehealth during the pandemic and open-ended questions on recommending/not recommending telehealth. RESULTS: In a sample of 148 providers from 21 countries, 60.5% reported that at least some of their patients had difficulties with Internet speed and connectivity and lacked knowledge about using electronic devices (43.2%) or the Internet (45.4%). Lacking privacy at home (66.0%) and childcare (26.0%) were reported patient challenges. Internet connectivity or speed were issues for providers (43.2%) themselves. Improving patient reach was a reported telehealth benefit (64.2%). Geographical access (43.2%) and physical limitations (35.8%) were considerations in offering telehealth. Considerations for not recommending telehealth were patient age (24.3%) and lacking technological knowledge (29.1%). CONCLUSIONS: Telehealth for mental healthcare may improve patient access issues caused by geographical and transportation conditions and patient functionality. Findings provide insight into telehealth benefits and challenges in Latino patient populations. Future studies should examine patient access and use by region.

Validation of the Mexican version of the Schedule of Attitudes Toward Hastened Death in patients undergoing palliative care in Mexico.

OBJECTIVES: The Schedule of Attitudes Toward Hastened Death (SAHD) has emerged as a valid and reliable tool to assess the wish to hasten death (WTHD) among patients diagnosed with advanced cancer; however, the instrument has never been culturally adapted and validated for patients in Mexico. This study sought to validate and abbreviate the SAHD tool for use among patients attending the Palliative Care Service of the Instituto Nacional de Cancerología in Mexico. METHODS: The SAHD was culturally adapted from a previously published validation in patients from Spain. Eligible patients included Spanish literate subjects treated as outpatients in the Palliative Care Service, with an Eastern Cooperative Oncology Group (ECOG) performance status of 0-3. Patients were asked to answer the Mexican version of SAHD (SAHD-Mx) instrument and the Brief Edinburgh Depression Scale (BEDS). RESULTS: A total of 225 patients were included in the study. Median positive response in the SAHD-Mx was 2 (range 0-18). Positive correlation was identified between the SAHD-Mx scale and ECOG performance status (r = 0.188, p = 0.005), as well as BEDS (r = 0.567, p < 0.001). SAHD-Mx displayed strong internal consistency (alpha = 0.85) and adequate reliability from test-retest phone interviews (r = 0.567, p < 0.001). Using the confirmatory factor analysis model, a factor was identified and the number of items was reduced to 6, including items 4, 5, 9, 10, 13, and 18. SIGNIFICANCE OF RESULTS: The SAHD-Mx emerges as an adequate tool, with appropriate psychometric characteristics, for assessing WTHD among patients diagnosed with cancer undergoing palliative care in Mexico. .

Quality of life, anxiety, depression, and distress in patients with advanced and metastatic lung cancer.

OBJECTIVE: Lung cancer (LC) patients have shown a predisposition for developing emotional and physical symptoms, with detrimental effects on the quality of life (QoL). This study evaluates the bidirectional relationship between main psychological disorders and clinical/sociodemographic factors with the QoL. METHODS: In this observational cross-sectional study, patients with a confirmed LC diagnosis from February 2015 to March 2018 were eligible for this study. Each participant completed screening instruments of anxiety, depression, distress, and QoL assessment. Other relevant clinical data were extracted from electronic health records. Then comparisons, correlations, and logistic regression analyses were performed. RESULTS: Two hundred and four cases were eligible; of them, the median age was 61 (24-84) years, most had clinical stage IV (95%), and most were under first-line therapy (53%). Concerning psychological status, 46% had symptoms of emotional distress, 35% anxiety, and 31% depression. Patients with psychological disorders experienced a worse global QoL than those without psychological impairment (p < 0.001). Increased financial issues and physical symptoms, combined with lower functioning, were also significantly associated with anxiety, depression, and distress. In the multivariate analysis, female sex and emotional distress were positively associated with an increased risk of depression; likewise, female sex, low social functioning, insomnia, and emotional distress were associated with anxiety. CONCLUSIONS: Emotional symptoms and QoL had a significant bidirectional effect on this study; this underscores the necessity to identify and treat anxiety, depression, and distress to improve psychological well-being and the QoL in LC patients.

