An international field study for the reliability and validity of the EORTC communication questionnaire EORTC QLQ-COMU26.


Journal

Health and quality of life outcomes
ISSN: 1477-7525
Titre abrégé: Health Qual Life Outcomes
Pays: England
ID NLM: 101153626

Informations de publication

Date de publication:
10 Oct 2024
Historique:
received: 01 05 2024
accepted: 16 09 2024
medline: 10 10 2024
pubmed: 10 10 2024
entrez: 10 10 2024
Statut: epublish

Résumé

The EORTC Quality of Life Group has developed a questionnaire to evaluate cancer patients' perception of their communication with healthcare professionals (HCPs): the EORTC QLQ-COMU26. In this study we test the validity and reliability of this novel measure in an international and culturally diverse sample of cancer patients. Cancer patients completed the following EORTC questionnaires at two time points (before and during treatment): the QLQ-COMU26 (including a debriefing questionnaire), the QLQ-C30, and specific IN-PATSAT32 scales. These data were used to assess: the cross-cultural applicability, acceptability, scale structure, reliability, convergent/divergent validity, known-groups validity, and responsiveness to change of the QLQ-COMU26. Data were collected from 498 patients with various cancer diagnoses in 10 European countries, Japan, Jordan and India (overall 5 cultural regions). At most, only 3% of patients identified an item as confusing and 0.6% as upsetting, which indicates that the questionnaire was clear and did not trigger negative emotional responses. Confirmatory factor analysis and multi-trait scaling confirmed the hypothesised QLQ-COMU26 scale structure comprising six multi-item scales and four single items (RMSEA = 0.025). Reliability was good for all scales (internal consistency > 0.70; test-retest reliability > 0.85). Convergent validity was supported by correlations of ≥ 0.50 with related scales of the IN-PATSAT32 and correlations < 0.30 with unrelated QLQ-C30 scales. Known-groups validity was shown according to sex, education, levels of anxiety and depression, satisfaction with communication, disease stage and treatment intention, professional evaluated, and having a companion during the visit. The QLQ-COMU26 captured changes over time in groups that were defined based on changes in the item of satisfaction with communication. The EORTC QLQ-COMU26 is a reliable and valid measure of patients' perceptions of their communication with HCPs. The EORTC QLQ-COMU26 can be used in daily clinical practice and research and in various cancer patient groups from different cultures. This questionnaire can help to improve communication between patients and healthcare professionals.

Sections du résumé

BACKGROUND BACKGROUND
The EORTC Quality of Life Group has developed a questionnaire to evaluate cancer patients' perception of their communication with healthcare professionals (HCPs): the EORTC QLQ-COMU26. In this study we test the validity and reliability of this novel measure in an international and culturally diverse sample of cancer patients.
METHODS METHODS
Cancer patients completed the following EORTC questionnaires at two time points (before and during treatment): the QLQ-COMU26 (including a debriefing questionnaire), the QLQ-C30, and specific IN-PATSAT32 scales. These data were used to assess: the cross-cultural applicability, acceptability, scale structure, reliability, convergent/divergent validity, known-groups validity, and responsiveness to change of the QLQ-COMU26.
RESULTS RESULTS
Data were collected from 498 patients with various cancer diagnoses in 10 European countries, Japan, Jordan and India (overall 5 cultural regions). At most, only 3% of patients identified an item as confusing and 0.6% as upsetting, which indicates that the questionnaire was clear and did not trigger negative emotional responses. Confirmatory factor analysis and multi-trait scaling confirmed the hypothesised QLQ-COMU26 scale structure comprising six multi-item scales and four single items (RMSEA = 0.025). Reliability was good for all scales (internal consistency > 0.70; test-retest reliability > 0.85). Convergent validity was supported by correlations of ≥ 0.50 with related scales of the IN-PATSAT32 and correlations < 0.30 with unrelated QLQ-C30 scales. Known-groups validity was shown according to sex, education, levels of anxiety and depression, satisfaction with communication, disease stage and treatment intention, professional evaluated, and having a companion during the visit. The QLQ-COMU26 captured changes over time in groups that were defined based on changes in the item of satisfaction with communication.
CONCLUSION CONCLUSIONS
The EORTC QLQ-COMU26 is a reliable and valid measure of patients' perceptions of their communication with HCPs. The EORTC QLQ-COMU26 can be used in daily clinical practice and research and in various cancer patient groups from different cultures. This questionnaire can help to improve communication between patients and healthcare professionals.

