Memorial Symptom Assessment Scale-Short Form Research Articles

Effects of the "AI-TA" Mobile App With Intelligent Design on Psychological and Related Symptoms of Young Survivors of Breast Cancer: Randomized Controlled Trial.

Young women often face substantial psychological challenges in the initial years following cancer diagnosis, leading to a comparatively lower quality of life than older survivors. While mobile apps have emerged as potential interventions, their effectiveness remains inconclusive due to the diversity in intervention types and variation in follow-up periods. Furthermore, there is a particular dearth of evidence regarding the efficacy of these apps' intelligent features in addressing psychological distress with these apps. This study aims to evaluate the effectiveness of a mobile app with intelligent design called "AI-TA" on cancer-related psychological health and ongoing symptoms with a randomized controlled design. Women aged 18 to 45 years diagnosed with breast cancer were randomly assigned to the intervention or control group. The intervention was AI-TA, which included 2-way web-based follow-up every 2 weeks. Both intention-to-treat (ITT) and per-protocol (PP) analyses employed repeated measurement analysis of variance. The participants' background features, primary outcomes (psychological distress and frequency, self-efficacy, and social support), and secondary outcomes (quality of life) were measured using multiple instruments at 3 time points (baseline, 1-month intervention, and 3-month intervention). A total of 124 participants were randomly allocated to the control group (n=62, 50%) or intervention group (n=62, 50%). In total, 92.7% (115/124) of the participants completed the intervention. Significant improvements in psychological symptoms (Memorial Symptom Assessment Scale-Short Form) were observed in the ITT group from baseline to 1-month intervention relative to the control group (ITT vs control: 1.17 vs 1.23; P<.001), which persisted at 3-month follow-up (ITT vs control: 0.68 vs 0.91; P<.001). Both the ITT and PP groups exhibited greater improvements in self-efficacy (Cancer Behavior Inventory-Brief Version) than the control group at 1-month (ITT vs PP vs control: 82.83 vs 77.12 vs 65.35; P<.001) and 3-month intervention (ITT vs PP vs control: 92.83 vs 89.30 vs 85.65; P<.001). However, the change in social support (Social Support Rating Scale) did not increase significantly until 3-month intervention (ITT vs control: 50.09 vs 45.10; P=.002) (PP vs control: 49.78 vs 45.10; P<.001). All groups also experienced beneficial effects on quality of life (Functional Assessment of Cancer Therapy-Breast), which persisted at 3-month follow-up (P<.001). The intelligent mobile app AI-TA incorporating intelligent design shows promise for reducing psychological and cancer-related symptoms among young survivors of breast cancer. Chinese Clinical Trial Registry ChiCTR2200058823; https://www.chictr.org.cn/showproj.html?proj=151195.

Relationships Between Socio-behavioral Factors and the Symptoms Among Asian American Breast Cancer Survivors: A Structural Equation Modeling.

Despite increased research on breast cancer survivors, little is known about how socio-behavioral factors influence the symptoms among racial/ethnic minority breast cancer survivors, particularly Asian American breast cancer survivors (AABCS). This study examined the relationship between multiple socio-behavioral factors in AABCS, including attitudes, perceived barriers, and social influences, and their symptom experiences, with an emphasis on the mediating effect of self-efficacy. This secondary analysis used data collected from 195 AABCS women recruited through online and offline communities from January 2017 to June 2020. Study variables were measured using validated instruments such as the Questions on Attitudes, Self-Efficacy, Perceived Barriers, and Social Influences; the Cancer Behavior Inventory; and the Memorial Symptom Assessment Scale-Short Form. For structural equation modeling based on Bandura's self-efficacy theory, mediation analysis was performed using SPSS version 26.0 and AMOS 28. The overall fitness of the hypothetical model to the data is acceptable (χ2 = 51.36, P < .001; goodness-of-fit index = 0.95, adjusted goodness-of-fit index = 0.89, comparative fit index = 0.96, Tucker-Lewis index = 0.94, normed fit index = 0.94, and root-mean-square error of approximation index = 0.08). Both attitudes and social influences indirectly influenced symptom distress through self-efficacy (β = -0.054, P = .019, and β = -0.053, P = .017, respectively). Perceived barriers had indirect effects through self-efficacy (β = 0.121, P = .024) and significant direct effects (β = 0.605, P = .003) on symptom distress. Our findings supported that the self-efficacy for coping mediated their symptom experience among AABCS. In addition, there were significant relationships among attitudes, perceived barriers, social influences, and symptom experience. Future theory-driven interventions need to consider self-efficacy and socio-behavioral factors in symptom management among AABCS.

