共查询到20条相似文献，搜索用时 15 毫秒
1.
Zhen-ye Lv Zhong-Sheng Zhao Zai-Yuan Ye Yuan-Yu Wang Hui-Ju Wang Qiong Yang 《Pathology, research and practice》2018,214(4):536-541
Background
The present study examined the clinical significance of metastasis-associated protein 1 (MTA1) in the progression and patient survival of gastric cancer.Methods
Paraffin-embedded resected tissues of gastric cancer mucosa (n?=?436) and adjacent normal mucosa (n?=?92) were assessed immunohistochemically for MTA1 protein, and scored according to the percentage of cells positively stained for MTA1 combined with stain intensity. Associations between MTA1 staining scores and clinicopathological factors, including survival time, were evaluated.Results
The staining scores for MTA1 were significantly higher in gastric cancer tissues than in matched normal tissues. MTA1 scores positively correlated with tumor size, depth of invasion, presence of lymph node metastasis, lymphatic involvement, venous invasion, distal metastasis, and advanced clinical staging. Patients with high MTA1 scores in gastric cancer tissues had a significantly lower five-year survival rate compared with patients with low MTA1 scores. The multivariate analysis indicated that MTA1 protein levels in resected gastric cancer tissues, as reflected by immunohistochemical staining, are an independent prognostic index of gastric carcinoma (P?<?0.01).Conclusion
MTA1 immunopositivity was significantly associated with progression of gastric cancer, and may be helpful in gastric cancer prognosis. 相似文献2.
Xiangwen Zhang Tingting Zhou Wenbin Li Taotao Zhang Ninwei Che Guo Zu 《Pathology, research and practice》2018,214(8):1105-1109
Background
Few studies have reported the clinical and prognostic significance of C/EBP homologous protein (CHOP) in advanced gastric cancer (GC). Therefore, the present study investigated the expression of CHOP in advanced GC patients to determine its potential prognostic role.Methods
The levels of CHOP in 95 patients with advanced GC and adjacent non-cancerous tissues were evaluated by qRT-PCR, western blot and immunohistochemistry. Furthermore, the association of CHOP expression with clinicopathological parameters and prognosis of advanced GC patients was analyzed.Results
The levels of CHOP were down-regulated in advanced GC compared with non-cancerous tissues (P<0.01). In addition, high CHOP expression more frequently occurred in advanced GC tissues with depth of invasion of T1-2 (P?<?0.01), lower clinical stage (TNM Ⅰ-Ⅱ stage) (P<0.05) and without lymph node metastasis (P<0.05). No significant difference was observed between the expression of CHOP and age, gender, tumor size, lesion site and differentiation (P>0.05). The Kaplan-Meier survival analyses showed that the overall survival rate of advanced GC patients with positive CHOP expression was significantly higher than that of patients with negative CHOP expression (P<0.01). Univariate and multivariate Cox proportional hazards models revealed that low CHOP expression (OR?=?0.314, 95%CI: 0.176～0.794, P?=?0.003) was an independent factor for poor overall survival in advanced GC patients.Conclusion
Low expression of CHOP predicts the poor prognosis of advanced GC patients, and CHOP may be a prognostic biomarker for patients with advanced GC. 相似文献3.
Vincent Kalumire Cubaka Michael Schriver Peter Vedsted Gregory Makoul Per Kallestrup 《Patient education and counseling》2018,101(9):1601-1610
Objective
To identify, adapt and validate a measure for providers’ communication and interpersonal skills in Rwanda.Methods
After selection, translation and piloting of the measure, structural validity, test-retest reliability, and differential item functioning were assessed.Results
Identification and adaptation: The 14-item Communication Assessment Tool (CAT) was selected and adapted.Validity and reliability testing
Content validation found all items highly relevant in the local context except two, which were retained upon understanding the reasoning applied by patients. Eleven providers and 291 patients were involved in the field-testing. Confirmatory factor analysis showed a good fit for the original one factor model. Test-retest reliability assessment revealed a mean quadratic weighted Kappa?=?0.81 (range: 0.69–0.89, N?=?57). The average proportion of excellent scores was 15.7% (SD: 24.7, range: 9.9–21.8%, N?=?180). Differential item functioning was not observed except for item 1, which focuses on greetings, for age groups (p?=?0.02, N?=?180).Conclusion
The Kinyarwanda version of CAT (K-CAT) is a reliable and valid patient-reported measure of providers’ communication and interpersonal skills. K-CAT was validated on nurses and its use on other types of providers may require further validation.Practice implication
K-CAT is expected to be a valuable feedback tool for providers in practice and in training. 相似文献4.