Cultural adaptation process of cancer-related interventions: A step-by-step guide.

INTRODUCTION: To contribute to the reduction and elimination of cancer-related local and global health disparities, interventions must be culturally adapted to reach diverse cultural groups and demonstrate success in improving clinical and psychosocial outcomes. We provide step-by-step information on the conceptual and methodological challenges involved in culturally adapting interventions and provide guidelines, suggestions, tools, and concrete steps for implementing the process. METHODS: This article provides information, guidelines, suggestions, tools, and concrete steps, based on three rigorous models of cultural adaptations, for implementing this process, followed with examples from the field, to illustrate the conceptual and methodological challenges involved in culturally adapting interventions. CONCLUSION: Our systematic step-by-step approach recommends (1) the guidance of well-established research models; (2) use of multiple data sources and input from various stakeholders (i.e., from patients and providers); (3) qualitative and quantitative data usage and integration; (4) a steering committee with multiple perspectives, stakeholders assessments, and qualitative analyses; (5) consensus meetings; and (6) diverse representation on the steering committee and/or research team.

Efecto de intervenciones psicológicas sobre variables psicosociales en pacientes con cáncer colorrectal: una revisión narrativa de la literatura / Effect of psychological interventions on psychosocial variables in patients with colorectal cancer: a narrative review of the literature

Objetivo: Describir los efectos de intervenciones psicológicas sobre ansiedad, depresión, malestar emocional y/o calidad de vida (CdV) de pacientes con cáncer colorrectal. Método: Revisión narrativa de la literatura en MEDLINE, PsycINFO, CINAHL y Cochrane Library, 2011-2021. Resultados: Se obtuvieron 553 artículos, de los cuales se incluyeron doce. La mayoría fueron intervenciones breves, individuales y presenciales. La Terapia Cognitivo-Conductual fue la intervención más reportada, mostrando efectos positivos en CdV, específicamente en pacientes con estoma; la Terapia de Aceptación y Compromiso y la terapia centrada en soluciones también identificaron mejorías en CdV. La terapia de reminiscencia y una intervención para la autoeficacia redujeron la ansiedad y depresión. No se comprobó la efectividad del entrenamiento en relajación y de escritura; la psicoeducación mostró efectos inconsistentes. Conclusión: Existe una escasez de estudios realizados durante los últimos años, los cuales no evidencian un consenso del modelo terapéutico que produzca mejores consistentes en el bienestar psicológico. (AU)

Objective: To describe the effects of psychological interventions on anxiety, depression, emotional distress and/or quality of life (QoL) of patients with colorectal cancer. Methods: Narrative literature review in MEDLINE, PsycINFO, CINAHL and Cochrane Library, 2011-2021. Results: A total of 553 articles were obtained, of which twelve were included. Most were brief, individual, face-to-face interventions. Cognitive Behavioral Therapy was the most reported intervention, showing positive effects on QoL, specifically in stoma patients; Acceptance and Commitment Therapy and solution-focused therapy also identified improvements in QoL. Reminiscence therapy and a self-efficacy intervention reported significant improvements in anxiety and depression. Relaxation and writing training were not proven effective; psychoeducation showed inconsistent effects. Conclusion: There is a paucity of studies conducted during the last years, which do not evidence a consensus of the therapeutic model that produces consistent improvements in psychological well-being. (AU)

Escala de Adherencia Terapéutica para tratamiento de Cáncer de Mama (EAT-CaMa): Una evaluación multidimensional / Therapeutic Adherence Scale for the treatment of Breast Cancer (EAT-CaMa): A multidimensional assessment

