Clinical Evaluation Questionnaire Research Articles

Managing cancer and living meaningfully (CALM): Implementation in Dutch cancer care.

Managing Cancer and Living Meaningfully (CALM) is a brief, evidence-based psychotherapy tailored for patients with advanced cancer that has not yet been implemented routinely in Dutch cancer care. The aim of this study was to assess the feasibility, acceptability, sustainability and effectiveness of CALM in different clinical settings in the Netherlands. In 2019 and 2020 a multi-center, intervention-only study was performed in three Dutch cancer care settings. Professionals were trained to provide CALM under supervision. Patients diagnosed with advanced cancer were included and filled out questionnaires to measure depression (Patient Health Questionnaire-9), death anxiety (Death and Dying Distress Scale), and anxiety (hospital anxiety and depression scale-anxiety) at baseline, 3 and 6months. The Clinical Evaluation Questionnaire was used to assess acceptability of CALM at 3 and 6months. Sixty-four patients (55% of the eligible patients) were included in the study and 85% of the included patients received 3 or more CALM sessions. Of the 24 trained therapists, 15 (63%) started providing CALM. Two years post-study, CALM was provided in each center by a total of 19 therapists. On average, patients perceived CALM to be at least somewhat helpful. A significant decrease in severity of depression (p=0.006), death anxiety (p=0.008), and anxiety (p=0.024) was observed over time. This study shows that CALM therapy is feasible, acceptable, and sustainable in three Dutch cancer care settings, although not all predefined feasibility criteria for therapists were met. CALM can be effective in decreasing feelings of depression, anxiety, and death anxiety in patients with advanced cancer.

Clinical evaluation questionnaire in advanced cancer: a psychometric study of a novel measure of healthcare provider interactions

ObjectivesThe Clinical Evaluation Questionnaire (CEQ) is a patient-reported experience measure (PREM) that assesses the perceived benefit of therapeutic interactions of patients with advanced cancer with their healthcare providers concerning issues...

Comparison of self-, peer, and teachers' evaluation about the clinical skills of nursing students at the department of psychiatry.

BACKGROUND:Evaluating clinical performance is a challenge in nursing education. On the other hand, a single evaluation method cannot be used to judge different areas of interpersonal skills. Therefore, this study was conducted to compare the evaluation of teachers', peer, and self-evaluation of nursing students in the psychiatric ward of Baharan Hospital affiliated to Zahedan University of Medical Sciences.MATERIALS AND METHODS:In this analytical cross-sectional study, forty trainee students were selected by a census method in a time period and they were evaluated by three methods including self-, peer, and teachers’ evaluation. Their clinical skills were assessed using a school-based clinical evaluation questionnaire containing 15 questions in the areas of taking history, examination of psychiatric health, and the ability to communicate with the patient. The analyses were performed by SPSS-22 software.RESULTS:The mean and standard deviation of the evaluation scores of clinical teachers as well as peer and self-evaluation in the areas of taking patient's history were 13.82 ± 2.74, 14.46 ± 2.68, and 15.75 ± 2.56, respectively. In addition, the outcomes in the areas of psychiatric examination were 8.11 ± 1.54, 9.25 ± 2.70, and 10.43 ± 2.65 and in the areas of clinical communication were 8.93 ± 2.03, 9.04 ± 2.25, and 10.21 ± 1.98, respectively. There was a significant correlation between the mean of teachers’ evaluation and self-evaluation scores (P = 0.003) as well as comparing peer and self-evaluation (P = 0.048). However, no significant correlation was observed between teachers’ and peer evaluation (P = 0.062).CONCLUSION:Due to the difference in scores of different methods of evaluation, self- and peer evaluation can be used as a complementary method with teachers’ evaluation in measuring the clinical performance of clinical students.

