Stress-Related Growth Scale-Short Form: A Portuguese validation for cancer patients / Stress-Related Growth Scale-Short Form: validación portuguesa en pacientes con cáncer

Background/Objective: Cancer can be extremely disruptive, triggering high levels of distress, and at the same time transformative, promoting perceptions of positive life changes and growth. This study aims to analyze the psychometric proprieties of the Stress-Related Growth Scale Short-Form (SRGS-SF) in cancer patients. Method: 209 Cancer patients heterogeneous in disease stage and diagnosis completed: clinical and sociodemographic information, Distress Thermometer, Positive and Negative Affect Schedule, Visual-analogue Scale of Perceived Positive Life Changes, and Stress-Related Growth Scale-Short Form. Results: The analysis of internal structure pointed to an one-dimensional scale, with high reliability (.92) measured through the McDonald`s omega coefficient. Validity was also evidenced through significant correlations with other variables. Conclusions: The Portuguese version of the SRGS-SF seems to present the necessary psychometric proprieties to be considered a valid and reliable short tool, to assess perceptions of growth following cancer and contribute to targeted and integrative psycho-oncological interventions. (AU)

Antecedentes/Objetivo: El cáncer puede ser extremadamente disruptivo y transformador al mismo tiempo, provocando altos niveles de angustia que pueden promover la percepción de cambios positivos en la vida y crecimiento. Este estudio tiene como objetivo analizar las propiedades psicométricas de la Stress-Related Growth Scale-Short Form (SRGS-SF) en pacientes con cáncer. Método: 209 pacientes con cáncer heterogéneo en estadio de la enfermedad y diagnóstico han completado información clínica y sociodemográfica, Distress Thermometer, Positive and Negative Affect Schedule, Escala visual-analógica de los cambios de vida positivos percibidos y Stress-Related Growth Scale-Short Form. Resultados: El análisis de la estructura interna apuntó una estructura unifactorial con índices de ajuste adecuados y una alta fiabilidad (.92) evaluada a través del coeficiente omega de McDonald. La validez fue proporcionada a través de la evidencia de correlaciones significativas con otras variables. Conclusiones: La versión portuguesa del SRGS-SF parece presentar las propiedades psicométricas necesarias para ser considerada una herramienta corta válida y confiable, para evaluar las percepciones de crecimiento después del cáncer y contribuir para intervenciones psico-oncológicas específicas e integradoras. (AU)

Stress-Related Growth Scale-Short Form: A Portuguese validation for cancer patients.

ABSTRACT BACKGROUND/OBJECTIVE: Cancer can be extremely disruptive, triggering high levels of distress, and at the same time transformative, promoting perceptions of positive life changes and growth. This study aims to analyze the psychometric proprieties of the Stress-Related Growth Scale Short-Form (SRGS-SF) in cancer patients. METHOD: 209 Cancer patients heterogeneous in disease stage and diagnosis completed: clinical and sociodemographic information, Distress Thermometer, Positive and Negative Affect Schedule, Visual-analogue Scale of Perceived Positive Life Changes, and Stress-Related Growth Scale-Short Form. RESULTS: The analysis of internal structure pointed to an one-dimensional scale, with high reliability (.92) measured through the McDonald`s omega coefficient. Validity was also evidenced through significant correlations with other variables. CONCLUSIONS: The Portuguese version of the SRGS-SF seems to present the necessary psychometric proprieties to be considered a valid and reliable short tool, to assess perceptions of growth following cancer and contribute to targeted and integrative psycho-oncological interventions.

RESUMEN ANTECEDENTES/OBJETIVO: El cáncer puede ser extremadamente disruptivo y transformador al mismo tiempo, provocando altos niveles de angustia que pueden promover la percepción de cambios positivos en la vida y crecimiento. Este estudio tiene como objetivo analizar las propiedades psicométricas de la Stress-Related Growth Scale-Short Form (SRGS-SF) en pacientes con cáncer. MÉTODO: 209 pacientes con cáncer heterogéneo en estadio de la enfermedad y diagnóstico han completado información clínica y sociodemográfica, Distress Thermometer, Positive and Negative Affect Schedule, Escala visual-analógica de los cambios de vida positivos percibidos y Stress-Related Growth Scale-Short Form. RESULTADOS: El análisis de la estructura interna apuntó una estructura unifactorial con índices de ajuste adecuados y una alta fiabilidad (.92) evaluada a través del coeficiente omega de McDonald. La validez fue proporcionada a través de la evidencia de correlaciones significativas con otras variables. CONCLUSIONES: La versión portuguesa del SRGS-SF parece presentar las propiedades psicométricas necesarias para ser considerada una herramienta corta válida y confiable, para evaluar las percepciones de crecimiento después del cáncer y contribuir para intervenciones psico-oncológicas específicas e integradoras.