Identifiants

pubmed: 39385305
doi: 10.1186/s12955-024-02298-z
pii: 10.1186/s12955-024-02298-z
doi:

Types de publication

Journal Article Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

87

Informations de copyright

© 2024. The Author(s).

Références

Fallowfield L, Starkings R, Palmieri C, Tait A, Stephen L, May S, et al. Living with metastatic breast cancer (LIMBER): experiences, quality of life, gaps in information, care and support of patients in the UK. Support Care Cancer. 2023;31:459. https://doi.org/10.1007/s00520-023-07928-8 .
doi: 10.1007/s00520-023-07928-8 pmcid: 10335945
Grassi L, Caruso R, Costantini A. Communication with patients suffering from serious physical illness. Adv Psychosom Med. 2015;34:10–23. https://doi.org/10.1159/000369050 .
doi: 10.1159/000369050
Venetis MK, Robinson JD, Turkiewicz KL, Allen M. An evidence base for patient-centered cancer care: a meta-analysis of studies of observed communication between cancer specialists and their patients. Patient Educ Couns. 2009;77:379–83. https://doi.org/10.1016/j.pec.2009.09.015 .
doi: 10.1016/j.pec.2009.09.015
Carlson LE, Feldman-Stewart D, Tishelman C, Brundage MD, SCRN Communication Team. Patient-professional communication research in cancer: an integrative review of research methods in the context of a conceptual framework. Psychooncology. 2005;14: 812–28. https://doi.org/10.1002/pon.951 .
Feldman-Stewart D, Brundage MD, Tishelman C, SCRN Communication Team. A conceptual framework for patient-professional communication: an application to the cancer context. Psychooncology. 2005;14: 801–9. https://doi.org/10.1002/pon.950 .
Ansmann L, Kowalski C, Ernstmann N, Ommen O, Pfaff H. Patients’ perceived support from physicians and the role of hospital characteristics. Int J Qual Healthcare. 2012;24:501–8. https://doi.org/10.1093/intqhc/mzs048 .
doi: 10.1093/intqhc/mzs048
Alby F, Zucchermaglio C, Fatigante M. Communicating Uncertain News in Cancer Consultations. J Cancer Educ. 2017;32:858–64. https://doi.org/10.1007/s13187-016-1070-x .
doi: 10.1007/s13187-016-1070-x
Adamson M, Choi K, Notaro S, Cotoc C. The Doctor-Patient Relationship and Information-Seeking Behavior: Four Orientations to Cancer Communication. J Palliat Care. 2018;33:79–87. https://doi.org/10.1177/0825859718759881 .
doi: 10.1177/0825859718759881
Moore PM, Rivera Mercado S, Grez Artigues M, Lawrie TA. Communication skills training for healthcare professionals working with people who have cancer. Cochrane Database Syst Rev. 2013;28:3. https://doi.org/10.1002/14651858.CD003751.pub3 .
doi: 10.1002/14651858.CD003751.pub3
Trudel JG, Leduc N, Dumont S. Perceived communication between physicians and breast cancer patients as a predicting factor of patients’ health-related quality of life: a longitudinal analysis. Psychooncology. 2014;23:531–8. https://doi.org/10.1002/pon.3442 .
doi: 10.1002/pon.3442
Pozzar RA, Xiong N, Mazzola E, Wright AA, Goff BA, Tulsky JA, et al. Health-related quality of life, patient-centred communication and self-efficacy in ovarian cancer: a mediation analysis. BMJ Support Palliat Care. 2022. https://doi.org/10.1136/spcare-2022-004029 .
doi: 10.1136/spcare-2022-004029
Rogge AA, Helmer SM, King R, Canella C, Icke K, et al. Effects of training oncology physicians advising patients on complementary and integrative therapies on patient-reported outcomes: A multicenter, cluster-randomized trial. Cancer. 2021;127:2683–92. https://doi.org/10.1002/cncr.33562 .
doi: 10.1002/cncr.33562
Morgan M. The doctor–patient relationship. In: Scambler G, editor. Sociology as applied to medicine. Edinburgh: Saunders/Elsevier; 2008. p. 49–65.
Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington: National Academy Press; 2001.