The French National Registry of patients with Facioscapulohumeral muscular dystrophy

BackgroundFacioscapulohumeral muscular dystrophy is a rare inherited neuromuscular disease with an estimated prevalence of 1/20,000 and France therefore harbors about 3000 FSHD patients. With research progress and the development of targeted therapies, patients’ identification through registries can facilitate and improve recruitment in clinical trials and studies.ResultsThe French National Registry of FSHD patients was designed as a mixed model registry involving both patients and physicians, through self-report and clinical evaluation questionnaires respectively, to collect molecular and clinical data. Because of the limited number of patients, data quality is a major goal of the registry and various automatic data control features have been implemented in the bioinformatics system. In parallel, data are manually validated by molecular and clinical curators. Since its creation in 2013, data from 638 FSHD patients have been collected, representing about 21% of the French FSHD population. The mixed model strategy allowed to collect 59.1% of data from both patients and clinicians; 26 and 14.9% from respectively patients and clinicians only. With the identification of the FSHD1 and FSHD2 forms, specific questionnaires have been designed. Though FSHD2 patients are progressively included, FSHD1 patients still account for the majority (94.9%). The registry is compatible with the FAIR principles as data are Findable, Accessible and Interoperable. We thus used molecular standards and standardized clinical terms used by the FILNEMUS French network of reference centers for the diagnosis and follow-up of patients suffering from a rare neuromuscular disease. The implemented clinical terms mostly map to dictionaries and terminology systems such as SNOMED-CT (75% of terms), CTV3 (61.7%) and NCIt (53.3%). Because of the sensitive nature of data, they are not directly reusable and can only be accessed as aggregated data after evaluation and approval by the registry oversight committee.ConclusionsThe French National Registry of FSHD patients belongs to a national effort to develop databases, which should now interact with other initiatives to build a European and/or an international FSHD virtual registry for the benefits of patients. It is accessible at www.fshd.fr and various useful information, links, and documents, including a video, are available for patients and professionals.

SPARC 2017 MBC Challenge: Validation of CALM Therapy Model in MBC Patients in Portugal: An Intervention to Address Patients' Psychosocial Needs

Background: Psychological distress is common in patients with metastatic cancer and the progression of disease brings multiple predictable challenges. However, there are very few cost-effective evidence-based interventions that address these specific needs of this population. CALM (Managing Cancer and Living Meaningfully) is a brief intervention model recently developed in Canada for this purpose. CALM includes 3-6 individual sessions, each approximately 45 minutes in length, delivered over 3 months, that cover 4 critical domains for this population: 1) symptom management and communication with health care providers; 2) changes in self and relations with close others; 3) spiritual well-being, or sense of meaning and purpose; 4) preparing for the future, sustaining hope and facing mortality. CALM has been successfully tested in Canada and other countries, showing significant reductions in depressive symptoms and death anxiety in therapy participants and a significant improvement in spiritual well-being over time. In Portugal there are no available short cost-effective psychotherapeutic interventions to address psychosocial needs of advanced cancer patients. Aims: (i) Translate and adapt the original CALM therapy manual for Portuguese patients with metastatic breast cancer (MBC) for its application and dissemination in Portugal and in other Portuguese speaking countries; (ii) Test the feasibility of the CALM therapy intervention in Portuguese patients with MBC; (iii) Test the effectiveness of CALM in reducing depression and other psychological distress in this population; (iv) Increase the availability of psychosocial resources to address the specific psychosocial needs of MBC patients and to reduce the current gap of psychosocial care for this population in Portugal and Portuguese speaking countries. Methods: Conduct a Phase II single-arm, intervention-only study, with assessments at baseline, 3 months and 6 months; Site Champalimaud Clinical Centre, Lisbon, PT; Primary outcome: depressive symptoms assessed by PHQ-9; Secondary outcome measures include: FACIT-Sp, measure of spiritual well-being in palliative care; Death and Dying Distress Scale (DADDS); Experiences in Close Relationships Inventory (ECR-M16); and the Clinical Evaluation Questionnaire (CEQ). We will also collect additional information including demographics and relevant medical data. We plan to recruit 35 patients over an 18-month period at the Breast Unit. Eligible participants will receive the CALM individual semistructured psychotherapy. The Canadian CALM team is closely monitoring and supporting the study. Results: In progress.

Folate and nutrients involved in the 1-carbon cycle in the pretreatment of patients for colorectal cancer.

To assess the ingestion of folate and nutrients involved in the 1-carbon cycle in non-treated patients with colorectal adenocarcinoma in a reference center for oncology in southeastern Brazil. In total, 195 new cases with colorectal adenocarcinoma completed a clinical evaluation questionnaire and a Food Frequency Questionnaire (FFQ). Blood samples from 161 patients were drawn for the assessment of serum folate. A moderate correlation was found between serum concentrations of folate, folate intake and the dietary folate equivalent (DFE) of synthetic supplements. Mulatto or black male patients with a primary educational level had a higher intake of dietary folate. Of patients obtaining folate from the diet alone or from dietary supplements, 11.00% and 0.10%, respectively, had intake below the recommended level. Of the patients using dietary supplements, 35% to 50% showed high levels of folic acid intake. There was a prevalence of inadequacy for vitamins B2, B6 and B12, ranging from 12.10% to 20.18%, while 13.76% to 22.55% of patients were likely to have adequate choline intake. The considerable percentage of patients with folate intake above the recommended levels deserves attention because of the harmful effects that this nutrient may have in the presence of established neoplastic lesions.

