http://nova.newcastle.edu.au/vital/access/services/Feed ${session.getAttribute("locale")} 5 http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:12266 Purpose: To evaluate caregivers’ experience of oncology services for ambulatory patients and to develop a short instrument (FAMCARE-6) suitable for computerised administration in the clinical setting. Methods: A sample of 234 caregivers recruited from 388 ambulatory oncology patients completed a computerised version of the 20-item family satisfaction with advanced cancer care (FAMCARE) instrument, which was originally developed for use in palliative care settings. Results: Caregivers reported generally high satisfaction with all aspects of ambulatory oncology services: overall score; mean, 3.96 (SD, 0.67); information giving, 3.88 (0.78); physical patient care, 4.00 (0.71); availability of care, 3.89 (0.77); and psychosocial care, 4.05 (0.72), from a possible score of 5. Factor analyses identified a single factor structure; the items were reduced to six (FAMCARE-6), which yielded a scale with adequate psychometric properties (completion rates over 90% for every item, correlation of 0.7 or above with the factor identified in the individual item factor analysis, and internal reliability of α=0.85). The overall mean score was 3.91 (SD, 0.73) for the FAMCARE-6. Conclusions: FAMCARE-6 can be used to assess caregiver satisfaction with ambulatory oncology services and may be suitable to be included as part of a computerised screening system for the psychological care of oncology patients. 2012-12-17T23:13:20.012Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:7316 Objective: To improve the acceptability of screening for depression and anxiety among patients with cancer there is a need for scales that are both very short and accurate. To date no very short questionnaire has been found to provide optimal performance for screening in oncology populations and other candidates must be examined. This study examined the concurrent validity of a relatively new, very short scale, the six item PSYCH-6 subscale of the Somatic and Psychological Health Report (SPHERE-12), in an oncology outpatient population. Methods: Cross-sectional survey of 340 oncology outpatients attending a regional hospital in Newcastle, Australia. The performance of the PSYCH-6 against the Hospital Anxiety and Depression Scale (HADS) was evaluated using correlation, Cohen's kappa, positive agreement and negative agreement. Results: The PSYCH-6 subscale of the SPHERE-12, at a cut-off point of 3, had substantial agreement with the total score of the HADS (HADS-T; κ = 0.73, p < 0.001). Negative agreement (0.92) was marginally higher than positive agreement (0.80). Conclusions: The PSYCH-6 scale of the SPHERE-12 at a cut-off point of 3 is an equivalent instrument to the HADS-T for detecting cases and excluding non-cases of anxiety and depression and is suitable for deployment in oncology populations. 2011-02-24T05:20:05.876Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:7226 Screening oncology patients for clinically significant emotional distress is a recommended standard of care in psycho-oncology. However, principles regarding the interpretation of screening and diagnostic tests developed in other areas of medicine have not been widely applied in psycho-oncology. This paper explores the application of the concepts of likelihood ratios and post-test probabilities to the interpretation of psychological screening instruments and demonstrates the development of an algorithm for screening for emotional distress and common psychopathology. Three hundred forty oncology/haematology outpatients at the Calvary Mater Newcastle, Australia completed the Distress Thermometer (DT), the PSYCH-6 subscale of the Somatic and Psychological Health Report and the Kessler-10 scale. The Hospital Anxiety and Depression Scale (HADS) (cutoff 15+) was used as the gold standard. Likelihood ratios showed that a score over threshold on the DT was 2.77 times more likely in patients who were cases on the HADS. These patients had a 53% post-test probability of being cases on the HADS compared with the pretest probability of 29%. Adding either the PSYCH-6 (3+) or the Kessler-10 (22+) to the DT (4+) significantly increased this post-test probability to 94% and 92%, respectively. The significance of these improvements was confirmed by logistic regression analysis. This study demonstrated the application of probability statistics to develop an algorithm for screening for distress in oncology patients. In our sample, a two-stage screening algorithm improved appreciably on the performance of the DT alone to identify distressed patients. Sequential administration of a very brief instrument followed by selective use of a longer inventory may save time and increase acceptability. 2011-02-17T00:10:13.668Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:5338 Objectives: To examine the feasibility of a computerised assessment and to compare resulting quality of life scores among oncology carers and patients. Methods: Six hundred and twenty-two subjects (carers n = 234, patients n = 388) attending an oncology or haematology clinic completed the WHO-Quality of Life-BREF (WHOQOL-BREF) and demographics on a personal computer. Age- and gender-standardised scores for carers and patients were compared to community norms. Carers were compared with patients using six three-way ANOVAs. Results: In total, 60.3% (234/388) of the patients had an accompanying carer attempt the survey and 93.6% (219 of 234) completed all items. The four domains of the WHOQOL-BREF had acceptable internal consistency (Cronbach alpha coefficients). Carers had lower quality of life on three domains (physical, psychological and environmental), and patients on two domains (physical and psychological), compared with the general community. Carers had higher overall satisfaction with their health than patients (standardised difference of 0.52 units-moderate effect). Conclusion: A computerised system for assessing quality of life was feasible and found that carers and patients had significant impairments in quality of life. Clinicians and services interested in quality of life for carers and patients may use computerised assessments to identify those with poorer quality of life. 2010-04-27T04:31:01.108Z ]]>