Persistent Fatigue in Patients With Hepatocellular Carcinoma Receiving Radiotherapy.

Radiation therapy has attracted much attention in the treatment of patients with hepatocellular carcinoma (HCC). However, the association between radiotherapy-related fatigue and HCC has been examined in only a few studies. This study was designed to explore the change over time in fatigue in patients with HCC treated with radiotherapy and related factors. One hundred patients were enrolled in this prospective longitudinal study using convenience sampling at a medical center in northern Taiwan. The Functional Assessment of Chronic Illness Therapy-Fatigue scale, the Brief Pain Inventory-Short Form, and the psychological subscale of Memorial Symptom Assessment Scale-Short Form were used to assess the symptoms at five time points: before radiotherapy (T0), during treatment (T1), and at 1 month (T2), 3 months (T3), and 6 months (T4) after radiotherapy. The generalized estimating equations method was used to determine the changes in fatigue and the influencing factors. Fatigue levels at T1, T2, T3, and T4 were significantly higher than that at T0. Higher fatigue was significantly associated with lower income and poorer functional status. Having worse pain levels and psychological symptoms were both associated with higher fatigue. The results indicate fatigue does not recover to the baseline (pretherapy) level by 6 months after radiotherapy. Thus, fatigue in patients with HCC receiving radiotherapy should be regularly and effectively assessed, and patients experiencing pain and psychological symptoms should be given greater attention from clinicians.

Symptom Experience and Quality of Life in Colorectal Cancer Patients Undergoing Chemotherapy – A Secondary Publication

Objective: To evaluate symptom experience and quality of life (QoL) and to identify the predictors of QoL among colorectal cancer patients undergoing chemotherapy. Methods: A cross-sectional study was conducted on 107 colorectal cancer patients at a university-affiliated hospital between June 1 and July 30, 2021. Functional Assessment of Cancer Therapy-Colorectal (FACT-C) and Memorial Symptom Assessment Scale-Short Form (MSAS-SF) were used to assess symptom experience and QoL of these patients. Data were analyzed using Pearson’s correlation, t-test, ANOVA, and hierarchical multiple regression. Results: The mean QoL score for colorectal cancer patients was 88.78 ± 20.08. The most frequently experienced physical and psychological symptoms were numbness/tingling and worrying. Physical and psychological symptoms have a significant negative association with QoL. Perceived economic status was significantly associated with QoL in patients’ general characteristics. The regression analyses showed that high psychological symptoms (β = -0.63, P &lt; 0.001), middle perceived economic status (β = -0.22, P = 0.009), and low perceived economic status (β = -0.36, P &lt; 0.001) were statistically significant in predicting patients’ low QoL. Conclusion: Symptom experience and QoL are essential variables that should be acknowledged when delivering health care to colorectal cancer patients. More attention to the reduction and comprehensive symptom management of psychological distress could improve QoL among colorectal cancer patients.

A Decision Tree Analysis on Symptom Experience of Asian American Breast Cancer Survivors.

Mainly due to their cultural attitudes toward symptoms and breast cancer, Asian American breast cancer survivors tend to suffer from symptoms and often delay in getting treatments, information, and support. To improve their symptom management, it would be important to determine risk groups among them. Decision tree analyses reportedly help determine risk groups by identifying the characteristics that are directly associated with target health outcomes. Using a decision tree analysis, this study aimed at identifying the characteristics that were closely linked to the symptom experience of Asian American breast cancer survivors. This was a part of a parent randomized controlled trial among Asian American breast cancer survivors. Only the data from 135 women at the pre-test were included. Multiple instruments were used to collect the data: the Memorial Symptom Assessment Scale-Short Form, the Cancer Behavior Inventory, the PRQ-2000, the Perceived Isolation Scale, and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using latent profile analysis and decision tree analyses. Two most frequently found profiles included the low symptom experience profile (72.6%) and the high symptom experience profile (27.4%). The high symptom experience profile was predicted by 2 combined characteristics; (a) high psychological needs for help (over 60.00 points), and (b) low psychological needs for help (cut point = 60.00), high perceived barriers (cut point = 1.62), and high social isolation (social support) (cut point = 2.33). These characteristics linked to Asian American breast cancer survivors with high symptom experience need to be considered in future intervention development.

Status and influential factors of spiritual well-being in cancer patients with drug clinical trials: a cross-sectional study.

