Development of an evidence-based educational resource in oncology: 'Living safely with bone metastases'.

Objective: To create an evidence-based patient education resource to better support cancer patients with bone metastases in carrying out safe movements during activities of daily living, to maintain their bone health and reduce the risk of fractures. Methods: A quality improvement project was conducted in three phases: Development of the Resource, Preliminary Feedback and Revision, and French Canadian Translation. Results: The educational resource Living Safely with Bone Metastases focuses on safe movement, activities of daily living, and exercise, organized within the sections Move with care, Stay safe in different environments and Follow an exercise program prescribed by a physiotherapist. Translation yielded a Canadian French version Vivre en toute sécurité avec des métastases osseuses. Conclusion: Living Safely with Bone Metastases is an accessible online and paper resource for patients and healthcare professionals, in order to promote ongoing disease management of individuals with bone metastases. Innovation: Cancer patients with bone metastases are at high risk of pathological fractures however resources on fracture prevention are lacking. Living Safely with Bone Metastases is an innovative health education resource that fills an important gap in oncology practice and has the potential to reduce the occurrence of fractures.

Psychometric Testing of the CHAMPS Questionnaire in French Canadians with COPD.

Physical activity is an important health behaviour in reducing morbidity and mortality in individuals with chronic obstructive pulmonary disease (COPD). Accurate measurement of the characteristics of physical activity is essential to understanding the impact of COPD on physical activity. In a previous article, we reported on the cross-cultural adaptation of the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to produce a Canadian French version. The CHAMPS yields four summary scores: two caloric expenditure scores (moderate-intensity activities and all activities) and two frequency scores (moderate-intensity activities and all activities). The objective of this study was to evaluate test-retest reliability and convergent construct validity, in both English and French versions of the CHAMPS, in individuals with COPD. Test-retest reliability was assessed by administering the CHAMPS at two visits (2-3 weeks apart), to 19 English-speaking and 18 French-speaking participants. Validity was assessed in 56 English-speaking and 74 French-speaking participants, who completed the CHAMPS, Short Form- (SF-) 36, and St. George's Respiratory Questionnaire (SGRQ) at a single visit. Results from reliability testing indicated that intraclass correlation coefficients (ICCs) generally met the threshold for good reliability (ICC > 0.6), with frequency scores showing greater stability than caloric expenditure scores. Validity testing yielded moderate correlations (r = 0.4-0.5) of the CHAMPS with the SF-36 domains and summary score capturing constructs of physical function, and with the SGRQ activity domain and total score. CHAMPS frequency scores for moderate-intensity activities correlated more strongly than other scores, with physical aspects of the SF-36 and SGRQ. The English and French versions of the CHAMPS did not show any substantial differences in reliability (frequency scores) or validity (frequency and caloric expenditure scores). Findings from this study support the reliability and validity of the CHAMPS. In particular, frequency scores for moderate-intensity activities can provide useful information on physical activity levels in individuals with COPD. This trial is registered with NCT00169897. ISRCTN registration number: IRSCTN32824512.

Cross-Cultural Adaptation of the CHAMPS Questionnaire in French Canadians with COPD.

Physical activity is difficult to measure in individuals with COPD. The Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire demonstrated strong clinometric properties when used with the elderly and with those affected by chronic disease. Study objectives were to translate, culturally adapt the CHAMPS into French, and reexamine its test-retest reliability and construct validity in French and English Canadians with COPD. This paper presents the cross-cultural adaptation of the CHAMPS; results of its clinometric testing will be described in another article. The CHAMPS examines the degree of physical activity performed in a typical week through two summary scales, caloric expenditure and activity frequency. The CHAMPS was only in English; thus, a cross-cultural adaptation was needed to translate the CHAMPS into French for use in French Canadians with COPD. Cross-cultural adaptation consisted of forward and back translation, with expert review at each stage of translation: minor inconsistencies were uncovered and rectified. Five French participants with COPD completed the finalized Canadian French CHAMPS and participated in cognitive debriefing; no problematic items were identified. A structured and stepwise, cross-cultural adaptation process produced the Canadian French CHAMPS, with items of equivalent meaning to the English version, for use in French Canadians with COPD.

Incorporating the International Classification of Functioning, Disability, and Health (ICF) into an electronic health record to create indicators of function: proof of concept using the SF-12.

OBJECTIVE: The purpose of this proof-of-concept study was to assess the feasibility of using a generic health measure to create coded functional status indicators and compare the characterization of a stroke population using coded functional indicators and using health-related quality-of-life summary measures alone. DESIGN: Multiple raters assigned International Classification of Functioning, Disability, and Health (ICF) codes to the items of the 12-Item Short Form Health Survey (SF-12). Data for comparing the information from the SF-12 and from ICF codes were derived from the Montreal Stroke Cohort Study that was set up to examine the long-term impact of stroke. Available for analysis were data from 604 persons with stroke, average age 69 years, and 488 controls, average age 62 years. MEASUREMENT: The SF-12 provides two summary scores, one for physical health and one for mental health. Domains of the ICF are coded to three digits, before the decimal; specific categorizations of impairments, activity limitations, and participation restrictions are coded to four digits before the decimal. RESULTS: Persons with stroke scored, on average, approximately 10 points lower than controls on physical and mental health. The ICF coding indicated that this was attributed, not surprisingly, to greater difficulty in doing moderate activities including housework, climbing stairs, and working and was not attributed to differences in pain. Differences in mental health were attributed most strongly to greater fatigue (impairment in energy), but all areas of mental health were affected to some degree. CONCLUSION: The ICF coding provided enhanced functional status information in a format compatible with the structure of administrative health databases.