Bamm EL, Rosenbaum P, Wilkins S, Stratford P, Mahlberg N. Exploring Client-Centered Care Experiences in In-Patient Rehabilitation Settings. Glob Qual Nurs Res. 2015;15(2):2333393615582036. https://doi.org/10.1177/2333393615582036 .
doi: 10.1177/2333393615582036
Epstein RM, Street RL Jr. Patient-centered communication in cancer care: promoting healing and reducing suffering. Bethesda, MD, USA: National Cancer Institute; 2007.
Johnston FM, Beckman M. Navigating difficult conversations. J Surg Oncol. 2019;120:23–9. https://doi.org/10.1002/jso.25472 .
doi: 10.1002/jso.25472
Huggins CF, Cameron IM, Scott NW, Williams JHG, Yoshikawa S, Sato W. Cross- Cultural Differences and Psychometric Properties of the Japanese Actions and Feelings Questionnaire (J-AFQ). Front Psychol. 2021;12: 722108. https://doi.org/10.3389/fpsyg.2021.722108 .
doi: 10.3389/fpsyg.2021.722108 pmcid: 8417608
Conley CC, Otto AK, McDonnell GA, Tercyak KP. Multiple approaches to enhancing cancer communication in the next decade: translating research into practice and policy. Transl Behav Med. 2021;30:2018–32. https://doi.org/10.1093/tbm/ibab089 .
doi: 10.1093/tbm/ibab089
McDaniel SH, Morse DS, Edwardsen EA, Taupin A, Gurnsey MG, Griggs JJ, et al. Empathy and boundary turbulence in cancer communication. Patient Educ Couns. 2021;104:2944–51. https://doi.org/10.1016/j.pec.2021.04.002 .
doi: 10.1016/j.pec.2021.04.002 pmcid: 8517043
Kaphingst KA, Peterson E, Zhao J, Gaysynsky A, Elrick A, Hong SJ, et al. Cancer communication research in the era of genomics and precision medicine: a scoping review. Genet Med. 2019;21:1691–8. https://doi.org/10.1038/s41436-018-0402-0 .
doi: 10.1038/s41436-018-0402-0
Jiang S, Hong YA, Liu PL. Trends of online patient-provider communication among cancer survivors from 2008 to 2017: a digital divide perspective. J Cancer Surviv. 2019;13:197–204. https://doi.org/10.1007/s11764-019-00742-4 .
doi: 10.1007/s11764-019-00742-4
Bloom JR, Marshall DC, Rodriguez-Russo C, Martin E, Jones JA, Dharmarajan KV. Prognostic disclosure in oncology - current communication models: a scoping review. BMJ Support Palliat Care. 2022;12:167–77. https://doi.org/10.1136/bmjspcare-2021-003313 .
doi: 10.1136/bmjspcare-2021-003313 pmcid: 9119949
Kuijpers MMT, van Veenendaal H, Engelen V, Visserman E, Noteboom EA, Stiggelbout AM, et al. Shared decision making in cancer treatment: A Dutch national survey on patients’ preferences and perceptions. Eur J Cancer Care (Engl). 2022;31:e13534. https://doi.org/10.1111/ecc.13534 .
doi: 10.1111/ecc.13534
Arraras JI, Greimel E, Sezer O, Chie WC, Bergenmar M, Costantini A, et al. An international validation study of the EORTC QLQ-INFO25 questionnaire: an instrument to assess the information given to cancer patients. Eur J Cancer. 2010;46:2726–38. https://doi.org/10.1016/j.ejca.2010.06.118 .
doi: 10.1016/j.ejca.2010.06.118
Street RL, Elwyn G, Epstein RM. Patient preferences and healthcare outcomes: an ecological perspective. Expert Rev Pharmacoecon Outcomes Res. 2012;12:167–80. https://doi.org/10.1586/erp.12.3 .
doi: 10.1586/erp.12.3
Wheelwright S, Bjordal K, Bottomley A, Alexandra Gilbert A, Martinelli F, Madeline Pe M, et al. EORTC Quality of Life Group Module Development Guidelines. 5th ed. Brussels: EORTC QL Group; 2021.
Arraras JI, Kuljanic K, Sztankay M, Wintner LM, Costantini A, Chie WC, et al. Initial phases in the development of a European Organisation for Research and Treatment of Cancer communication-specific module. Psychooncology. 2015;24:36–240. https://doi.org/10.1002/pon.3597 .
doi: 10.1002/pon.3597
