Symptoms, Illness Perceptions, Self-Efficacy and Health-Related Quality of Life Following Colorectal Cancer Treatment

Introduction: Lower health-related quality of life (HRQoL) is associated with fatigue, poor mental and poor gastrointestinal health during the first three months after colorectal cancer (CRC) treatment. Research indicates that maintaining usual activities has a positive impact on HRQoL after treatment for CRC. Illness perceptions have been associated with HRQoL in other cancer diseases, and self-efficacy has been associated with HRQoL in gastrointestinal cancer survivors. Our knowledge about illness perceptions and self-efficacy in relation to maintaining everyday activities and HRQoL following CRC treatment is incomplete. Aim: To explore associations between HRQoL, fatigue, mental health, gastrointestinal health, illness perceptions and self-efficacy in relation to maintaining everyday activities, three months after surgical CRC treatment. A further aim was to test the Maintain Function Scale in a CRC population. Method: The study was cross-sectional. Forty-six persons participated. Data were collected using questionnaires. Descriptive and analytical statistics were used. Results: Persons who were more fatigued, depressed, worried, and had more diarrhea were more likely to report lower HRQoL. Increased fatigue and diarrhea were associated with decreased HRQoL. Concerning illness perceptions, persons who reported negative emotions and negative consequences of CRC were more likely to report lower HRQoL. Persons scoring higher on self-efficacy were more likely to report higher HRQoL. Increased self-efficacy was associated with increased HRQoL. The Maintain Function Scale was suitable for assessing self-efficacy in relation to maintaining everyday activities. Conclusions: Nursing support to improve self-efficacy and illness perceptions and to minimize symptoms during recovery should have a favorable impact on HRQoL.

The Single-Item Measure of Stress Symptoms after Myocardial Infarction and Its Association with Fatigue

Surviving a myocardial infarction (MI) can be a stressful event entailing challenges in daily life during the recovery period. Experiencing fatigue symptoms post-MI has been described as bothersome and occurs in nearly half of patients four months and two years after MI. The aetiology of fatigue disorder is unclear, but research has shown that fatigue plays an important role in the relationship between stress and perceived poor health. Previous findings indicate that having access to an easily administered stress measurement is worthwhile both in the clinic and in research. The single-item measure of stress symptoms has not been validated in persons treated for MI. The aim was to validate the single-item measure of stress symptoms and to explore its association with fatigue in a sample of persons treated for MI. Methods: 142 respondents completed the questionnaires of the Multidimensional Fatigue Inventory-20, the single-item measure of stress symptoms and the Perceived Stress Scale-10 (PPS-10) two months post-MI. Correlation analysis and t-tests were used to validate the single-item stress measure and its association with post-MI fatigue. Results: The convergent validity of the single-item measure of stress symptoms was confirmed. In analyses of relations between stress and fatigue, it was found that the single-item stress measure was strongly associated with both the global fatigue score and all four fatigue dimension scores (general, physical and mental fatigue as well as reduced activity). Conclusion: The single-item measure of stress symptoms was found to be a valid measure of post-MI stress. Also, the measure was useful in assessing associations between stress and fatigue and could therefore indicate that post-MI fatigue experiences should be further explored in full using multidimensional fatigue assessment.

Impact of Virtual Disaster Collaboration Exercises on Disaster Leadership at Hospitals in Saudi Arabia

This study measured the impact of virtual three-level collaboration (3LC) exercises on participants’ perceived levels of collaboration, learning, and utility (CLU) at hospitals in the southern region of Saudi Arabia. Our 3LC exercise is a tabletop training tool used to facilitate disaster education and document CLU. This model enables the practitioner to acquire new knowledge and promotes active learning. An English version of the CLU scale, the validated Swedish survey tool, was applied to 100 healthcare managers or leaders in various positions at both the operational and tactical levels after conducting the 3LC exercises. The response rate was 100%, although not all questions were answered in some cases. The results show that most participants strongly agreed that the exercises focused on collaboration (r^(2) = 0.767) and that they had acquired new knowledge during the exercises. There was a statistically significant association between participation in the collaboration exercises and perceived learning (r^(2) = 0.793), as well as between perceived learning and utility (r^(2) = 0.811). The collaboration exercises enhance the perceived effects of CLU. They also improve the ability of participants to adapt situational strategies to achieve a safer society. Although exercises were conducted virtually, they were well received by the participants and achieved a value M = 4.4 CLU score, which opens up new dimensions in collaboration simulation exercises.