Behaviors and Mental Disorders

All Conditions

Behavioral Symptoms

Background Improving patient-provider communication is a fundamental and cost-effective method to advance patient outcomes, including symptom management which is often the primary goal of care for patients with advanced cancer. Unfortunately, some studies revealed the poor quality of symptom communication among cancer patients and healthcare providers. While these evidences suggest important gaps in communication about symptoms with some of the most vulnerable patients, little is known about the patterns and associating factors of symptom communication.

Purpose and Specific Aims The proposed 3-year pilot project aims to provide an enrich and systematic description of symptom communication by validating a newly developed typology of interaction patterns of symptom communication (TIPSC) between patients with advanced cancer, their caregivers, and healthcare providers and explore factors related to each interaction pattern. The specific aims are to: (1) validate TIPSC in Taiwanese advanced cancer population, (2) explore patients' /caregivers' experience and thoughts of symptom discussion in regard to their interaction patterns and symptom management, and (3) examine relationships between interaction patterns and (a) demographic factors, (b) symptom severity, (c) congruence in symptom assessment between patients/caregivers and providers, (d) patients'/caregivers' perceived ability to communicate with providers, and (e) patient/caregiver satisfaction.

Sampling This pilot study plans to recruit about 50 patient/caregiver - oncologist dyads. The recruitment process contains three stages. First, medical oncologists who are currently in clinical practice at participating institutions and care for patients with solid tumors will be approached. Second, participating oncologists' patients will be recruited if they are: (1) currently a patient of a participating oncologist, (2) diagnosed with stage III or IV solid cancer, (3) aged 20 years or older, (4) able to tolerate an interview that will last approximately 30 minus, and (5) able to speak Chinese or Taiwanese. Finally, if applicable, adult caregivers who intent to join selected out-patient-department (OPD) visit with the patients will also be recruited.

Research Design This is a mixed-methods study with a two-phase exploratory sequential design. The first phase is a qualitative descriptive study in which the investigators will record patient/caregiver-oncologist OPD visits and conduct patient/caregiver interviews to address aim 1 and 2. Discourse and conversation analysis will be used to analyze the recorded visits and content analysis will be used to analyze the interviews. The second phase is a correlational study in which the investigators use questionnaires to measure variables and examine their relationship with interaction patterns (aim 3). Descriptive statistics, binomial logistic regression, and linear regression will be used to analyze quantitative data.

Expecting Results This is a pioneering study addressing the patterns and associating factors of symptom communication in Taiwanese patients with advanced cancer. The findings will systematically map out the patient/caregiver-provider symptom communication and identify relationships between communication patterns and meaningful indicators. This proposed study is a critical step to understand patient/caregiver-provider communication regarding symptoms in order to pinpoint symptom management and communication barriers and design proper interventions in Taiwan.

Symptom Communication in Advanced Cancer

A Mixed-Methods Pilot Study of Symptom Communication in Advanced Cancer: Patterns and Associating Factors

congruence of symptom management between patients and providers

Ministry of Science and Technology, Taiwan

National Taiwan University Hospital

Neoplasms

Heart and Blood Diseases

Blood and Lymph Conditions

Immune System Diseases

Rare Diseases

Multiple Myeloma

Neoplasms, Plasma Cell

Neoplasms by Histologic Type

Hemostatic Disorders

Blood Coagulation Disorders

Vascular Diseases

Paraproteinemias

Blood Protein Disorders

Hematologic Diseases

Hemorrhagic Disorders

Lymphoproliferative Disorders

Immunoproliferative Disorders

Quality of Life

This research study's procedures include screening for eligibility, participant designation of a caregiver and a series of questionnaires.

* Patients will be asked to identify a caregiver (e.g. a relative or friend) upon whom they rely for help and has an in-person contact with the patient at least 2x per week.
* Both patients with or without identified caregivers will complete a one time series of questionnaires.

  * The questionnaires are completed one time only and measure quality of life, mood, coping strategies, and prognostic understanding and can be completed in the hospital, clinic, over the email, or telephone with assistance provided as needed.Questionnaires take approximately 20 minutes to complete.

This research study's procedures include screening for eligibility, participant designation of a caregiver and a series of questionnaires.

* Patients will be asked to identify a caregiver (e.g. a relative or friend) upon whom they rely for help and has an in-person contact with the patient at least 2x per week.
* Both patients with or without identified caregivers will complete a one time series of questionnaires.

  * The questionnaires are completed one time only and measure quality of life, mood, coping strategies, and prognostic understanding and can be completed in the hospital, clinic, over the email, or telephone with assistance provided as needed.Questionnaires take approximately 20 minutes to complete

Series of questions covering quality of life, physical and psychological symptom burden, mood, and illness and prognostic understanding administered in person or remotely.

Questionnaire

Elizabeth K O'Donnell, MD

Jacalyn Rosenblatt, MD

Omar Nadeem, MD

The main purpose of this study is to examine differences in quality of life and psychological distress for both Multiple Myeloma patients receiving treatment and their caregivers and to assess patient and caregiver prognostic understanding (understanding of the likely course of a disease over time) of Multiple Myeloma to guide development of more personalized treatment plans.

This study looks to further understand quality of life changes throughout multiple myeloma therapy for both patients and caregivers to help determine ways to improve patient and caregiver understanding of illness and in turn, tailor customized treatment that best aligns with patient preferences.

The study will use a series of questionnaires to measure quality of life, mood, coping strategies, and prognostic understanding.

This research study's procedures include screening for eligibility, participant designation of a caregiver and a series of questionnaires.

- It is expected that about 180 people undergoing treatment for multiple myeloma and up to 180 of their caregivers will take part in this research study.

-- The questionnaires are completed one time only and measure quality of life, mood, coping strategies, and prognostic understanding and can be completed in the hospital, clinic, over the email, or telephone with assistance provided as needed.Questionnaires take approximately 20 minutes to complete.

Multiple Myeloma (MM) Quality of Life (QOL) Study

Quality of Life and Psychological Distress in Patients With Multiple Myeloma and Their Caregivers

The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: \[contact information for Sponsor Investigator or designee\]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.

Describe patient QOL scores by lines of therapy. Functional Assessment of Cancer Therapy-Multiple Myeloma(FACT-MM) will be used to assess QOL, which has been validated for use in multiple care settings.\[10\]. The FACT-MM consists of four subscales assessing well-being across four domains (physical, functional, emotional, and social). These self-reported measures possess strong psychometric properties and have been validated for patients with cancer \[Appendix E\].

Describe cargiver QOL scores by associated patient line of therapy

Describe and compare patient QOL Functional Assessment of Cancer Therapy-Multiple Myeloma (FACT-MM) scores by line of therapy. The FACT-MM consists of four subscales assessing well-being across four domains (physical, functional, emotional, and social). These self-reported measures possess strong psychometric properties and have been validated for patients with cancer

Describe and compare patient symptoms (ESAS) scores by line of therapy. The Edmonton Symptom Assessment System (ESAS) will be used to ascertain the symptom burden experienced by patients. This previously validated survey assesses nine symptoms frequently reported by patients with cancer: pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath \[

Describe and compare patient fatigue symptoms (FACIT-Fatigue) by line of therapy.

The Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-Fatigue), a 13-item FACIT subscale specific to fatigue that measures an individual's level of fatigue during their usual daily activities over the past week.\[13, 14\] The level of fatigue is measured on a 4-point Likert scale .

Describe and compare patient anxiety and depression symptoms Hospital Anxiety and Depression Scale (HADS) to assess symptoms of depression and anxiety in all study participants. The HADS is a 14-item questionnaire that contains two 7-item subscales assessing depression and anxiety symptoms during the past week.. Scores on each subscale range from 0 to 21, with a cutoff of 8 or greater denoting clinically significant anxiety or depression

Describe and compare patient anxiety and depression symptoms Hospital Anxiety and Depression Scale Hospital Anxiety and Depression Scale (HADS) to assess symptoms of depression and anxiety in all study participants. The HADS is a 14-item questionnaire that contains two 7-item subscales assessing depression and anxiety symptoms during the past week.. Scores on each subscale range from 0 to 21, with a cutoff of 8 or greater denoting clinically significant anxiety or depression

Describe and compare post-traumatic stress symptoms (PCL-C) by line of therapy The Post-Traumatic Stress Disorder Checklist (PCL) to assess symptoms of post-traumatic stress in patients and caregivers. The PCL is a 17 item self-reported measure that evaluates symptoms of post traumatic stress disorder according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV

Describe and compare patient coping (Brief Cope) by line of therapy. The Brief Cope, a 28-item questionnaire that assess 14 methods of coping (e.g., self-distraction, humor, denial) using a 4-point Likert scale

Describe and compare caregiver burden and QOL (CARGOQOL) scores by line of therapy. CareGiver Oncology QOL questionnaire (CARGOQOL) will be used to measure caregiver QOL. The CarGOQOL is a 29-item well-validated instrument to measure QOL in multiple domains.

Describe and compare caregiver anxiety and depression symptoms (caregiver HADS) by line of therapy. The Hospital Anxiety and Depression Scale will be used to (HADS) to assess symptoms of depression and anxiety in all study participants (patients and family caregivers). The HADS is a 14-item questionnaire that contains two 7-item subscales assessing depression and anxiety symptoms during the past week. Scores on each subscale range from 0 to 21, with a cutoff of 8 or greater denoting clinically significant anxiety or depression

Describe and compare caregiver anxiety and depression symptoms (caregiver HADS) by line of therapy. The Hospital Anxiety and Depression Scale will be used to (HADS) to assess symptoms of depression and anxiety in all study participants (patients and family caregivers). The HADS is a 14-item questionnaire that contains two 7-item subscales assessing depression and anxiety symptoms during the past week. . Scores on each subscale range from 0 to 21, with a cutoff of 8 or greater denoting clinically significant anxiety or depression

Describe and compare caregiver coping (Brief Cope) Brief Cope, a 28-item questionnaire that assess 14 methods of coping (e.g., self-distraction, humor, denial) using a 4-point Likert scale

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Symptom Communication in Advanced Cancer	NCT05667571	Communication Cancer Symptom, Behavi...		20 Years -	National Taiwan University Hospital
Multiple Myeloma (MM) Quality of Life (QOL) Study	NCT04388735	Multiple Myelom... Quality of Life Symptom, Behavi...	Questionnaire	18 Years -	Massachusetts General Hospital
Multiple Myeloma (MM) Quality of Life (QOL) Study	NCT04388735	Multiple Myelom... Quality of Life Symptom, Behavi...	Questionnaire	18 Years -	Massachusetts General Hospital

Spots Global Cancer Trial Database for symptom, behavioral