Introducción: La adherencia terapéutica es un aspecto clave en el éxito del tratamiento en oncología, sin embargo, su medición es un reto dentro del sistema de salud. Asimismo, no se tienen escalas especificas validas o construidas para evaluar la adherencia en pacientes con cáncer de mama. Objetivo:Determinar las propiedades psicométricas de la Escala de Adherencia Terapéutica al Cáncer de Mama (EAT-CaMa). Método:Se empleó un diseño no experimental, instrumental con un muestreo no probabilístico. Se incluyeron 189 participantes con diagnóstico de CaMa entre 21 y 84 años. Análisis estadísticos: Se realizó un análisis factorial exploratorio y consistencia interna. Resultados: La EAT-CaMa de 27 reactivos, obtuvo una consistencia interna global α= 0,81 y una varianza explicada del 64%. Se identificaron factores de autoeficacia y comunicación médico paciente, así como varios indicadores. Conclusión:El EAT-CaMa es un instrumento breve, válido y confiable para la evaluación multidimensional de la adherencia al tratamiento en población con CaMa. La estructura factorial identificada corrobora componentes reportados en la literatura y clínicamente relevantes. Se recomienda su usoen la atención clínica (inicio y seguimiento del tratamiento) y en investigación (AU)

Introduction: The therapeutic adherence is a key aspect in the success of the oncology treatment, however its measurement is a challenge within the health system. Likewise, there are no valid or constructed scales to assess adherence in patients with breast cancer. Objective: To determine the psychometric properties of the Breast Cancer Therapeutic Adherence Scale (EAT-CaMa). Method: A non-experimental, instrumental design with a non-probabilistic sampling was used, for convenience. One hundred eighty nine participants with a diagnosis of breast cancer, between 21 and 84 years old, were included. Statistical analysis: An exploratory factor analysis was performed. Results: An exploratory factor analysis and internal consistency were carried out. Results: The EAT-CaMa of 27 questions obtained a global internal consistency α = 0.81 and an explained variance of 64%. Self-efficacy and physician-patient communication factors were identified, as well as several indicators. Conclusion: The EAT-CaMa is a short, valid and reliable instrument for the multidimensional evaluation of adherence to treatment in the Mexican breast cancer population. The identified factorial structure corroborates components reported in the literature and clinically relevant. It is recommended for use in clinical care (initiation and follow-up of treatment) and in future research (AU)

International adaptation of Meaning-Centered Psychotherapy for Latinos: Providers' views on pre-implementation.

Background: This qualitative study aims to identify facilitators of and barriers to the implementation of Meaning-Centered Psychotherapy (MCP) by providers of mental health services to Latinos in the US and Latin America using the practical, robust implementation and sustainability model (PRISM). This information will be used to increase usability and acceptability of MCP for Latino patients with cancer and their providers in Latin America and the US. Methods: A total of 14 Latino cancer patient mental health providers completed in-depth semi-structured interviews. Participants were recruited from 9 countries and 12 different sites. They provided feedback about barriers to and facilitators of implementation of MCP at the patient, provider, and clinic levels in their clinical setting. The qualitative data from the interviews was coded according to PRISM domains. Three analysts independently coded the transcripts; discrepancies between analysts were resolved through discussion and consensus. Results: Based on PRISM, themes were: clinic environment (protected time for training and supervision), intervention characteristics (adapt the intervention using more simple language, include more visual aids, include more family-oriented content), patient (develop materials for the identification and screening of patients, provide educational materials, increase motivation and knowledge about psychotherapy, assess commitment to psychotherapy, adapt for the inpatient vs. outpatient setting), provider (receive interactive/participatory training, educational materials, ongoing supervision, have flexibility of delivering the intervention in a less structured manner, theoretical framework of the provider) and external environment (work at policy level to integrate services for oncology patients). Conclusion: These qualitative data revealed potential facilitators and barriers of this intervention (MCP) on an international scale. Identified cultural, contextual, and healthcare systems factors illustrated the importance of examining pre-implementation needs prior to implementing a trial. We will design and plan a future RCT using the PRISM framework and these pre-implementation data. Plain Language Summary: This study integrates frameworks of implementation science and cultural adaptation through the examination of pre-implementation contextual issues at the preparation phase of a cultural adaptation of a psychotherapeutic intervention, Meaning-Centered Psychotherapy (MCP), for Latinos with advanced cancer. By examining implementation needs early in the implementation process, during preparation, the intervention can be adapted in a way that attends to and addresses the providers' most cited challenges in implementation: having a rigid protocol/structure, complexity of the intervention, disease burden preventing adherence to the intervention, transportation, and competing demands, and limited clinic space to offer the intervention.