The purpose of this study was to investigate the spiritual well-being status of cancer patients in drug clinical trials and its influencing factors, and to provide theoretical support for the spiritual health intervention of clinical trial cancer patients. This cross-section study was conducted among 244 cancer patients in clinical trials. The Memorial Symptom Assessment Scale Short Form (MSAS-SF), Connor-Davidson Resilience Scale 10 (CD-RISC 10), and Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-SP-12) were used to measure symptom burden, psychological resilience, and spiritual well-being. The Multiple Linear Regression Model was used to determine the influencing factors of patients' spiritual health. The overall spiritual health level of cancer patients with clinical trials was high (36.87 ± 11.0), and the spiritual health level was positively correlated with psychological resilience (r = 0.872, P < 0.001). Religious belief, nationality, treatment regimen, and resilience were independent risk factors for the spiritual health of cancer patients in clinical trials. Patients with religious beliefs (β = 0.097, P = 0.012), ethnic minorities (β = 0.087, P = 0.023), and high resilience scores (β = 0.874, P < 0.001) had higher levels of spiritual health. Patients who received single antineoplastic therapy (β = - 0.079, P = 0.028) had lower levels of spiritual health. Our study found that the spiritual health of cancer patients in clinical trials was at a high level, superior to cancer patients receiving conventional anti-tumor therapy. Religious belief, nationality, treatment regimen, and psychological resilience were the influential factors of spiritual health.

Immigration Transition and Symptom Distress Changes by a Technology-Based Intervention: Asian American Breast Cancer Survivors.

Technology-based programs using computers and mobile devices are known to be effective in providing information and support to marginalized populations including immigrants. Yet, little is still known on the factors that may influence the effectiveness of technology-based programs in improving symptom experience, including immigration transition, especially among Asian American breast cancer survivors. This study aimed to identify the characteristics related to immigration transition that significantly affected the symptom distress changes by a technology-based information and coaching/support program among Asian American breast cancer survivors. This secondary analysis was conducted with the data from 102 Asian American breast cancer survivors from a randomized clinical trial in progress. Multiple instruments were used: the questions on background characteristics and immigration transition and the Memorial Symptom Assessment Scale-Short Form. The data were analyzed using repeated-measurement analyses and decision tree analyses. The mean changes in the symptoms distress scores were as follows: -0.12 (SD, 0.47) in the Global Distress Index scores; -0.08 (SD, 0.43) in the physical symptom distress scores; and -0.15 (SD, 0.65) in the psychological symptom distress scores. The characteristics with the highest impact on the symptom distress score changes included the immigration age for Global Distress Index and physical symptom distress score and the level of acculturation for psychological symptom distress score.

Abstract LB145: The relationship of socio-behavioral factors to the symptom experience of Asian American breast cancer survivors: a structural equation model

Abstract Background: Despite an increasing number of studies among breast cancer survivors, little is known about how socio-behavioral factors influence the symptom experience of racial/ethnic minority breast cancer survivors, especially Asian American breast cancer survivors. The identified socio-behavioral factors could give directions for development of unique intervention components that are tailored to a specific population in needs. Purpose: This study examined the relationship of multiple socio-behavioral factors including attitudes, perceived barriers, social influences, and self-efficacy to the symptom experiences of Asian American breast cancer survivors. Methods: This secondary analysis was conducted using data collected from 195 Asian American female breast cancer survivors. Subjects were recruited from January 2017 to June 2020 through online and offline communities and groups. The study variables were measured using validated instruments such as the Questions on Attitudes, Self-Efficacy, Perceived Barriers, and Social Influences (QASPS); the Cancer Behavior Inventory (CBI); and the Memorial Symptom Assessment Scale-Short Form (MSAS-SF). The hypothetical model was built based on Bandura’s self-efficacy theory. Mediation analysis was conducted using structural equation modeling with SPSS version 26.0 and Amos 28. Results: The overall fitness of the hypothetical model to the data was acceptable (χ2=51.36, p&amp;lt;.001, the goodness of fit index [GFI] = .95, adjusted GFI [AGFI] = .89, comparative fit index [CFI] = .96, Tucker-Lewis index [TLI] = .94, normed fit index [NFI] = .94, and root mean square error of approximation [RMSEA] = .08 Attitude and perceived barrier and social influence had a significant direct effect on self-efficacy (direct effect, β = 0.247, p =.003; β = -0.552, p =.003; β = 0.241, p =.002, respectively). Attitudes indirectly influenced symptom distress scores through self-efficacy (β =-0.054, p = .019). Perceived barriers had a significant direct effect (β = 0.605, p=.003), indirect effect (indirect effect, β = 0.121, p =.024), and a total effect on symptom distress scores (total effect, β = 0.726, p =.004). In addition, social influence had an indirect effect on symptom distress scores through self-efficacy (β = -0.053, p = .017) Conclusions: The findings supported that the self-efficacy for coping had a mediating effect on their symptom experience among Asian American breast cancer survivors as well as identified meaningful associations with attitudes, perceived barriers and social influences and symptom experience. Future research and practice should consider socio-behavioral factors, especially self-efficacy, in symptom management of Asian American breast cancer survivors. Acknowledgments: The parent study was funded by the National Institutes of Health (NCI/NINR; 1R01CA203719). Citation Format: Seo Yun Kim, Heejung KIM, Wonshik Chee, Eun-ok Im. The relationship of socio-behavioral factors to the symptom experience of Asian American breast cancer survivors: a structural equation model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB145.

Trajectories of quality of life in breast cancer survivors during the first year after treatment: a longitudinal study

BackgroundAlthough quality of life (QOL) improves over time for most breast cancer patients after their treatment, some patients may show different patterns of QOL. Beyond determining distinct QOL trajectories, identifying characteristics of patients who have different trajectories can help identify breast cancer patients who may benefit from intervention. We aimed to identify trajectories of QOL in breast cancer patients for one year after the end of primary treatment, to determine the factors influencing these changes.MethodsThis longitudinal study recruited 140 breast cancer patients. Patients' QOL, symptom experience, self-efficacy, and social support were assessed using the Functional Assessment of Cancer Therapy Scale-G, Memorial Symptom Assessment Scale-Short Form, Self-Efficacy Scale for Self-Management of Breast Cancer, and Interpersonal Support Evaluation List-12. Data were collected immediately after the end of primary treatment (T1) and at three (T2), six (T3), and 12 months (T4) after primary treatment. Group-based trajectory modeling was used to identify distinct subgroups of patients with similar patterns of QOL change after treatment. A one-way analysis of variance was used to determine which variables were associated with trajectory membership. A multinomial logistic regression was performed to identify factors associated with trajectory group membership.ResultsWe analyzed 124 patients (mean age: 48.75 years). Latent class analysis of the QOL identified three trajectory groups: the low QOL group (n = 27; 21.1%), moderate QOL group (n = 57; 45.3%), and high QOL group (n = 40; 33.6%). The low QOL group showed consistently low QOL after the end of primary treatment, and the moderate QOL group showed a slight decrease in QOL from T1 to T3, which returned to the T1 level at T4. The high QOL group maintained a consistently high QOL. By multinomial logistic regression, psychological symptoms (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.22–0.99) predicted a moderate QOL, and both psychological symptoms (OR 0.19, 95% CI 0.07–0.51) and belonging support (OR 1.60, 95% CI 1.06–2.39) predicted a high QOL.ConclusionIdentifying high-risk groups for reduced QOL after the end of primary treatment is necessary. Moreover, psychosocial interventions should be provided to alleviate psychological symptoms and increase belonging support to enhance patients' QOL.Trial registration Not registered.

Validation of the Thai Version of the Memorial Symptom Assessment Scaled - Short Form Among Cholangiocarcinoma Patients.

The Memorial Symptom Assessment Scale-Short Form (MSAS-SF), a standard instrument for assessing cancer patients' symptoms, has been validated in numerous languages. However, it has not been validated in Thai. The purpose of this study was to translate the MSAS-SF into Thai and determine its psychometric properties in Cholangiocarcinoma (CCA) patients. The MSAS-SF was translated into Thai, and 231 CCA patients completed the questionnaires, which included baseline characteristics, T-MSAS-SF, Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep), and the Hospital Anxiety and Depression Scale (HADS). Cronbach's alpha coefficient was used to assess reliability for internal consistency. For convergent validity, Pearson's correlation coefficient was used to calculate the relationship between the T-MSAS-SF and the T-CaSUN, HADS, and FACT-Hep subscales. Subscale and total T-MSAS-SF internal consistency reliability was moderately high, with Cronbach alpha coefficients ranging from 0.76 to 0.87. For convergent validity, the majority of T-MSAS-SF scores had moderate to low inverse correlation with FACT-Hep, HADS T-CaSUN subscales with the correlation coefficients-0.10 to -0.68 (p<0.05), reflecting that they were measuring a similar construct. Our findings showed that the T-MSAS-SF has acceptable validity and reliability to assess the psychometric properties of early to advance stage CCA patients during treatment and early post-treatment stage.

Abstract 5881: The efficacy of a technology-based support program on survivorship experience: Asian American breast cancer survivors

Abstract Purpose: A technology-based intervention without face-to-face interactions could work better for many women from cultures where breast cancer is still a stigmatizing experience. Also, a technology-based intervention could meet the necessity of information and support without time and/or geographical restrictions. The purpose of this study was to test the efficacy of a technology-based support program for Asian American breast cancer survivors (TICAA) in enhancing the women’s breast cancer survivorship experience. Methods: This was a randomized controlled intervention with repeated measures (pretest [Time Point 0; T0], post 1-month [T1], and post 3-months [T2]). A total of 199 Asian American breast cancer survivors were recruited/retained through online and offline settings and included in the data analysis. While the intervention group was requested to use the TICAA and the American Cancer Society (ACS) website on breast cancer for 3 months, the control group was requested to use the ACS website for 3 months. Multiple instruments were used: the Cancer Behavior Inventory (CBI), the Personal Resource Questionnaire (PRQ), the Perceived Isolation Scale (PIS), the Support Care Needs Survey-34 Short Form (SCNS), the Memorial Symptom Assessment Scale-Short Form (MSAS), and the Functional Assessment of Cancer Therapy Scale-Breast Cancer (FACT-B). The data were analyzed using growth curve models, fitted within the framework of mixed effects modeling, and mediation analyses. Results: Within the mixed-effect model, there were significant decreases in the needs for help scores (SCNS scores) from T0 to T2 (β = -3.0236, p = .005) and the symptom distress scores (MSAS scores) from T0 to T1 and T2 (β = -2.8131, p &amp;lt; .001; β = -3.0356, p &amp;lt; .001). Yet, the change over time in the quality-of-life scores (FACT-B scores) was not statistically significant although the fixed effect of time was significant (β = -1.0476, p = .004). All the theory-based mediators (attitudes, self-efficacy, perceived barriers, and social influences) had statistically significant mediating impact on all outcome variables (needs for help, symptom distress, and quality-of-life; all p &amp;lt; .001), but there were differences in the mediating effects among different individual outcome variables. Conclusions: The findings supported the efficacy of the technology-based program in reducing the need for help and symptoms of Asian American breast cancer survivors. Further studies are needed on the differences in the effects of theory-based mediators on different outcome variables. Citation Format: Eun-Ok Im, Wonshik Chee, Sudeshna Paul, TICAA Research Team. The efficacy of a technology-based support program on survivorship experience: Asian American breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5881.

Abstract CT512: A technology-based intervention using computers and mobile devices: To improve symptom experience of Asian American breast cancer survivors

Abstract Purpose: Especially with the COVID19 pandemic, the necessity of technology-based interventions using computers and mobile devices has increased in cancer survivorship management including symptom management. However, little is known about the effectiveness of a technology-based intervention in improving symptom experience of racial/ethnic minorities including Asian American breast cancer survivors. The purpose of this study was to examine the efficacy of a technology-based intervention in improving symptom experience of Asian American breast cancer survivors. Methods: This study was conducted as a part of an ongoing randomized clinical trial among 199 Asian American breast cancer survivors. The technology-based intervention included three sub-ethnic specific social media sites, interactive online educational sessions, and online resources. Both groups (intervention and control groups) used the American Cancer Society’s website on breast cancer, and only the intervention group used the technology-based intervention. Only the data collected using the questionnaire on background characteristics and health/disease status and the Memorial Symptom Assessment Scale-Short Form (MSAS) were analyzed for this study. The data were analyzed using separate intent-to-treat growth curve models. Results: While both groups reported decreases in symptom scores from the pre-test to post 3-months (p&amp;lt;.01), the intervention group had larger decreases in symptom scores compared with the control group (p&amp;lt;.01). There existed significant group * time interactive effects on the Global Distress Index (β = - 0.234), the Physical Symptom Distress scores (β = -0.266), the psychological symptom distress scores (β = - 0.212c), the total number of symptoms (β = -0.261), and the total symptom distress scores ( β = -0.261). Conclusions: The findings of this study clearly indicated symptom improvement among Asian American breast cancer survivors by a technology-based intervention using computers and mobile devices. Further studies with diverse racial/ethnic minorities are warranted to confirm the effectiveness of technology-based interventions in improving symptom experience of cancer survivors across different types of cancer. Citation Format: Eun-Ok Im, Gayeong Kim, Ruiqi Jin, Mi-Yong Choi, Sudeshna Paul, Wonshik Chee. A technology-based intervention using computers and mobile devices: To improve symptom experience of Asian American breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT512.