Hamideh Salimzadeh Roghaye Khabiri Maryam Khazaee-pool Somayeh Salimzadeh Alireza Delavari 《Patient education and counseling》2018,101(6):1082-1087
Objective
To measure the impact of motivational interviewing (MI) on cancer knowledge and screening practice among first degree relatives (FDRs) of patients with colon cancer.Methods
This randomized controlled trial targeted patients with colon cancer first to recruit their possible FDRs. Digit randomization of the eligible index patients into intervention or control groups resulted in allocating their belonging FDRs to the same study arm. FDRs (n?=?120) in intervention arm received MI counseling on phone by a trained oncology nurse and FDRs (n?=?120) in control group received standard generic information by a physician on phone. Primary outcome was the rate of documented colonoscopy in FDRs within six months after the baseline.Results
A total of 227 FDRs were followed up, 115 in the intervention and 112 in the control group. At follow-up, the uptake of screening colonoscopy in the intervention group was 83.5% versus 48.2% in controls (crude odds ratio, 5.4; 95% confidence interval, 2.9–10.0, P?<?.001).Conclusion
This was the first randomized controlled trial in Iran that confirmed the efficaciousness of a phone-based MI counseling in improving colonoscopy uptake among family members of patients with colon cancer.Practice implications
Phone-based motivational counseling that involves trained nurses or health providers seems to be feasible approach in Iran health system and enhances screening for colon cancer. 相似文献5.
Rebekah Laidsaar-Powell Phyllis Butow Frances Boyle Ilona Juraskova 《Patient education and counseling》2018,101(6):970-982
Objective
Family caregivers regularly attend medical consultations and are often involved in decision-making; however, there are few practical strategies to guide effective communication for the clinician-patient-family trio. We aimed to develop and evaluate the first comprehensive guidelines for oncology physicians and nurses, on how to positively and effectively involve family caregivers of adult patients in consultations and patient care (TRIO Guidelines-1) and how to manage challenging interactions with family caregivers (TRIO Guidelines-2).Methods
The TRIO Guidelines were based on a comprehensive literature review and input from an expert advisory group (n?=?10). They underwent two rounds of formal evaluation via an online Delphi consensus process involving international experts (n?=?35), and a subset were piloted with 24 breast cancer clinicians in a workshop format.Results
TRIO Guidelines-1 incorporate strategies and sub-strategies on facilitating collaborative and effective family involvement (6 topics). Example wording, behaviours, and level of evidence are provided throughout. All 24 clinicians rated the guidelines as helpful after the pilot workshop.Conclusion
These guidelines will be a useful educational tool for clinicians and medical/nursing students.Practice implications
By equipping clinicians with strategies to facilitate effective and collaborative family engagement, the TRIO Guidelines have the potential to transform communication in clinical practice. 相似文献6.
Teng Li Jing Yu Xinyu Luo Weiguo Ren Yue Zhang Bangwei Cao 《Pathology, research and practice》2018,214(4):560-564
Background
Expression of VEGFRs may affect cancer prognosis. The aim of this work is to evaluate the prognostic significance of VEGFRs of patients with gastric cancer.Methods
The databases PubMed, Embase, Web of Science, and Cochrane Library as well as ASCO and ESMO were searched systematically for articles reporting the prognostic significance of tissue VEGFRs in gastric cancer. The statistical analyses were carried out using Stata version 12.0.Results
A total of 8 articles comprising 950 patients were eligible for meta-analysis. The combined HR of studies evaluating total VEGFRs overexpression was 1.42 (95% CI 1.01-2.00, P?=?0.044), suggesting that it had prognosis significance in overall survival of gastric cancer. Subgroup analysis showed that it was VEGFR-2 (HR 1.81, 95% CI 1.31–2.49, P?<?0.001) but not VEGFR-3 (HR 0.91, 95% CI 0.45–1.82, P?=?0.787) overexpression was associated with an increased risk of median overall survival (mOS) and it can be a potentially predictive biomarker for gastric cancer.Conclusions
VEGFR-2 overexpression is a promising negative prognosis predictor for patients with gastric cancer. The prognosis significance of VEGFR-3 still need further study. 相似文献7.
Haochang Hu Cong Zhou Bin Li Yanfei Chen Jie Dai Yiyi Mao Tianyi Huang Hang Yu Min Chen Jun Zhao Shiwei Duan 《Pathology, research and practice》2018,214(10):1572-1578
Purpose
Ras association domain family 1 isoform A (RASSF1A), a member of Ras association domain family, plays an important role in tumorigenesis. The goal of our meta-analysis was to assess the diagnostic value of RASSF1A hypermethylation in colorectal cancer (CRC).Methods
PubMed, Embase, CNKI and Wanfang databases were used to conduct literature selection. The association between RASSF1A methylation and CRC risk was evaluated by odds ratios (ORs) and 95% confidence intervals (CIs). Summary receiver operating characteristics (SROC) test was used to estimate the diagnostic value of RASSF1A methylation for CRC.Results
A total of 22 articles among 1736 CRC and 811 non-tumor samples were included in the current meta-analysis. Our results showed that RASSF1A hypermethylation was found more frequently in CRC than non-tumor samples (OR?=?6.02, 95% CI?=?4.57–7.93, P?<? 0.001). Our SROC test showed that RASSF1A hypermethylation had an area under the curve (AUC) of 0.71 with a pooled sensitivity of 0.33 (95% CI?=?0.31–0.36), a pooled specificity of 0.86 (95% CI?=?0.84–0.89), a positive-likelihood ratio of 3.18 (95% CI?=?1.99–5.09), a negative-likelihood ratio of 0.71 (95% CI?=?0.63–0.80), and a diagnostic odds ratio of 5.53 (95% CI?=?3.40–9.00). Data mining study indicated that a trend of increased RASSF1A expression was found in the CRC cell line C2C12 after 5-AZA treatment.Conclusions
Our study established that RASSF1A hypermethylation might have a potential value in the clinical diagnosis of CRC. 相似文献8.
Xiaoqing Shi Bingjie Li Yingying Yuan Liyinghui Chen Yadi Zhang Meng Yang Junjie Wang Dongchun Qin 《Pathology, research and practice》2018,214(8):1142-1148
Purpose
The association between myeloperoxidase (MPO) polymorphism and the risk of cervical cancer is inconclusive. We performed a meta-analysis to clarify if a correlation exists between MPO polymorphism and the risk for developing cervical cancer.Methods
All case-control research studies that determined a relationship between MPO and cervical cancer reported up until March 1, 2018 in PubMed, Web of Science, VIP, WanFang, and the CNKI Database were accessed and included. The strength of association was evaluated with pooled odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs). We used sensitivity analysis to detect the stability of our results, conducted Q-test to evaluate heterogeneity and applied Begg’s funnel plot and Egger’s test to investigate any publication bias among selected studies.Results
In this meta-analysis, we included 5 eligible studies in the final evaluation, which included 1125 patients with cervical cancer and 1150 cancer-free control patients. A potential association between the MPO ?463 G?>?A polymorphism and cervical cancer risk was observed (recessive model: OR?=?0.65, 95%, CI: 0.43–0.98, P?=?0.038; homozygous model: OR?=?0.65, 95%, CI: 0.43–0.99, P?=?0.045), which indicates that genotype AA reduces the risk of cervical cancer by 35% compared to GG/GA or GG genotypes in our results. A stratified analysis by ethnicity identified a significant correlation among Caucasian patients (recessive model: OR?=?0.57, 95%, CI: 0.34–0.95, P?=?0.029; homozygous model: OR?=?0.60, 95%, CI: 0.36–0.99, P?=?0.048) and a stratified analysis by source of control identified a significant correlation among population-based studies.Conclusions
Our results suggest that the presence of polymorphism, ?463 G?>?A in patients might offer them protection against cervical cancer. By implementing randomized case-control or cohort studies with larger sample sizes, the clinical significance of our results can be further strengthened and verified. 相似文献9.
Adrie J. Bouma Paul van Wilgen Koen A.P.M. Lemmink Roy Stewart Arie Dijkstra Ron L. Diercks 《Patient education and counseling》2018,101(12):2134-2144
Objective
Intervening on barrier beliefs (BBs) may inhibit the role of barriers as mediating factors in lifestyle behavior. The aim of this study was to analyze the effects of a barrier-belief counseling intervention (BBCI) on physical activity (PA) and healthy food intake.Methods
An RCT was conducted in a primary care setting among adults (aged 18–70), with two interventions: a BBCI (n?=?123) and a standardized lifestyle group intervention (SLI) (n?=?122). A non-treated hanging control group (n?=?36) received no intervention. Outcomes on PA (accelerometer and SQUASH) and fruit and vegetable intake (self-report) were measured with follow-ups at 6, 12 and 18 months, and analyzed using multiple regression.Results
The BBCI was more effective on PA compared with the SLI (p?<?.01): in the short term all PA outcomes improved (p?<?.05), in the long term moderate-to-vigorous PA outcomes improved (p?<?.05), all with small effect sizes. No differences between interventions were found on fruit and vegetable intake. None of the outcomes in the control group changed over time.Conclusions
BBCI in primary care improves PA compared with SLI.Practice implications
The customized BB approach seems promising for implementation in healthcare practice to stimulate PA. 相似文献10.
Katherine K.W. Lam William H.C. Li O.K. Chung K.Y. Ho S.Y. Chiu H.S. Lam Godfrey C.F. Chan 《Patient education and counseling》2018,101(11):1947-1956
Objective
This study examined the effectiveness of an integrated programme in promoting physical activity, reducing fatigue, enhancing physical activity self-efficacy, muscle strength and quality of life among Chinese children with cancer.Methods
A randomised controlled trial was conducted in a Hong Kong public hospital. Seventy eligible children were randomly assigned to an experimental group (n?=?37) or a control group (n?=?33). The experimental group received an integrated programme with 28 home visits from coaches over a 6-month period. The control group received a placebo intervention. The primary outcome was fatigue at 9 months (3 months after intervention completion). Secondary outcomes were physical activity levels, physical activity self-efficacy, muscle strength and quality of life at 9 months, assessed at baseline, and 6 and 9 months after starting the intervention.Results
The experimental group reported significantly lower levels of cancer-related fatigue, higher levels of physical activity and physical activity self-efficacy, greater right- and left-hand grip strength and better quality of life than the control group at 9 months.Conclusion
The programme is effective and feasible to implement among children with cancer and offers an alternative means of ameliorating the healthcare burden.Practice implications
Healthcare professionals should build multidisciplinary partnerships to sustain such programmes. 相似文献11.
Caterina Vicentini Cinzia Cantù Davide Antonello Michele Simbolo Andrea Mafficini Claudio Luchini Borislav Rusev Antonio Benito Porcaro Roberto Iacovelli Matteo Fassan Vincenzo Corbo Matteo Brunelli Walter Artibani Aldo Scarpa Rita T. Lawlor 《Pathology, research and practice》2018,214(10):1675-1680
Introduction
One of the most common sites of distant metastasization of prostate cancer is bone, but to date reliable biomarkers able to predict the risk and timing of bone metastasization are still lacking.Patients and methods
Surgically resected paraffin embedded samples from 12 primary prostate cancers that developed metachronous bone metastasis at different time points were studied (six cases within 2 years, six cases after 5 years from surgery). A targeted next-generation DNA and RNA sequencing able to assess simultaneously mutations, copy number alterations and fusion events of multiple genes was used. Immunohistochemistry was used to assess mTOR pathway activation.Results
Rearrangements of ETS family genes, molecular alterations in PTEN and TP53 genes were detected in 10, 6 and 5 cancers, respectively. Nine samples showed TMPRSS2-ERG fusions, which were associated with increased ERG expression at immunohistochemistry. mTOR pathway activation was documented in 6 patients, with a clear trend of prevalence in late-metastatic patients (p?=?0.08).Conclusions
A simultaneous next-generation targeted DNA and RNA sequencing is applicable on routine formalin-fixed paraffin-embedded tissues to assess the multigene molecular asset of individual prostate cancers. This approach, coupled with immunohistochemistry for ERG and mTOR pathway proteins, may help to better characterize prostate cancer molecular features with a potential impact on clinical decisions. 相似文献12.