Psychosocial and Psychiatric Aspects of Patients Awaiting Liver Transplant

Introduction Psychosocial and psychiatric aspects influence adherence to treatment and, consequently, the prognosis of liver transplantation. Psychosocial and psychiatric pretransplant assessment helps physicians to make clinical and therapeutic decisions. Aim To describe psychosocial and psychiatric aspects of patients awaiting liver transplant at the Coimbra University Hospital Centre. Methods A psychosocial and clinical evaluation questionnaire developed for our study was responded by 31 patients referred for psychological/psychiatric assessment to the Liaison Psychiatry Consultation at Coimbra University Hospital Centre, during the year of 2012. Results Mean age was 48 years. 52% of them were females and 71% were married. Mean years of shooling was 7 years. At the time of the evaluation 35% were working, 19% were not actively working due to their hepatic disease and 23% were unemployed. The main causes for transplant were alcoholic liver disease (55%) and familial amyloidotic polyneuropathy (26%). More than half of patients (58%) had psychiatric history, mostly alcoholism and depression. At the time of evaluation, 42% presented depressive and/or anxiety symptoms. 19% did not reveal full understanding about their liver disease, mainly related to transplant surgical complications and medication side effects. Social and medical satisfaction was reported by 58% and non and poor satisfaction was identified in 3% and 26%,respectively. Conclusions Results indicate that psychosocial and psychiatric risk factors of nonadherence behavior after transplant are frequent on patients awaiting liver transplant. Psychological/psychiatric assessment is very important for selection and orientation of these patients.

Translation and cultural adaptation of the Hip Outcome Score to the Portuguese language

Objectiveto translate the Hip Outcome Score clinical evaluation questionnaire into Portuguese and culturally adapt it for Brazil. Methodsthe Hip Outcome Score questionnaire was translated into Portuguese following the methodology consisting of the steps of translation, back-translation, pretesting and final translation. Resultsthe pretesting was applied to 30 patients with hip pain without arthrosis. In the domain relating to activities of daily living, there were no difficulties in comprehending the translated questionnaire. In presenting the final translation of the questionnaire, all the questions were understood by more than 85% of the individuals. Conclusionthe Hip Outcome Score questionnaire was translated and adapted to the Portuguese language and can be used in clinical evaluation on the hip. Additional studies are underway with the objective of evaluating the reproducibility and validity of the Brazilian translation.

Tradução e adaptação cultural do Hip Outcome Score para a língua portuguesa

Objectiveto translate the Hip Outcome Score clinical evaluation questionnaire into Portuguese and culturally adapt it for Brazil. Methodsthe Hip Outcome Score questionnaire was translated into Portuguese following methodology consisting of the steps of translation, back‐translation, pretesting and final translation. Resultsthe pretesting was applied to 30 patients with hip pain without arthrosis. In the domain relating to activities of daily living, there were no difficulties in comprehending the translated questionnaire. In presenting the final translation of the questionnaire, all the questions were understood by more than 85% of the individuals. Conclusionthe Hip Outcome Score questionnaire was translated and adapted to the Portuguese language and can be used in clinical evaluation on the hip. Additional studies are underway with the objective of evaluating the reproducibility and validity of the Brazilian translation.

Translation, cross-cultural adaptation and validation of the Brazilian version of the Nonarthritic Hip Score.