The Acceptability and Feasibility of Routine Use of Validated Cancer Symptom Assessment Instruments Among Patients and Nurses in the Oncology Ward at Princess Marina Hospital, in Gaborone, Botswana.

This cross-sectional study evaluated the acceptability and feasibility of oncology nurses using validated cancer symptom assessment instruments to assess symptom burden. A consecutive sample of cancer patients and oncology ward nurses at a hospital in Gaborone, Botswana, was used. Patients' symptom burden was assessed using the Memorial Symptom Assessment Scale-Short Form and the Visual Analog Scale-Pain, and patient- and nurse-acceptability data were assessed using the Client Satisfaction Questionnaire and the Intervention Rating Profile. Rates of participation, assessment length of time, and rates of completed Memorial Symptom Assessment Scale-Short Form and Visual Analog Scale-Pain determined feasibility. The sample included 124 patients (female, 84) and 20 nurses (female, 14). The mean (SD) Client Satisfaction Questionnaire score was 30.1 (2.8; minimum-maximum, 19-32), and the mean (SD) Intervention Rating Profile score was 86.8 (4.3; minimum-maximum, 74-90). There was a significant difference in the scores of the Intervention Rating Profile between preassessment (mean [SD], 80.1 [6.0]) and postassessment (mean [SD], 86.8 [4.3]; t19 = -4.853, P < .001). All patient participants (100%) completed assessments. The routine nursing assessment was acceptable to and feasible among patients and nurses. Nurses can integrate validated instruments into routine nursing assessment to determine patients' symptom burden for quick referrals to palliative care.

Remote Monitoring of the Performance Status and Burden of Symptoms of Patients With Gastrointestinal Cancer Via a Consumer-Based Activity Tracker: Quantitative Cohort Study.

BackgroundThe number of older patients with gastrointestinal cancer is increasing due to an aging global population. Minimizing reliance on an in-clinic patient performance status test to determine a patient’s prognosis and course of treatment can improve resource utilization. Further, current performance status measurements cannot capture patients' constant changes. These measurements also rely on self-reports, which are subjective and subject to bias. Real-time monitoring of patients' activities may allow for a more accurate assessment of patients’ performance status while minimizing resource utilization.ObjectiveThis study investigates the validity of consumer-based activity trackers for monitoring the performance status of patients with gastrointestinal cancer.MethodsA total of 27 consenting patients (63% male, median age 58 years) wore a consumer-based activity tracker 7 days before chemotherapy and 14 days after receiving their first treatment. The provider assessed patients using the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scale and Memorial Symptom Assessment Scale-Short Form (MSAS-SF) before and after chemotherapy visits. The statistical correlations between ECOG-PS and MSAS-SF scores and patients’ daily step counts were assessed.ResultsThe daily step counts yielded the highest correlation with the patients' ECOG-PS scores after chemotherapy (P<.001). The patients with higher ECOG-PS scores experienced a higher fluctuation in their step counts. The patients who walked more prechemotherapy (mean 6071 steps per day) and postchemotherapy (mean 5930 steps per day) had a lower MSAS-SF score (lower burden of symptoms) compared to patients who walked less prechemotherapy (mean 5205 steps per day) and postchemotherapy (mean 4437 steps per day).ConclusionsThis study demonstrates the feasibility of using inexpensive, consumer-based activity trackers for the remote monitoring of performance status in the gastrointestinal cancer population. The findings need to be validated in a larger population for generalizability.

Characteristics of Asian-American Breast Cancer Survivors Retained in a 3-Month Technology-Based Intervention.

Technology-based intervention programs are known to be effective in approaching socially excluded groups or racial/ethnic minorities, including this specific population. However, the retention of participants in technology-based intervention studies is far more complicated and challenging compared with conventional studies targeting racial/ethnic minorities. This study aimed to identify the complex characteristics of the groups within Asian American breast cancer survivors who were successfully retained in a 3-month technology-based intervention study. This secondary analysis of the data from a larger ongoing intervention study included 155 Asian American breast cancer survivors. Major variables were measured using multiple instruments including the questions on characteristics of the participants, the Personal Resource Questionnaire, perceived isolation, Memorial Symptom Assessment Scale-Short Form, Cancer Behavior Inventory, 34-item Supportive Care Needs Survey Short Form, and Functional Assessment of Cancer Therapy Scale-Breast Cancer. Data analyses were done through χ2 tests, t tests, and decision tree analyses. The retention rates differed by subethnicity (P = .025), immigration age (P < .001), and stage of breast cancer (P = .003). The decision tree indicated four groups with the highest probability of retention: (a) those who were diagnosed with stage II, III, or IV breast cancer, (b) those who immigrated to the United States after turning 31 years old, and (c) those who had high perceived barriers. This study provides directions for future retention strategies for technology-based interventions among Asian American breast cancer survivors. Participants' characteristics need to be considered in developing retain strategies for technology-based interventions among Asian American breast cancer survivors.

Determinants of quality of life in women immediately following the completion of primary treatment of breast cancer: A cross-sectional study.

BackgroundsMany breast cancer patients experience significant distress immediately following the completion of primary treatment. Women who report low levels of quality of life (QOL) early in this phase of transitional survivorship tend to experience diminished long-term adjustment. However, since most of the prior studies on survivors were conducted on patients at various times, studies on QOL of women during the end of primary treatment have been insufficient. This study aimed to identify determinants of QOL in women with breast cancer immediately following the completion of treatment.MethodsA cross-sectional study was conducted on 140 disease-free breast cancer patients who had completed therapy in the past 1 month at university hospitals. Functional Assessment of Cancer Therapy-Breast (FACT-B), Memorial Symptom Assessment Scale-Short Form (MSAS-SF), Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B), and Interpersonal Support Evaluation List-12 (ISEL-12) scales were used to assess predictors and QOL. The data were analyzed using the Pearson correlation, t-test, ANOVA, and hierarchical multiple regression.ResultsThe mean score of QOL for breast cancer survivors was 97.23 (±20.01). Chemotherapy and perceived economic status were significantly associated with QOL in terms of sociodemographic and disease/treatment-related characteristics. Physical and psychological symptoms and social support had a significant association with QOL. The regression analyses showed that physical and psychological symptoms and belonging support were statistically significant in predicting the QOL of breast cancer survivors.ConclusionsThe variables of symptom experience and social support must be acknowledged when improving women’s QOL immediately after their completion of primary breast cancer treatment. Greater focus on the reduction of symptom distress and increasing a sense of belonging could improve QOL among breast cancer survivors.

A Decision Tree Analysis on the Impact of a Technology-Based Program on Symptom Distress: Asian American Breast Cancer Survivors.

Using a decision tree analysis, this study aimed to identify the characteristics of the groups within Asian American breast cancer survivors whose symptom distress scores were effectively improved by a technology-based program. This was a secondary analysis of the data from an ongoing randomized controlled trial among 115 Asian American breast cancer survivors. The instruments were questions on background factors; the Memorial Symptom Assessment Scale-Short Form; the Cancer Behavior Inventory; the Questions on Attitudes, Subjective Norm, Perceived Behavioral Control, and Behavioral Intention; and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using chi-square tests, t tests, repeated measurement analyses, and decision tree analyses. The decrease in the global distress index scores was the largest (1.253 points) among those with high psychological support needs. The decrease in the physical symptom distress scale scores was the largest (1.133 points) among those with high physical and daily living support needs who had a short US residence period and who were young. The decrease in the psychological symptom distress scores was the largest (1.511) among those with high psychological support needs. The findings suggest several characteristics of the groups within Asian American breast cancer survivors whose symptom distress could be highly improved by a technology-based intervention.

Sub-Ethnicity and Survivorship Experience: Asian American Breast Cancer Survivors.

The purpose of the study was to explore the associations of sub-ethnicity to the survivorship experience of Asian American breast cancer survivors and identify the multiple factors that influenced their survivorship experience. This was a secondary analysis of the data among 94 Asian American breast cancer survivors from a larger ongoing study. Instruments included: questions on background characteristics, the perceived isolation scale, the Personal Resource Questionnaire, the Memorial Symptom Assessment Scale-Short Form, and the Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using hierarchical logistic and multiple regression analyses. After controlling for other factors, being a Japanese American (ref. = being a Chinese American) was significantly associated with pain scores (odds ratio [OR] = -0.32, p < .01), symptom distress scores (β = -0.27, p < .01), and the quality of life scores (β = 0.22, p = .03). Sub-ethnic variations in cultural attitudes, values, and beliefs need to be considered in future research/practice with Asian American breast cancer survivors.

