The development and validation of a patient-reported outcome measure to assess financial hardship among older cancer survivors in China: hardship and recovery with distress survey
BackgroundFinancial hardship has been described as a patient’s economic experiencefollowing cancer-related treatment. Standardized patient-reported outcome measures(PROM) to assess this distress has not been well-studied, especially among older cancer survivors.ObjectiveThe aim of this study was to...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1151465/full |
| _version_ | 1797842505045114880 |
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| author | Li Liu Li Liu Li Liu Aihua Zhang Mingzhu Su Mingzhu Su Xiaojie Sun Xiaojie Sun Di Shao Di Shao Joyce Cheng Nengliang (Aaron) Yao |
| author_facet | Li Liu Li Liu Li Liu Aihua Zhang Mingzhu Su Mingzhu Su Xiaojie Sun Xiaojie Sun Di Shao Di Shao Joyce Cheng Nengliang (Aaron) Yao |
| author_sort | Li Liu |
| collection | DOAJ |
| description | BackgroundFinancial hardship has been described as a patient’s economic experiencefollowing cancer-related treatment. Standardized patient-reported outcome measures(PROM) to assess this distress has not been well-studied, especially among older cancer survivors.ObjectiveThe aim of this study was to develop and validate PROM for assessing the financial hardship of older cancer survivors in China.MethodsItems were generated using qualitative interviews and literature review. Items were screened based on Delphi expert consultation and patients’ opinions. Item response theory (IRT) and classical test theory (CTT) were used to help reduce items. Retained items formed a pilot instrument that was subjected to psychometric testing. A cut-off score for the new instrument for predicting poor quality of life was identified by receiver operating characteristic (ROC) analysis.ResultsQualitative interviews and literature review generated 135 items, which were reduced to 60 items because of redundancy. Following Delphi expert consultation and patients’ evaluation, 24 items with high importance were extracted. Sixteen items were selected due to satisfactory statistical analysis based on CTT and IRT. Ten items were retained and comprised 2 domains after loadings in exploratory factor analysis (EFA). Internal consistency was satisfactory (α = 0.838). Test-retest reliability was good (intraclass correlation, 0.909). The ROC analysis suggested that the cut-off of 18.5 yielded an acceptable sensitivity and specificity.ConclusionsThe PROM for Hardship and Recovery with Distress Survey (HARDS) consists of 10 items that specifically reflect the experiences of financial hardship among older Chinese cancer survivors, and it also showed good reliability and validity in clinical settings. |
| first_indexed | 2024-04-09T16:49:00Z |
| format | Article |
| id | doaj.art-5adae649646a4d9cb01d7200e1c205fa |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-09T16:49:00Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-5adae649646a4d9cb01d7200e1c205fa2023-04-21T18:21:56ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-04-011310.3389/fonc.2023.11514651151465The development and validation of a patient-reported outcome measure to assess financial hardship among older cancer survivors in China: hardship and recovery with distress surveyLi Liu0Li Liu1Li Liu2Aihua Zhang3Mingzhu Su4Mingzhu Su5Xiaojie Sun6Xiaojie Sun7Di Shao8Di Shao9Joyce Cheng10Nengliang (Aaron) Yao11Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaNational Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, ChinaSchool of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaSchool of Nursing, Shandong First Medical University, Shandong Academy of Medical Sciences, Taian, Shandong, ChinaCentre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaNational Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, ChinaCentre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaNational Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, ChinaCentre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaNational Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, ChinaSchool of Medicine, Johns Hopkins University, Baltimore, MD, United StatesSchool of Medicine, University of Virginia, Charlottesville, VA, United StatesBackgroundFinancial hardship has been described as a patient’s economic experiencefollowing cancer-related treatment. Standardized patient-reported outcome measures(PROM) to assess this distress has not been well-studied, especially among older cancer survivors.ObjectiveThe aim of this study was to develop and validate PROM for assessing the financial hardship of older cancer survivors in China.MethodsItems were generated using qualitative interviews and literature review. Items were screened based on Delphi expert consultation and patients’ opinions. Item response theory (IRT) and classical test theory (CTT) were used to help reduce items. Retained items formed a pilot instrument that was subjected to psychometric testing. A cut-off score for the new instrument for predicting poor quality of life was identified by receiver operating characteristic (ROC) analysis.ResultsQualitative interviews and literature review generated 135 items, which were reduced to 60 items because of redundancy. Following Delphi expert consultation and patients’ evaluation, 24 items with high importance were extracted. Sixteen items were selected due to satisfactory statistical analysis based on CTT and IRT. Ten items were retained and comprised 2 domains after loadings in exploratory factor analysis (EFA). Internal consistency was satisfactory (α = 0.838). Test-retest reliability was good (intraclass correlation, 0.909). The ROC analysis suggested that the cut-off of 18.5 yielded an acceptable sensitivity and specificity.ConclusionsThe PROM for Hardship and Recovery with Distress Survey (HARDS) consists of 10 items that specifically reflect the experiences of financial hardship among older Chinese cancer survivors, and it also showed good reliability and validity in clinical settings.https://www.frontiersin.org/articles/10.3389/fonc.2023.1151465/fullolder cancer survivorshealth outcomepatient-reported outcome measurefinancial hardshipfinancial toxicity |
| spellingShingle | Li Liu Li Liu Li Liu Aihua Zhang Mingzhu Su Mingzhu Su Xiaojie Sun Xiaojie Sun Di Shao Di Shao Joyce Cheng Nengliang (Aaron) Yao The development and validation of a patient-reported outcome measure to assess financial hardship among older cancer survivors in China: hardship and recovery with distress survey Frontiers in Oncology older cancer survivors health outcome patient-reported outcome measure financial hardship financial toxicity |
| title | The development and validation of a patient-reported outcome measure to assess financial hardship among older cancer survivors in China: hardship and recovery with distress survey |
| title_full | The development and validation of a patient-reported outcome measure to assess financial hardship among older cancer survivors in China: hardship and recovery with distress survey |
| title_fullStr | The development and validation of a patient-reported outcome measure to assess financial hardship among older cancer survivors in China: hardship and recovery with distress survey |
| title_full_unstemmed | The development and validation of a patient-reported outcome measure to assess financial hardship among older cancer survivors in China: hardship and recovery with distress survey |
| title_short | The development and validation of a patient-reported outcome measure to assess financial hardship among older cancer survivors in China: hardship and recovery with distress survey |
| title_sort | development and validation of a patient reported outcome measure to assess financial hardship among older cancer survivors in china hardship and recovery with distress survey |
| topic | older cancer survivors health outcome patient-reported outcome measure financial hardship financial toxicity |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1151465/full |
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