Arraras JI, Wintner LM, Sztankay M, Tomaszewski KA, Hofmeister D, Costantini A, et al. EORTC QLQ-COMU26: a questionnaire for the assessment of communication between patients and professionals. Phase III of the module development in ten countries. Support Care Cancer. 2017; 25:1485–94. https://doi.org/10.1007/s00520-016-3536-0 .
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res. 2010;19:39–49. https://doi.org/10.1007/s11136-010-9606-8 .
doi: 10.1007/s11136-010-9606-8
Kuliś D, Bottomley A, Velikova G, Greimel E, Koller M. EORTC Quality of Life Group translation procedure. 4th ed. Brussels: EORTC QL Group; 2017.
Aaronson N, Ahmedzai S, Bergmann B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: A Quality-of-Life Instrument for Use in International Clinical Trials in Oncology. J Nat Cancer Institute. 1993;85:365–76. https://doi.org/10.1093/jnci/85.5.365 .
doi: 10.1093/jnci/85.5.365
Brédart A, Bottomley A, Blazeby JM, Conroy T, Coens C, D’Haese S, et al. An international prospective study of the EORTC cancer in-patient satisfaction with care measure (EORTC IN-PATSAT32). Eur J Cancer. 2005;41:2120–31. https://doi.org/10.1016/j.ejca.2005.04.041 .
doi: 10.1016/j.ejca.2005.04.041
Chin WW, Gopal A, Salisbury WD. Inf Syst Res. 1997;8:342–67.
doi: 10.1287/isre.8.4.342
Hair J, Black W, Babin B, Anderson R, Tatham R. Multivariate Data Analysis. 6th ed. Upper Saddle River: Pearson Prentice Hall; 2006.
Hu L, Bentler P. Cut-off criteria for fit indices in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model. 1996;6:1–55. https://doi.org/10.1080/10705519909540118 .
doi: 10.1080/10705519909540118
Bjorner JB, Kosinski M, Ware JE. Calibration of an item pool for assessing the burden of headaches: an application of item response theory to the headache impact test (HIT). Qual Life Res. 2003;12:913–33. https://doi.org/10.1023/a:1026163113446 .
doi: 10.1023/a:1026163113446
Ware JE, Gandek B. For the IQOLA project group. Methods for testing data quality, scaling assumptions, and reliability: the IQOLA Project Approach. J Clin Epidemiol. 1998;51:945–52. https://doi.org/10.1016/S0895-4356(98)00085-7 .
Fayers PM, Machin D. Quality of Life: the Assessment, Analysis and Interpretation of Patient-reported Outcomes. 3rd ed. Chichester: John Wiley & Sons; 2015.
doi: 10.1002/9781118758991
Abma IL, Rovers M, van der Wees PJ. Appraising convergent validity of patient-reported outcome measures in systematic reviews: constructing hypotheses and interpreting outcomes. BMC Res Notes. 2016;19(9):226. https://doi.org/10.1186/s13104-016-2034-2 .
doi: 10.1186/s13104-016-2034-2
Burnand B, Kernan WN, Feinstein AR. Indexes and boundaries for “quantitative significance” in statistical decisions. J Clin Epidemiol. 1990;43:1273–84. https://doi.org/10.1016/0895-4356(90)90093-5 .
doi: 10.1016/0895-4356(90)90093-5
Lake PW, Conley CC, Pal T, Sutton S, Vadaparampil ST. Anxiety and depression among Black breast cancer survivors: Examining the role of patient-provider communication and cultural values. Patient Educ Couns. 2022;105:2391–6. https://doi.org/10.1016/j.pec.2021.12.020 .
doi: 10.1016/j.pec.2021.12.020 pmcid: 10777429
Maly RC, Liu Y, Liang LJ, Ganz PA. Quality of life over 5 years after a breast cancer diagnosis among low-income women: Effects of race/ethnicity and patient-physician communication. Cancer. 2015;121:916–26. https://doi.org/10.1002/cncr.29150 .
doi: 10.1002/cncr.29150
Rai A, Han X, Zheng Z, Yabroff KR, Jemal A. Determinants and Outcomes of Satisfaction With Healthcare Provider Communication Among Cancer Survivors. J Natl Compr Canc Netw. 2018;16:975–84. https://doi.org/10.6004/jnccn.2018.7034 .
doi: 10.6004/jnccn.2018.7034
