Search

Dear Editor,IntroductionCommunication between patient and professional is a keyelementinthesupportofferedtocancerpatients[1,2],espe-cially those with advanced disease. Adequate informationdisclosure, particularly when receiving bad news, involvesa process in which communication is very important [3].Models of care indicate the type of relationship andcommunication that is established between the patientand the professional. In recent years, the care given tocancer patients has changed from being paternalistic topatient centered and on the basis of patient autonomy.The paternalistic model is an asymmetrical relationshipwith the professional occupying the dominant positionand the patient merely cooperating. Professionals employtight interviewing methods to elicit the necessary medicalinformation while providing little opportunity for patientsto participate [4]. Patient-centered cancer care,ontheotherhand,respectsandrespondstotheindividualpatient’spreferences,needs,andvaluesallowingforflexibilityintherelations between patients and professionals [5].The concept of patient-centered cancer care includespatient-centered communication (PCC), which is definedin terms of processes and outcomes of the patients and cli-nician interaction [6]:1. Eliciting, understanding, and validating the patients’perspective (representations, concerns, feelings, etc.);2. Understanding patients within their own psychologi-cal and social contexts;3. Reaching a shared understanding of patient’s prob-lems and how to treat them; and4. Helping patients share power by offering them mean-ingful involvement in health-related choices.Within the PCC model, Epstein et al. [6] suggest thefollowing six core functions: fostering healing relation-ships, exchanging information, responding to emotions,managing uncertainty, making decisions, and enablingpatient self-management. These authors understand

Objective Informational needs among cancer patients are similar, but the degree of information disclosure in different cultural areas varies. In this paper, we present the results of a cross-cultural study on information received. Methods The EORTC information questionnaire, EORTC QLQ-INFO25, was administered during the treatment process. This questionnaire evaluates the information that patients report they have received. Cross-cultural differences in information have been evaluated using statistical tests such as Kruskall–Wallis and multivariate models with covariates to account for differences in clinical and demographic characteristics across areas. Results Four hundred and fifty-one patients from three cultural areas, North–Middle Europe, South Europe, and Taiwan, were included in the study. Significant differences among the three cultural areas appeared in eight QLQ-INFO25 dimensions: information about the disease; medical tests; places of care; written information; information on CD/tape/video; satisfaction; wish for more information; and information helpfulness. North–Middle Europe patients received more written information (mean = 67.2 (North) and 33.8 (South)) and South Europe patients received more information on different places of care (mean = 24.7 (North) and 35.0 (South)). Patients from North–Middle Europe and South Europe received more information than patients from Taiwan about the disease (mean = 57.9, 60.6, and 47.1, respectively) and medical tests (70.9, 70.4, and 54.5), showed more satisfaction (64.8, 70.2, and 35.0), and considered the information more helpful (71.9, 73.9, and 50.4). These results were confirmed when adjusting for age, education, and disease stage. Conclusion There are cross-cultural differences in information received. Some of these differences are based on the characteristics of each culture. Copyright © 2011 John Wiley & Sons, Ltd.

Objective: The aim of this study was to examine the reliability and validity of the Taiwan Chinese Version of the EORTC QLQ-OV28. Methods: The authors translated the questionnaire according to the guideline of the EORTC. A total of 96 patients with ovarian cancer in National Taiwan University Hospital were interviewed with the questionnaire and the EORTC QLQ-C30 between September 2004 and September 2007. Answer distribution and psychometric properties of the EORTC QLQ-OV28 were examined. Results: The mean age of the patients was 54 (standard deviation 12 years). Most of the patients were in FIGO stages III or IV. Two thirds were on-treatment (chemotherapy). Items for gastrointestinal (GI) symptoms, menopausal symptoms, and sexuality showed more flooring effects than others. Missing values were frequent in further questions about sexual activity. After excluding conditional questions, the Cronbach's alpha coefficients of most scales were satisfactory (0.74–0.89), except other chemotherapy side effects (0.63) and menopausal symptoms (0.39). The item-to-own and item-to-other scales correlation showed satisfactory results. Patients who were on-treatment had significantly poorer quality of life (QoL) scores in most symptom scales. Conclusions: The EORTC QLQ-OV28 is a valid instrument to assess QoL issues of patients with ovarian cancer in Taiwan, a country of a different culture. Copyright © 2009 John Wiley & Sons, Ltd.

The objective of this study was to test the reliability and validity of the Taiwan Chinese version of the EORTC QLQ-C30 (version 3) and EORTC QLQ-BR23. The authors followed the guidelines of translation and pilot testing of the questionnaires. The questionnaires were given to 35 breast cancer patients under active treatment and 54 under follow-up at the National Taiwan University Hospital from November 2000 to October 2001. A retest was conducted one to two weeks after the first interview/form completion for the follow-up group. The intraclass correlation coefficients of the two questionnaires were moderate to high in the follow-up group. The Cronbach's α coefficients of most scales of the two questionnaires were ≥ 0.70 except that of physical functioning (0.68), cognitive functioning (0.53), and arm symptoms (0.59). Correlations of scales measuring similar dimensions of the EORTC QLQ-C30 and the SF-36 were moderate. Patients in the active treatment group had more serious QOL problems due to disease and treatment. Results of this study showed that the Taiwan Chinese version of the two questionnaires had good test/retest reliability, high internal consistency in most scales, and could show the expected differences between patients in active chemotherapy and follow-up group. Copyright © 2003 John Wiley & Sons, Ltd.

The relatively high incidence of gastric cancer in Taiwan warranted the need of a disease-specific quality of life (QOL) instrument. We translated the EORTC QLQ-C30 and QLQ-STO22 according to the guidelines from the EORTC. A total of 100 patients were interviewed. Convergent and discriminant validity, Cronbach's alpha coefficient and known-groups comparisons were used to examine the reliability and validity. We found good reliability for multi-item subscales of the QLQ-C30 and QLQ-STO22 (Cronbach's alpha coefficient: 0.70-0.94) except cognitive functioning of the QLQ-C30 and eating restriction of the QLQ-STO22. Patients in the active treatment group experienced compromised functional status and worse treatment-associated symptoms than those in the follow-up group. Similar results were found in comparisons based on Eastern Cooperative Oncology Group (ECOG) Performance Status and dysphagia grades. The study has ascertained the cross-cultural validity, reliability and clinical applicability of the Taiwan Chinese version of the EORTC QLQ-C30 and QLQ-STO22.