Sarina R. Isenberg Rebecca A. Aslakson James N. Dionne-Odom Katherine Clegg Smith Sarabdeep Singh Susan Larson John F.P. Bridges Thomas J. Smith Jennifer L. Wolff Debra L. Roter 《Patient education and counseling》2018,101(6):1066-1074
Objective
To examine the association between family companion presence during pre-surgical visits to discuss major cancer surgery and patient-provider communication and satisfaction.Methods
Secondary analysis of 61 pre-surgical visit recordings with eight surgical oncologists at an academic tertiary care hospital using the Roter Interaction Analysis System (RIAS). Surgeons, patients, and companions completed post-visit satisfaction questionnaires. Poisson and logistic regression models assessed differences in communication and satisfaction when companions were present vs. absent.Results
There were 46 visits (75%) in which companions were present, and 15 (25%) in which companions were absent. Companion communication was largely emotional and facilitative, as measured by RIAS. Companion presence was associated with more surgeon talk (IRR 1.29, p?=?0.006), and medical information-giving (IRR 1.41, p?=?0.001). Companion presence was associated with less disclosure of lifestyle/psychosocial topics by patients (IRR 0.55, p?=?0.037). In adjusted analyses, companions’ presence was associated with lower levels of patient-centeredness (IRR 0.77, p 0.004). There were no differences in patient or surgeon satisfaction based on companion presence.Conclusion
Companions’ presence during pre-surgical visits was associated with patient-surgeon communication but was not associated with patient or surgeon satisfaction.Practice implications
Future work is needed to develop interventions to enhance patient-companion-provider interactions in this setting. 相似文献13.
Joe Jabbour Haryana M. Dhillon Heather L. Shepherd Puma Sundaresan Chris Milross Jonathan R. Clark 《Patient education and counseling》2018,101(10):1736-1740
Objective
Is there a relationship between decision-making preferences and psychological distress?Methods
Patients who had received treatment for head and neck cancer (HNC) at four institutions within NSW, Australia were invited to complete a single questionnaire.Results
Five hundred and ninety-seven patients completed the questionnaire. The majority of patients (308, 54%) preferred shared decision making. Significant predictors of a preference towards active decision making were education level (OR 2.1 for tertiary, p?<?0.001), primary cancer site (OR 1.9 for thyroid compared to salivary gland, p?=?0.024) and gender (OR 1.4 for female, p?=?0.028). Mean psychological distress score on Kessler 6 (K6) was 9 (Range: 0–28). Significant predictors of psychological distress were age (p?<?0.001), gender (p?<?0.001), primary site (p?<?0.01), and decision preference (p?<?0.01).Conclusion
HNC patients who are either tertiary educated or female are more likely to prefer active involvement in decision-making. Psychological distress is more likely in patients actively involved in decision making, younger patients, and in females.Practice implications
: Patients experienced paternalistic decision-making, but most preferred active or a shared approached. Clinicians need to be aware of potential for psychological distress in active decision-makers and refer patients for psychosocial support. 相似文献14.