The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study.

BACKGROUND: Decision-making in palliative care can be complex due to the uncertain prognosis and general fear surrounding decisions. Decision-making in palliative care may be influenced by spiritual and cultural beliefs or values. Determinants of the decision-making process are not completely understood, and spirituality is essential for coping with illness. Thus, this study aims to explore the influence of spirituality on the perception of healthcare decision-making in palliative care outpatients. METHODS: A cross-sectional study was developed. A battery of tests was administered to 95 palliative outpatients, namely: sociodemographic questionnaire (SQ), Decisional Conflict Scale (DCS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale (FACIT-Sp), and a semi-structured interview (SSI) to study one's perception of spirituality and autonomy in decision-making. Statistical analyses involved descriptive statistics for SQ and SSI. The Mann-Whitney test was used to compare scale scores between groups and correlations were used for all scales and subscales. The analysis of patients' definitions of spirituality was based on the interpretative phenomenological process. RESULTS: Spiritual wellbeing significantly correlated with greater levels of physical, emotional and functional wellbeing and a better quality of life. Greater spiritual wellbeing was associated with less decisional conflict, decreased uncertainty, a feeling of being more informed and supported and greater satisfaction with one's decision. Most patients successfully implemented their decision and identified themselves as capable of early decision-making. Patients who were able to implement their decision presented lower decisional conflict and higher levels of spiritual wellbeing and quality of life. Within the 16 themes identified, spirituality was mostly described through family. Patients who had received spiritual care displayed better scores of spiritual wellbeing, quality of life and exhibited less decisional conflict. Patients considered spirituality during illness important and believed that the need to receive spiritual support and specialised care could enable decision-making when taking into consideration ones' values and beliefs. CONCLUSION: The impact of spiritual wellbeing on decision-making is evident. Spirituality is a key component of overall wellbeing and it assumes multidimensional and unique functions. Individualised care that promotes engagement in decision-making and considers patients' spiritual needs is essential for promoting patient empowerment, autonomy and dignity.

[Demoralization: introducing the concept and its importance for palliative care]. / Desmoralização: o conceito e a importância para cuidados paliativos.

Demoralization refers to a persistent failure of coping with stress as defined by Jerome Frank thirty years ago. Feelings of despair, isolation, hopelessness, loss of meaning and existential distress are the core features of the definition of demoralization. It is frequently associated with a chronic medical illness, fear of loss of dignity and perception of being a burden on others and it evolves to a desire to die. The authors reviewed the literature related to this concept and present the evidence related to the diagnosis, classification, treatment and relation of demoralization with the palliative care setting.

Breaking bad news: experiences and preferences of advanced cancer patients at a Portuguese oncology centre.

The disclosure of information to patients about diagnosis and prognosis and other aspects of care is still a matter of debate. We have conducted a study in advanced cancer patients about their experiences and preferences concerning this issue. A questionnaire was developed and completed during the first appointment in the outpatient clinic of an oncology centre's palliative care unit, before the patient had any contact with the staff of the unit. The study was conducted on a convenience sample of 47 patients. We found that 34 (72%) of those patients thought they had been informed of their diagnosis, most of them by the hospital doctor. However, not all stated the diagnosis in a manner clearly showing that they were aware of the nature of their disease. Most patients were with a family member when the diagnosis was disclosed, which is what the majority had preferred. Of the 13 uninformed patients, only one preferred to remain uninformed. Most patients (89%) participated in decisions concerning treatment, although only 68% thought they should have participated. Some 39 patients (83%) were informed that they were being referred to the palliative care unit, but surprisingly only eight had received an explanation of the unit's function. We concluded that, although most patients had been informed of their disease, there remains many problems, the most important of which, in our view, is the difference between the information provided and the patients' needs.