Arraras JI, Illarramendi JJ, Viudez A, Lecumberri MJ, de la Cruz S, Hernandez B, et al. The cancer outpatient satisfaction with care questionnaire for chemotherapy, OUT-PATSAT35 CT: a validation study for Spanish patients. Support Care Cancer. 2012;20:3269–78. https://doi.org/10.1007/s00520-012-1467-y .
doi: 10.1007/s00520-012-1467-y
Finkelstein A, Carmel S, Bachner YG. Physicians' communication styles as correlates of elderly cancer patients' satisfaction with their doctors. Eur J Cancer Care (Engl). 2017;26(1). https://doi.org/10.1111/ecc.12399 .
Song L, Weaver MA, Chen RC, Bensen JT, Fontham E, Mohler JL, et al. Associations between patient-provider communication and socio-cultural factors in prostate cancer patients: a cross-sectional evaluation of racial differences. Patient Educ Couns. 2014;97:339–46. https://doi.org/10.1016/j.pec.2014.08.019 .
doi: 10.1016/j.pec.2014.08.019 pmcid: 4252656
Siminoff LA, Graham GC, Gordon NH. Cancer communication patterns and the influence of patient characteristics: disparities in information-giving and affective behaviors. Patient Educ Couns. 2006;62:355–60. https://doi.org/10.1016/j.pec.2006.06.011 .
doi: 10.1016/j.pec.2006.06.011
Timmermans LM, van der Maazen RW, Leer JW, Kraaimaat FW. Palliative or curative treatment intent affects communication in radiation therapy consultations. Psychooncology. 2006;15:713–25. https://doi.org/10.1002/pon.1008 .
doi: 10.1002/pon.1008
Arraras JI, Illarramendi JJ, Viudez A, Ibáñez B, Lecumberri MJ, de la Cruz S, et al. Determinants of patient satisfaction with care in a Spanish oncology day hospital and its relationship with quality of life. Psychooncology. 2013;22:2454–61. https://doi.org/10.1002/pon.3307 .
doi: 10.1002/pon.3307
Manfredi C, Kaiser K, Matthews AK, Johnson TP. Are racial differences in patient-physician cancer communication and information explained by background, predisposing, and enabling factors? J Health Commun. 2010;15:272–92. https://doi.org/10.1080/10810731003686598 .
doi: 10.1080/10810731003686598 pmcid: 2862581
IBM SPSS Statistics for Windows, Version 27.0. Armonk: IBM Corp; 2020.
 R Core Team. R: A Language and Environment for Statistical Computing. Vienna: R Foundation for Statistical Computing; 2023. 
Cohen J. Statistical Power Analysis for the Behavioral Sciences. New York, NY: Routledge Academic; 1988.
Adelman RD, Greene MG, Phongtankuel V, Silva MD. Communication involving special populations: older adults with cancer. Curr Opin Support Palliat Care. 2019;13:64–8. https://doi.org/10.1097/SPC.0000000000000408 .
doi: 10.1097/SPC.0000000000000408
Brédart A, Kop JL, Fiszer C, Sigal-Zafrani B, Dolbeault S. Breast cancer survivors' perceived medical communication competence and satisfaction with care at the end of treatment. Psychooncology. 201;24:1670–8. https://doi.org/10.1002/pon.3836 .
Sparks L, Nussbaum JF. Health literacy and cancer communication with older adults. Patient Educ Couns. 2008;71:345–50. https://doi.org/10.1016/j.pec.2008.02.007 .
doi: 10.1016/j.pec.2008.02.007
Cancer Stat Facts: Cancer of Any Site. Surveillance, Epidemiology, and End Results (SEER) Program. Bethesda: National Cancer Institute; 2022.
Fletcher K, Prigerson HG, Paulk E, Temel J, Finlay E, Marr L, et al. Gender differences in the evolution of illness understanding among patients with advanced cancer. J Support Oncol. 2013;11:126–32. https://doi.org/10.12788/j.suponc.0007 .
doi: 10.12788/j.suponc.0007 pmcid: 4161613
Arraras JI, Greimel E, Chie WC, Sezer O, Bergenmar M, Costantini A et al; European Organisation for Research and Treatment of Cancer Quality of Life Group. Cross-cultural differences in information disclosure evaluated through the EORTC questionnaires. Psychooncology. 2013; 22:268–75. https://doi.org/10.1002/pon.2088 .