Soo Jin Kang Kang Hee Sim Bok Rye Song Jeong-Eun Park Soo Jung Chang Chanho Park Mi Sook Lee 《Patient education and counseling》2018,101(8):1468-1476
Objective
To develop and examine the psychometric properties of the Korean Health Literacy Scale for Diabetes Mellitus (KHLS-DM), and to establish reasonable cutoff scores.Methods
Initially, 299 items were generated to measure diabetes-related words, numeracy, and information utilization. Content validity assessment and preliminary tests were conducted. After exploratory factor analysis (EFA) and Rasch analysis, the remaining 65 items were administered to a quota sample of 500 diabetic patients aged 40–74 years. The items were narrowed down to 58 items based on an item fit index. To obtain cutoff scores, Jaeger’s method and the Bookmark method were employed.Results
A confirmatory factor analysis (CFA) was performed, and a three-factor model was supported (χ2/df?=?3.891, CFI?=?0.92, TLI?=?0.91, RMSEA?=?0.04). The overall scores ranged from 0 to 58, and two cutoff points were established. The scale exhibited good internal consistency (Cronbach’s α?=?0.83).Conclusions
The KHLS-DM is a reliable and valid measure with cutoff points to classify individuals into three groups (adequate, marginal, and inadequate).Practice implications
The standard setting may be useful for researchers to validate health literacy measures in other countries and populations. 相似文献15.
Kamuran Ibis Sezer Saglam Esra Kaytan Saglam Pinar Firat Dilek Yilmazbayhan Alper Toker Berker Ozkan Veysel S. Hancer Murat Buyukdogan Rian Disci Kezban Nur Pilanci 《Pathology, research and practice》2018,214(9):1291-1296
Background
To assess the prognostic importance of carbonic anhydrase IX (CA IX), a hypoxic biomarker, after neoadjuvant treatment in Stage III non-small cell lung cancer (NSCLC) patients.Methods
Tissue CA IX expression was examined after surgical resection in 77 patients who had undergone neoadjuvant treatment. The effects of CA IX overexpression and other clinical factors on disease-free survival and overall survival were investigated.Results
In multivariate analysis, number of neoadjuvant chemotherapy (CT) courses and gender emerged as significant independent predictors for disease-free survival, where administration of 2–3 courses of neoadjuvant chemotherapy (CT) (HR, 3.2 [95% CI 1.3–7.6], p?=?0.009) and female gender were associated with poor survival (HR, 3.2 [95% CI 1.3–7.7], p?=?0.009). The only significant independent predictor for overall survival was recurrence (HR, 5.6 [95% CI 2.4–12.8], p?<?0.001). On the other hand, CA IX overexpression was not associated with disease free survival (p?=?0.560) or overall survival (p?=?0.799).Discussion
Our results do not suggest a prognostic role for CA IX overexpression in stage III NSCLC patients who received neoadjuvant treatment. 相似文献16.
Silas Antonio Juvencio de Freitas Filho João Paulo Silva Servato Rodrigo Tavares de Sá Carla Silva Siqueira Paulo Rogério de Faria Adriano Mota Loyola Sérgio Vitorino Cardoso 《Pathology, research and practice》2018,214(6):876-880
Objective
Histones regulate chromatin density and therefore influence gene expression and cellular proliferation. These properties are modified by methylation, acetylation and phosphorylation of histones. The aim of this study was to investigate the variation of specific modified histones in actinic cheilitis (AC) and squamous cell carcinoma of the lip (SCCL).Methods
Samples of non-neoplastic tissue of the lip (NNTL, n?=?9), AC (n?=?33), and SCCL (n?=?27) were submitted to immunohistochemistry to detect the modified histones H3K36me3, H3K9ac, H4K12ac, and H3S10?ph.Results
Reactivity for all of the modified histones was significantly decreased from NNTL to AC, but not from AC to SCCL. Dysplasia in AC or histological grade in SCCL were not related to the reactivity of any modified histones.Conclusions
Histone modifications are related to initial actinic damage, but not to malignant transformation in the lip. 相似文献17.