Abstract CT147: The impact of a technology based program on symptom distress among Asian American breast cancer survivors

Abstract Purpose: Asian American breast cancer survivors are reported to experience physical and psychological symptoms that could be easily avoidable because of their cultural stigma and hesitance related to breast cancer. Also, they are more likely to have delays in getting help, information, and support. Studies have indicated a dire need to support Asian American breast cancer survivors in their symptom management while considering their cultural hesitance and stigma. Technology-based programs using computers and mobile devices are reported to help improve symptom experience of cancer survivors including Asian American breast cancer survivors. The purpose of this study was to decide the specific characteristics of Asian American breast cancer survivors whose symptom distress was effectively improved by a technology-based program. Methods: This study was a part of a randomized controlled trial among 115 Asian American breast cancer survivors. The instruments included: multiple questions on background factors and disease factors, the Cancer Behavior Inventory, the Questions on Attitudes, Subjective Norm, Perceived Behavioral Control, and Behavioral Intention, the Memorial Symptom Assessment Scale-Short Form, and the Supportive Care Needs Survey-Short Form 34. The data analysis was done through chi-square tests, t-tests, repeated measurement analyses, and decision tree analyses. Results: The interactions between time and group were significant in the changes of the global distress index (GDI) and physical symptom distress (PHYS) scores (p&amp;lt;.05). Those with high psychological support needs had the largest decrease in the GDI scores (1.253 points). Those with high physical and daily living support needs who had a short U.S. residence period and who were young had the largest decrease in the PHYS scores (1.133 points). Those with high psychological support needs had the largest decrease in the psychologic symptom distress scores (1.511 points). Conclusions: The findings of this study indicated several characteristics of Asian American breast cancer survivors whose symptom distress was highly decreased by a technology-based intervention (e.g., those who had a short U.S. residence period, those who were young, etc.). These characteristics need to be considered in the future design and implementation of a technology-based intervention among this specific population. Table 1.Changes in the Symptom Distress scores (n=115).PrePost 1 monthPost 3 monthspPost 3 months- PrepM±SDM±SDM±SDtime *groupM±SDCont. vs. Int.GDICont.1.410±0.6921.445±0.6631.438±0.628.0210.028±0.534.012Int.1.543±0.6961.326±0.6071.325±0.589-0.218±0.498Total1.475±0.6941.387±0.6361.383±0.609-0.092±0.529PHYSCont.1.170±0.5321.242±0.5601.260±0.567.0070.090±0.506.002Int.1.292±0.6131.155±0.5761.089±0.500-0.202±0.459Total1.229±0.5741.199±0.5671.177±0.540-0.052±0.503PSYCHCont.1.525±0.8411.502±0.7551.506±0.740.136-0.019±0.722.157Int.1.657±0.8491.389±0.6881.453±0.704-0.204±0.672Total1.589±0.8431.447±0.7221.480±0.720-0.109±0.702 Citation Format: Eun-Ok Im, Jee-Seon Yi, Wonshik Chee. The impact of a technology based program on symptom distress among Asian American breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr CT147.

Symptom prevalence, burden and correlates among people living with HIV in Vietnam: a two-centre self-report study

ABSTRACT Physical and psychological symptoms among people living with HIV (PLWH) adversely affect quality of life and treatment adherence. Study objectives were: (i) to determine validity and reliability of a Vietnamese translation of the Memorial Symptom Assessment Scale–Short Form (MSAS-SF) among PLWH in Vietnam; (ii) to measure prevalence and burden of physical and psychological symptoms using the MSAS-SF including the Global Distress Index (GDI), Physical Distress subscale (PHYS), and Psychological Distress subscale (PSY); (iii) to identify symptom burden risk factors. We recruited 567 patients. Cronbach’s alpha scores were: total MSAS-SF 0.91, GDI 0.83, PHYS 0.85, PSYCH 0.81. The scale showed good discriminant validity (low vs high function) (p < 0.001). The mean number of symptoms was 7.66, and the most prevalent were “worrying” (41.6%), “lack of energy” (40.6%), “feeling irritable” (40.4%), and “feeling sad” (39.2%). Monthly income below the poverty line was independently associated with increased: GDI,, PHYS, and PSY and a greater number of symptoms. The Vietnamese version of the MSAS-SF is valid to measure symptom prevalence and burden in HIV-positive populations. Here is a high symptom prevalence and burden among PLWH in Vietnam, especially those living in poverty, and a great need for palliative care integrated with HIV treatment.