22.5 Research into Psychosocial Issues

Question 1

List a key difference in the focus of quantitative scales and qualitative data

Answer 1

Quantitative scales record responses to items that researchers consider important

Qualitative data reveal what is important to participants

Question 2

List 3 quantitative rating scales that measure anxiety/fear

Answer 2

See table 22.5.1

1. Generalized anxiety disorder-7 (GAD-7)
2. Beck Anxiety Inventory
3. Hospital Anxiety and Depression scale (HADS)

Question 3

List 3 quantitative instruments measuring depression

Answer 3

See table 22.5.2.

1. Beck Depression Inventory
2. Geriatric Depression Scale
3. Hospital Anxiety and Depression Scale
4. Patient Health Questionnaire (PHQ-9)

Question 4

List 3 quantitative scales for measuring distress

Answer 4

See table 22.5.3.

1. Brief symptom inventory
2. General Health Questionnaire (GHQ-12)
3. SCARED
4. Distress thermometer

Question 5

List 3 quantitative scales measuring pain and symptom management

Answer 5

See table 22.5.4.

1. Brief pain inventory
2. ESAS
3. MSAS

Question 6

List 3 scales measuring suffering, existential, and spiritual issues

Answer 6

See table 22.5.5:
1. Demoralization scale
2. Demoralization scale II
3. Death and dying distress scale (DADDS)
4. Post-traumatic growth inventory
5. Spiritual needs inventory

Question 7

List 3 instruments measuring coping and adaptation

Answer 7

See table 22.5.6:

1. Brief COPE
2. Life orientation test-revised LOT-R
3. Mini mental adjustment to cancer mini-MAC

Question 8

List 3 instruments to meaure delirium

Answer 8

see table 22.5.7:

1. CAM
2. MMSE
3. Memorial delirium assessment scale (MDAS)

Question 9

List 2 instruments that measure social support in palliative care patients

Answer 9

See table 22.5.8

1. Bottomley social support scale
2. Duke functional social support scale

Question 10

List 2 instruments to measure caregiving issues.

Answer 10

see table 22.5.9:

1. Brief assessment scale for caregivers (BASC)
2. Caregiver QOL scale - Cancer
3. Caregiver reaction assessment

Question 11

List 2 instruments measuring family issues

Answer 11

see table 22.5.9.

1. FAMCARE (fam satification with care)
2. F-COPES (assess family level coping)
3. Family relationship index (cohesion/conflict)

Question 12

List 2 instruments measuing pediatric aspects of advanced illness

Answer 12

see table 22.5.11

1. Childhood cancers stressors inventory
2. Multi-dimensional anxiety scale for children (MASC)
3. Pediatric cancer QOL inventory

Question 13

List 2 instruments measuring sexuality and intimacy

Answer 13

see table 22.5.13:

1. changes in sexual function questionnaire (CSFQ-14)
2. Relationship assessment scale

Question 14

List 2 scales measuring quality of life and functional status

Answer 14

see table 22.15.14

1. Assessment of QOL at EOL
2. McGill QOL questionnaire
3. Palliative care outcomes scale

Question 15

List 2 scales measuring the dying process

Answer 15

see table 22.5.15:

1. Beck Hopelessness scale (designed to assess suicidality)
2. Death and Dying Distress Scale (DADDS)
3. Good death inventory

Question 16

List 3 qualitative research methods into psychosocial issues

Answer 16

1. semi- or open-ended interviews
2. focus groups
3. observation and field notes
4. publicly available documents and/or audiovisual media

Question 17

List the research design that will best answer the following questions:

1. Therapy (treatment)
2. Prevention
3. Diagnosis
4. Prognosis (forecast)
5. Aetiology (causation)
6. Meaning

Answer 17

see table 22.5.16

1. Randomized controlled trial (RCT)
2. RCT or prospective study
3. RCT or cohort study
4. Cohort study and/or case–control series
5. Cohort study
6. Qualitative study

Question 18

Define a systematic review

Answer 18

Systematic reviews identify, appraise, and synthesize all ‘empirical evidence that meets pre-specified eligibility criteria to answer a given research question’

Question 19

List 3 methodological issues with RCTs in pall care

Answer 19

1. patient refusers and withdrawals
2. undeclared confounding treatments
3. dose variations and fidelity of the treatment applied
4. defaults in interim assessments
5. deaths prior to outcome measurements.

Question 20

1. Define cohort studies
2. List 3 types of cohort studies

Answer 20

1. Observational studies that follow groups of patients over time to assess how certain variable affect outcomes
2. Cohort studies may be:

Retrospective - data from group of patients evaluated over time via survey of records

cross-sectional patients are sampled cross-sectionally in real time and selected patient-specific historical data are collected for a specified time period.

prospective follow patients with key differences of interest and compare outcomes across exposure factors, including interventions. They can provide valuable information on the nature of a relationship and the possibility of a causal association. The prospective design eliminates recall bias.

Question 21

what is a case control study?

Answer 21

A type of observational study that matches patients with a disease or a specific treatment to controls, and collects historical data for a specified time to investigate group-specific associations with potential aetiological factors.

* usually retrospective
* an alternative to retrospective cohort

Question 22

What are cross-sectional studies?

What is their usual focus?

Answer 22

Cross-sectional studies capture associations between an outcome and exposures at one point in time.

The focus of interest is often outcome prevalence, for example, symptoms, illness, or rating scale findings

Question 23

what is metasynthesis

Answer 23

Meta-synthesis: a range of methods used to synthesize outcomes from multiple qualitative studies examining a similar phenomenon

Question 24

List 2 qualitative methodologies for analyzing data

Answer 24

1. Grounded theory
2. Meta-synthesis
3. Qualitative descriptive design
4. Interpretive phenomology
5. Framework method
6. Ethnography
7. Narrative inquiry

Question 25

Describe mixed-methods research. What is an advantage of this approach?

Answer 25

Mixed methods research uses both quantitative and qualitative approaches in a single study and either merges the qualitative and quantitative data concurrently or connects them sequentially, one method leading to another to further explore a construct or phenomena

Mixed methods research can triangulate different data sets to confirm and explain findings more comprehensively or be designed so that two or more methods complement and inform each other

Question 26

List 3 methodological difficulties in psychosocial research

Answer 26

1. Design issues:
   - defining criteria for palliative care patients or caregivers
   - accounting for patient heterogeneity
   - selection of outcome measures that adequately capture complex psychosocial aspects
   - standardizing psychosocial interventions across sites
   - health professional ‘gatekeeping’, - ethics review board concerns about vulnerable populations,
   - recruitment problems.
2. Performance issues:
   - obtaining informed consent, -minimizing attrition,
   - controlling for confounding variables
3. Patient issues:
   - include fluctuating physical energy and cognitive status and inevitable deterioration, which necessitates a minimally burdensome methodology.