Identification of clinical tumor stages related mRNAs and miRNAs in cervical squamous cell carcinoma
Chenggang Yang Jing Ren Bangling Li Dongmei Zhang Cui Ma Cheng Cheng Yaolan Sun Lina Fu Xiaofeng Shi 《Pathology, research and practice》2018,214(10):1638-1647
Objectives
The aim of this study is to identify the clinical tumor stage related mRNAs and miRNAs, shedding light on the potential molecular mechanisms of cervical squamous cell carcinoma (CSCC).Methods
Firstly, the mRNA and miRNA next-generation sequencing data were downloaded. Secondly, clinical tumor stage correlation analysis of mRNAs and miRNA was performed, followed by the functional enrichment analysis of all clinical tumor stage related mRNAs. Thirdly, differentially expression analysis of mRNAs and miRNA between different clinical tumor stages was performed, followed by target gene prediction of these differentially expressed miRNAs.Results
3 mRNAs (PER1, PRKAB1 and PMM2) and 5 miRNAs (hsa-mir-486, hsa-mir-451, hsa-mir-424, hsa-mir-144 and hsa-mir-450a-2) were overlapped from stage 1, stage 2, stage 3 and stage 4.Conclusions
Alterations of differentially expressed mRNAs and miRNAs may offer important insights into the molecular mechanisms in the pathology of CSCC. 相似文献18.
Anirban Banerjee Paul Hendrick Purba Bhattacharjee Holly Blake 《Patient education and counseling》2018,101(5):767-778
Objectives
The aim of this review was to identify, appraise and synthesise the outcome measures used to assess self-management in patients with chronic pain.Methods
Medline, Embase, CINAHL, PsycINFO, the Cochrane Library and Google Scholar were searched to identify quantitative measures used within randomised or non-randomised clinical trials to assess self-management in adults (≥18 years) with chronic pain.Results
25 RCTs published between 1998 and 2016 were included in this review. Studies included patients with chronic pain, hip/knee osteoarthritis, rheumatoid arthritis, chronic low back pain, fibromyalgia and chronic fatigue syndrome. Included studies utilised 14 different measures assessing a variety of constructs including self-efficacy (n?=?19), coping (n?=?4), empowerment (n?=?2), pain attitude and management (n?=?3), self-care (n?=?1), role behaviour (n?=?1) and multiple constructs of self-management (n?=?1). The Chronic Pain Coping Inventory (CPCI) and Health Education Impact Questionnaire (heiQ) cover different self-management related constructs across the physical, mental and social health domains.Conclusion
The review identified 14 measures used as proxy measure to assess self-management in patients with chronic pain. These measures have good content and construct validity, and internal consistency. However additional research is required to develop their reliability, responsiveness and interpretability.Practice implications
Multi-constructs measures (CPCI, heiQ) are suitable for assessing self-management. 相似文献19.
Gina Bravo Modou Sene Marcel Arcand Élodie Hérault 《Patient education and counseling》2018,101(7):1256-1261
Objective
To investigate how confidence in surrogates’ ability to make consistent decisions in the future change over time, in the context of an ACP intervention that did not improve surrogates’ ability to predict an older adult’s hypothetical treatment preferences.Methods
The study involved 235 older adults and surrogates, randomly allocated to an ACP or control intervention. At baseline, end of intervention, and six months later, participants were asked how confident they were in the surrogate making decisions in the future that would match the older adult’s wishes.Results
By the end of the intervention, confidence had increased among older adults and surrogates involved in ACP (OR?=?3.1 and 5.8 respectively, p?<?0.001), while less change occurred among controls. Over the following six months, confidence remained stable among older adults but decreased among surrogates (OR?=?0.5, p?=?0.005).Conclusion
ACP increases confidence in surrogates’ ability to make consistent decisions, which may lighten the burden of substitute decision making. Efforts to improve substitute decision-making must continue so that participants’ confidence is not based on the mistaken assumption that surrogates can make consistent decisions.Practice implications
Professionals involved in ACP should inform participants that confidence in the surrogate may increase in the absence of enhanced predictive ability. 相似文献20.
Ewa Czeczuga-Semeniuk Marzenna Galar Katarzyna Jarząbek Piotr Kozłowski Nela A. Sarosiek Sławomir Wołczyński 《Advances in medical sciences》2018,63(2):242-248