Dignity therapy in Mexican lung cancer patients with emotional distress: Impact on psychological symptoms and quality of life.

Lung cancer (LC) is the most frequent and deadly neoplasm in the world, and patients have shown a tendency to have more emotional distress than other cancer populations. Dignity Therapy (DT) is a brief intervention aimed to improve emotional well-being in patients facing life-threatening illness. OBJECTIVE: To analyze the effect of DT on anxiety, depression, hopelessness, emotional distress, dignity-related distress, and quality of life (QoL) in a group of Mexican patients with stage IV LC undergoing active medical treatment with baseline emotional distress. METHOD: In this preliminary pretest-posttest study, patients received three sessions of DT and were evaluated with the HADS, Distress Thermometer, Patient Dignity Inventory, single-item questions, and QLQ-30. RESULTS: In total, 24 out of 29 patients completed the intervention. Statistically significant improvements were found in anxiety, depression, emotional distress, hopelessness, and dignity-related distress with large effect sizes. Patients reported that DT helped them, increased their meaning and purpose in life, their sense of dignity, and their will to live, while it decreased their suffering. No changes were found in QoL. SIGNIFICANCE OF RESULTS: DT was well accepted and effective in improving the emotional symptoms of LC patients with distress that were undergoing medical treatment. Although more research is warranted to confirm these results, this suggests that DT can be used in the context of Latin-American patients.

Detection of psychosocial distress in cancer patients: A survey of Mexican oncologists.

Purpose: Identification of patients' distress is relevant for an on-time referral to psychosocial treatment. The objective was to assess the implementation of the guidelines for distress managing in Mexican oncologists based on the NCCN guidelines.Design: The study was non-experimental and cross-sectional.Sample: Two hundred thirty-one oncologists participated with an average age of 38 ± 11 years.Methods: The likelihood of distress assessment was quantitatively evaluated.Findings: A high percentage of oncologists knew and used procedures to assess psychosocial discomfort. However, a smaller percentage used a valid and reliable instrument. Factors associated with performing distress identification procedures were knowing the distress guidelines and lack of time. Factors for questionnaire usage are the availability of brief instruments and the percentage of patients suffering from stress.Implications for Psychosocial Providers: Psychosocial providers should develop strategies to educate and ensure that oncologists are familiar with guidelines on distress in oncology. More dissemination of screening procedures and referral to psychosocial programs in oncology is required. Integrating a distress screening program involving psychosocial providers and oncologists should be approached as a routine in high-quality cancer care, to reduce the stigma associated with mental health services.

Validación del cuestionario básico de síntomas M. D. Anderson (MDASI)para pacientes con cáncer en población mexican / Validation of the basic symptom questionnaire M.D. Anderson (MDASI-M) for cancer patients in the Mexican populatio

Introducción: Los diferentes síntomas en el paciente con cáncer pueden afectar las actividades en la vida cotidiana, las decisiones terapéuticas, así como la calidad de vida. Por lo que identificar la sintomatología en este grupo de pacientes es de suma importancia. Objetivo: Validar el cuestionario básico de síntomas M. D. Anderson (MDASI) para pacientes con cáncer en población mexicana. Método: Se incluyeron 309 pacientes del Instituto Nacional de Cancerología con edad entre 18 a 85 años, el tipo de estudio fue transversal, no experimental. Instrumentos: Cuestionario básico de síntomas MDASI, Cuestionario de Calidad de Vida de la Organización Europea para el tratamiento e Investigación del cáncer (EORTC-QLQ-C30) y Termómetro de Distrés. Resultados: Un análisis factorial ajustado a dos factores presentó un instrumento con 12 reactivos, similar a la versión original. La consistencia interna de la escala global mostró un índice satisfactorio (0,86). Las alfas de Cronbach de cada subescala tuvieron un valor de 0,79 y 0,80 que explicaron el 48,04% de la varianza global. La validez, por medio de correlación con las medidas concurrentes, mostró resultados significativos (r de Pearson de 0,954 a -0,267, p<0,01). Conclusiones: El instrumento MDASI mostro propiedades psicométricas adecuadas, similar a la versión original. Es útil para la práctica clínica e investigación. Se recomienda realizar estudios complementarios para determinar su sensibilidad en efectos de intervenciones médicas y psicológicas (AU)

Introduction: The different symptoms in the patient with cancer can affect the activities in the daily life, the therapeutic decisions, as well as the quality of life. Thus, identifying the symptomatology n this group of patients is of the utmost importance. Objective: To validate the basic symptoms questionnaire M. D. Anderson (MDASI) for cancer patients in the Mexican population. Method: 309 patients from the National Cancer Institute were included, aged between 18 and 85 years, the type of study was transversal, not experimental. Instruments: Basic questionnaire of symptoms MDASI, Inventory of Quality of Life of the European Organization for the treatment and researching of cancer (EORTC-QLQ-C30) and Thermometer of Distrés. Results: A factorial analysis adjusted to two factors showed an instrument with 12 items, similar to the original version. The internal consistency of the global scale presented a satisfactory index (0.86). The Cronbach alphas of each subscale had a value of 0.79 and 0.80 that explained 48.04% of the global variance. The validity, by means of correlation with the concurrent measures, showed significant results (Pearson’s r from 0.954 to -0.267, p <0.01). Conclusions: The MDASI instrument produced adequate psychometric properties, similar to the original version. It is useful for clinical practice and research. Complementary studies are recommended to determine their sensitivity in the effects of medical and psychological interventions (AU)

Validation of the Patient Dignity Inventory in Mexican Cancer Patients.

Introduction: The Patient Dignity Inventory (PDI) is a reliable screening instrument for a variety of problems (physical, existential, and social) that affect the dignity of patients during their end of life. The PDI has been translated into several different languages and has been validated in different settings. As such, it is important to validate the instrument in patients with cancer in Mexico to assess dignity in this population. The aim of this study was to translate and validate the Spanish version of the PDI in Mexican patients with cancer. Methods: This is a cross-sectional study that included patients with cancer, both those enrolled and not enrolled in palliative care, at the Instituto Nacional de Cancerología in Mexico City from September 2018 to August 2019. A translation and back translation were performed to obtain the Mexican version of the PDI (PDI-Mx) instrument. Patients completed the PDI-Mx, the Hospital Anxiety and Depression Scale (HADS), and functional scales (Eastern Cooperative Oncology Group [ECOG] and Karnofsky). Psychometric properties were evaluated by determining internal consistency, exploratory and confirmatory factor analysis (CFA), and concurrent validity with the HADS. Results: We included 290 participants with cancer (145 in palliative care and 145 not enrolled in palliative care). The Cronbach's alpha of the PDI-Mx was 0.95. There was a significant correlation with the HADS (rs = 0.757, p < 0.0001). The factor analysis showed four factors that explain 64.7% of the model. The CFA presented adequate indicators, which show the adjustment of the structure that indicates a balanced and parsimonious model. Conclusions: The Mexican version of the PDI shows adequate psychometric properties in patients with cancer. We suggest the use of PDI-Mx in clinical care and research. The study was approved by the Institutional Review Board and Ethics Committee with numbers (016/063/CPI) and (CEI/1115/16) respectively.

Validation of an instrument to assess health care quality (FACIT-TS-PS) in cancer patients.

INTRODUCTION: Cancer patient satisfaction with the healthcare team is of great relevance for assessing the quality of the care provided by the health system. In Mexico, no valid and reliable tool is available to assess this construct. OBJECTIVE: To validate the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-Patient Satisfaction (FACIT-TS-PS) instrument, version 4, in cancer patients. METHOD: Cross-sectional design, non-probability convenience sampling. The sample consisted of 200 cancer-diagnosed patients, with mean age of 45.86 ± 15.01 years. Exploratory and confirmatory factor analyses were conducted. RESULTS: The exploratory factor analysis identified four factors, with a Cronbach alpha of 0.945, and an explained variance of 68.15 %. The confirmatory factor analysis indicated that the proposed theoretical model adjusts to the data with an error close to zero and, in addition, it is balanced and carefully measures overall patient satisfaction with the treatment. CONCLUSION: FACIT-TS-PS was shown to be a valid and reliable instrument for use in clinical care and research in Mexican cancer patients. Its use is recommended in the evaluation of oncology multidisciplinary healthcare teams in Mexico.

INTRODUCCIÓN: La satisfacción del paciente oncológico con el equipo de salud es de relevancia para evaluar la calidad de la atención del sistema de salud. En México no se dispone de una herramienta válida y confiable para evaluar este constructo. OBJETIVO: Validar el Instrumento de Evaluación de Funcionalidad en el Tratamiento para Enfermedades Crónicas-Satisfacción con el Tratamiento-Satisfacción del Paciente (FACIT-TS-PS) versión 4, en pacientes mexicanos con cáncer. MÉTODO: Diseño transversal, muestreo no probabilístico, por disponibilidad. La muestra consistió en 200 pacientes diagnosticados con cáncer, con edad promedio de 45.86 ± 15.01 años. Se realizó un análisis factorial exploratorio y confirmatorio. RESULTADOS: Se identificaron cuatro factores con un alfa de Cronbach de 0.945 y una varianza explicada de 68.15 %. El análisis factorial confirmatorio indicó que el modelo teórico propuesto se ajusta a los datos con error próximo a cero y que, además, es equilibrado y mide cuidadosamente la satisfacción global del paciente con el tratamiento. CONCLUSIÓN: FACIT-TS-PS mostró ser un instrumento válido y confiable para su uso en la atención clínica e investigación dirigida a pacientes mexicanos con cáncer. Se recomienda su utilización en la evaluación de equipos de salud multidisciplinarios en oncología en México.

Propiedades psicométricas de la Escala de Evaluación Funcional para el Tratamiento del Cáncer, versión próstata (FACT-P), en pacientes mexicanos.

BACKGROUND: Prostate cancer is the most frequent neoplasm in Mexican men, the research literature contains few studies that address prostate cancer patients and quality of life in Mexico. OBJECTIVE: To validate the Functional Assessment Cancer therapy (FACT-P) scale. METHOD: 201 males 49 to 90 years of age, at any clinical stage of prostate cancer, under treatment or follow-up participated. It's a non-experimental cross-sectional study. Patients were evaluated through the FACT-P jointly with the European Organization for Research and Treatment of Cancer Quality of Life and Hospital Anxiety and Depression Scale. Exploratory analysis examined the factorial structure, and confirmatory analysis to evaluate the adjustment of the exploratory model to the data. RESULTS: A four-factor model that explained 64.65% of the variance, Cronbach's alpha 0.79, and correlations were statistically significant, Pearson's r of 0.146-0.716, p < 0.01 and p < 0.05. Analyses also distinguished metastatic patients from non-metastatic ones. The main indices of the confirmatory model were satisfactory for the adjustment of data and showed an estimate error close to zero. CONCLUSIONS: This Mexican version of FACT-P showed reliability and validity comparable to the original one.

ANTECEDENTES: El cáncer de próstata es la neoplasia más frecuente en los varones mexicanos, pero pocos estudios han abordado la calidad de vida en los pacientes con cáncer de próstata en México. OBJETIVO: Validar la Escala de Evaluación Funcional para el Tratamiento del Cáncer, versión próstata (FACT-P). MÉTODO: 201 pacientes de 49 a 90 años en cualquier etapa clínica, en tratamiento o seguimiento. Diseño de estudio: transversal no experimental. Se usaron el FACT-P, el Inventario de la Organización Europea para la Investigación y Tratamiento del cáncer y Calidad de Vida, y la Escala de Ansiedad y Depresión Hospitalaria. Se realizaron análisis factorial exploratorio y análisis factorial confirmatorio para evaluar el ajuste del modelo de los datos, mediante el método de máxima verosimilitud. RESULTADOS: Se obtuvo un modelo de dos factores y dos indicadores que explicaron el 64.65% de la varianza, alfa de Cronbach 0.79, correlaciones estadísticamente significativas, r de Pearson de 0.146-0.716, p < 0.01 y p < 0.05. La escala discrimina los pacientes sin y con metástasis. Los principales índices del modelo confirmatorio sugieren un modelo estable y parsimonioso, con error próximo a cero, que se ajusta aceptablemente a los datos analizados. CONCLUSIONES: La versión mexicana del FACT-P posee una confiabilidad y una validez adecuadas, similares a las de la original.

Validación de FACIT-TS-PS en una muestra de pacientes mexicanos con cáncer / Validation of an instrument to assess health care quality (FACIT-TS-PS) in cancer patients

Resumen Introducción: La satisfacción del paciente oncológico con el equipo de salud es de relevancia para evaluar la calidad de la atención del sistema de salud. En México no se dispone de una herramienta válida y confiable para evaluar este constructo. Objetivo: Validar el Instrumento de Evaluación de Funcionalidad en el Tratamiento para Enfermedades Crónicas-Satisfacción con el Tratamiento-Satisfacción del Paciente (FACIT-TS-PS) versión 4, en pacientes mexicanos con cáncer. Método: Diseño transversal, muestreo no probabilístico, por disponibilidad. La muestra consistió en 200 pacientes diagnosticados con cáncer, con edad promedio de 45.86 ± 15.01 años. Se realizó un análisis factorial exploratorio y confirmatorio. Resultados: Se identificaron cuatro factores con un alfa de Cronbach de 0.945 y una varianza explicada de 68.15 %. El análisis factorial confirmatorio indicó que el modelo teórico propuesto se ajusta a los datos con error próximo a cero y que, además, es equilibrado y mide cuidadosamente la satisfacción global del paciente con el tratamiento. Conclusión: FACIT-TS-PS mostró ser un instrumento válido y confiable para su uso en la atención clínica e investigación dirigida a pacientes mexicanos con cáncer. Se recomienda su utilización en la evaluación de equipos de salud multidisciplinarios en oncología en México.

Abstract Introduction: Cancer patient satisfaction with the healthcare team is of great relevance for assessing the quality of the care provided by the health system. In Mexico, no valid and reliable tool is available to assess this construct. Objective: To validate the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-Patient Satisfaction (FACIT-TS-PS) instrument, version 4, in cancer patients. Method: Cross-sectional design, non-probability convenience sampling. The sample consisted of 200 cancer-diagnosed patients, with mean age of 45.86 ± 15.01 years. Exploratory and confirmatory factor analyses were conducted. Results: The exploratory factor analysis identified four factors, with a Cronbach alpha of 0.945, and an explained variance of 68.15 %. The confirmatory factor analysis indicated that the proposed theoretical model adjusts to the data with an error close to zero and, in addition, it is balanced and carefully measures overall patient satisfaction with the treatment. Conclusion: FACIT-TS-PS was shown to be a valid and reliable instrument for use in clinical care and research in Mexican cancer patients. Its use is recommended in the evaluation of oncology multidisciplinary healthcare teams in Mexico.