CONTEXT AND OBJECTIVE The Nonarthritic Hip Score (NAHS) is a clinical evaluation questionnaire that was developed in the English language to evaluate hip function in young and physically active patients. The aims of this study were to translate this questionnaire into the Brazilian Portuguese language, to adapt it to Brazilian culture and to validate it. DESIGN AND SETTING Cohort study conducted between 2008 and 2010, at Universidade do Estado do Rio de Janeiro (UERJ). METHODS Questions about physical activities and household chores were modified to better fit Brazilian culture. Reproducibility, internal consistency and validity (correlations with the Algofunctional Lequesne Index and the Western Ontario and McMaster Universities Arthritis Index [WOMAC]) were tested. The NAHS-Brazil, Lequesne and WOMAC questionnaires were applied to 64 young and physically active patients (mean age, 40.9 years; 31 women). RESULTS The intraclass correlation coefficient (which measures reproducibility) was 0.837 (P < 0.001). Bland-Altman plots revealed a mean error in the difference between the two measurements of 0.42. The internal consistency was confirmed through a Cronbach alpha of 0.944. The validity between NAHS-Brazil and Lequesne and between NAHS-Brazil and WOMAC showed high correlations, r = 0.7340 and r = 0.9073, respectively. NAHS-Brazil showed good validity with no floor or ceiling effects. CONCLUSION The NAHS was translated into the Brazilian Portuguese language and was cross-culturally adapted to Brazilian culture. It was shown to be a useful tool in clinical practice for assessing the quality of life of young and physically active patients with hip pain.

Treatment of obstructive sleep apnea syndrome in patients from a teaching hospital in Brazil: is it possible?

The aim of this study was to evaluate the efficacy of a cost-effective intra-oral appliance for obstructive sleep apnea syndrome built into a large teaching hospital. Out of 20 evaluated and treated patients, 14 concluded the study: eight men and six women, with a mean age of 42-46 (mean + SD) years and mean body mass index of 27.66. Inclusion criteria were mild or moderate apnea-hypopnea index (AHI) according to a polysomnographic study. All patients were treated with the monobloco intra-oral appliance. They were then submitted to a follow-up polysomnographic study after 60 days using the appliance. An orofacial clinical evaluation was carried out with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire and with clinical evaluation questionnaire devised by the Orofacial Pain Team before and 60 days after fitting the intra-oral appliance. The AHI showed a statistically meaningful (p = 0.002) reduction from 15.53 to 7.82 events per hour, a non-statistically significant oxygen saturation increase from 83.36 to 84.86 (p = 0.09), and Epworth's sleepiness scale reduction from 9.14 to 6.36 (p = 0.001). Three patients did not show any improvement. The most common side effect during the use of the appliance/device was pain and facial discomfort (28.57%), without myofascial or temporomandibular joint pain as evaluated by the RDC/TMD questionnaire. The intra-oral device produced a significant reduction of the apnea-hypopnea index during the study period with the use of the monobloco intra-oral appliance. Patients did not show prior myofascial pain or 60 days after use of the intra-oral appliance.

Antihypertensive safety and efficacy and physician and patient satisfaction: results from a phase 4 practice-based clinical experience trial with diltiazem LA

This study was undertaken to assess the safety and efficacy of a new long-acting formulation of diltiazem (DLA) (Cardizem LA; Biovail Pharmaceuticals, Inc., Bridgewater, NJ) in a large heterogeneous group of hypertensive patients, and to evaluate physician and patient treatment satisfaction. In this open-label, 30-day study, physicians enrolled patients with hypertension who were to be evaluated and treated at an initial visit and at 2 follow-up visits. Data recorded for each patient included demographic information, DLA dosing strength, blood pressure (BP) readings, and adverse events (AEs). A total of 15,155 physicians completed the baseline questionnaire, and 9679 (64%) completed the final clinical evaluation questionnaire. In all, 139,965 patients with hypertension were enrolled. Initial and follow-up BP data were recorded for 50,856 (36%) of these patients. On average, systolic BP (SBP) decreased from the initial visit by 10.9 mm Hg at the first follow-up (P<.0001) and by 15.5 mm Hg at the second follow-up (mean SBP, 135.7) (P<.0001). On average, diastolic BP (DBP) decreased by 6.7 mm Hg (P<.0001) and by 9.2 mm Hg (mean DBP, 79.4) (P<.0001), respectively. The most commonly reported AEs included edema, headache, dizziness, nausea, and rash; two thirds of these events were attributed to DLA. None of the AEs attributed to DLA was reported in more than 1% of patients. Both physicians and patients expressed a high degree of satisfaction with DLA. Results from this large-scale, open-label study show that DLA was safe and produced clinically meaningful reductions in SBP and DBP; in addition, a moderate to high degree of physician and patient satisfaction was reported in a large and heterogeneous cohort of patients with hypertension.