Auteurs

Juan Ignacio Arraras (JI)

Oncology Departments, Hospital Universitario de Navarra, Navarra Institute for Health Research (IdiSNA), Irunlarrea 3, Pamplona, 31008, Spain. jiarraras@correo.cop.es.

Johannes Giesinger (J)

University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.

Omar Shamieh (O)

King Hussein Cancer Center, Amman, Jordan.

Iqbal Bahar (I)

Cachar Cancer Hospital and Research Centre, Silchar, India.

Michael Koller (M)

Centre for Clinical Studies, University Hospital Regensburg, Regensburg, Germany.

Anne Bredart (A)

Psycho-Oncology Unit, SHARE - SHs And Outcome Research Team, Institut Curie and City University, Paris, France.

Anna Costantini (A)

S. Psycho-Oncology Service, Sant'Andrea Universitary Hospital, Rome, Italy.

Eva Greimel (E)

Medical University Graz, Graz, Austria.

Monika Sztankay (M)

University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.

Lisa M Wintner (LM)

University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.

Marina Carreiro de Sousa (MC)

Universidade Dos Açores, Ponta Delgada, Portugal.
Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.

Hiroto Ishiki (H)

National Cancer Center Hospital, Tokyo, Japan.

Meropi Kontogianni (M)

Harokopio University, Athens, Greece.

Maja Wolan (M)

University of Rzeszow, Rzeszów, Poland.

Yuichiro Kikawa (Y)

Kobe City Medical Center General Hospital, Kobe, Japan.

Anne Lanceley (A)

Department of Women's Cancer, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.

Ioannis Gioulbasanis (I)

Department of Medical Oncology, Animus Kyanus Stavros General Clinic, Larissa, Greece.

Amelie Harle (A)

University Hospitals Dorset, Poole, UK.

Uxue Zarandona (U)

Oncology Departments, Hospital Universitario de Navarra, Navarra Institute for Health Research (IdiSNA), Irunlarrea 3, Pamplona, 31008, Spain.

Dagmara Kulis (D)

European Organisation for Research and Treatment of Cancer, Brussels, Belgium.

Karin Kuljanic (K)

University Hospital Center Rijeka, Rijeka, Croatia.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH