Institute for the Study and Prevention of Cancer ISPO

Firenze, Italy

Institute for the Study and Prevention of Cancer ISPO

Firenze, Italy
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Brunelli C.,Italian National Cancer Institute | Bianchi E.,Italian National Cancer Institute | Murru L.,Italian National Cancer Institute | Monformoso P.,Italian Society of Logotherapy and Existential Analysis | And 6 more authors.
Supportive Care in Cancer | Year: 2012

Objective The first instruments developed to evaluate specific logotherapeutic dimensions were the Purpose In Life (PIL) and the Seeking Of Noetic Goals (SONG) tests, designed to reflect Frankl's concepts of, respectively, meaning in life attainment and will to meaning. This study aims to perform the Italian cultural adaptation and the psychometric validation of the PIL and SONG questionnaires. Methods We administered the PIL and SONG, culturally adapted into the Italian language, to 266 cancer patients. The psychometric validation appraised construct validity, internal consistency, test-retest reliability, known-group validity, and convergent validity of the two questionnaires with respect to one another. Results The factorial analysis indicates that the original single-factor solution can be maintained for both instruments (proportion of variance explained by the first factor 77% and 71% for the PIL and SONG, respectively). The results show excellent internal consistency (Cronbach's alpha of 0.91 for the PIL and 0.90 for the SONG) and test-retest reliability (intraclass correlation coefficient of 0.92 for the PIL and 0.81 for the SONG). As expected,males, believers, patients nearer to the diagnosis, and patients not undergoing psychological therapy have higher PIL and lower SONG scores, while expectations for age were not confirmed. The average level for the PIL was 107.3, while for the SONG, it was 66.1, and a negative correlation (-0.47) between PIL and SONG scores indicates good convergent validity of the two instruments. Conclusion Italian versions of the PIL and SONG are adequate and reliable self-report instruments for evaluating purpose in life and the motivation to find purpose for cancer patient populations. © Springer-Verlag 2012.


Borreani C.,Italian National Cancer Institute | Brunelli C.,Italian National Cancer Institute | Bianchi E.,Italian National Cancer Institute | Piva L.,Palliative Care Unit | And 2 more authors.
Journal of Pain and Symptom Management | Year: 2012

Context: The End-of-Life Preferences Interview (ELPI) was developed with the purpose of supporting physicians in communicating with advanced cancer patients. Objectives: This study aimed to evaluate ELPI feasibility and compare home care/hospice (HC-H) vs. outpatient (OU) care settings. Methods: Twenty-eight physicians were trained in the use of the ELPI and were asked to apply the new instrument in their daily clinical practice for two months. ELPI feasibility was evaluated through three indices: the percentage of eligible patients, the percentage of patients to whom the ELPI was proposed, and the percentage of completed interviews. Results: The 23 physicians participating in the data collection screened 633 patients, and 156 of them (25%, 95% confidence interval 21%-28%) were judged to be eligible. Eligibility in HC-H was lower than that in the OU setting (18% vs. 46%; P < 0.0001), whereas the differences were reduced when looking at patients to whom the ELPI was proposed (12% vs. 20%; P = 0.017) and who completed the ELPI (8% vs. 18%; P < 0.001). The percentage of eligible patients refusing the interview was very low in the entire sample (1.9%). Conclusion: Results indicate that discussing end-of-life preferences in an earlier disease phase, such as in the OU setting, could be preferable but that its accomplishment in this setting may be more difficult, mainly as a result of organizational reasons. This observation could indicate that the system is not yet ready to offer patients such an opportunity and although communication on these sensitive issues cannot be reduced to a procedure, the ELPI can become a useful tool to help physicians in accomplishing this difficult task. © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.


Miccinesi G.,Institute for the Study and Prevention of Cancer ISPO | Bianchi E.,Fondazione IRCCS Instituto Nazionale dei Tumori | Brunelli C.,Fondazione IRCCS Instituto Nazionale dei Tumori | Borreani C.,Fondazione IRCCS Instituto Nazionale dei Tumori
European Journal of Cancer Care | Year: 2012

The aim of the present study is to describe end-of-life preferences of advanced cancer patients willing to talk about death issues. Eighty-eight advanced cancer patients were interviewed through End of Life Preferences Interview (ELPI), a 23-item interview covering a wide range of end-of-life care issues. Most interviewed subjects were home care patients and their median survival after ELPI administration was 69 days. In total, 100% of responders expressed the will to receive some kind of information on the disease process and/or the treatments proposed. Approximately 77% declared to be willing to talk about what it is important at the end of life in case of worsening of their conditions and 31% prefer to be left alone in difficult moments. Approximately 67% choose home as the preferred place of death and 63% think it is preferable to die in a state of unconsciousness induced by drugs. About half of responders declare to believe in any kind of life after death and 40% consider very important to find any meaning at the end of life. ELPI can be a useful instrument to adapt the model of care to the specific needs and values of each patient. © 2012 Blackwell Publishing Ltd.


Giordano L.,Center for Cancer Prevention | Stefanini V.,Center for Cancer Prevention | Senore C.,Center for Cancer Prevention | Frigerio A.,Center for Cancer Prevention | And 6 more authors.
European Journal of Public Health | Year: 2012

Background: Several factors can influence access to population breast cancer screening. The aim of the study was to evaluate the impact of different information approaches, women's socio-demographic characteristics and organizational factors on mammography screening uptake. Methods: We selected 5744 women aged 40-45 years who were randomly assigned to be given letters with: (i) a pre-fixed appointment plus standard leaflet (Group 1); (ii) a pre-fixed appointment plus a more comprehensive booklet (Group 2); (iii) point (ii) plus the offer of a counselling session (Group 3); and (iv) an invitation to contact the centre to get information and arrange participation (Group 4). Results: Ninety-five women were excluded before the invitation and 5649 were randomized. After excluding undelivered letters (n=41) and women reporting an exclusion criterion following our invitation (n=248), the final eligible population was 5360 women. Participation rates following the first contact were 36.5, 39.9, 35.8 and 16.5 for Groups 1-4, respectively. The rates increased to 40.9, 43.6, 40.1 and 35.1 after the reminder letters. Women receiving more complete information had a higher uptake (Group 2), although not statistically significant. Differences among the four groups were maintained by controlling the effect of socio-demographic and attendance determinants. Regardless of intervention, participation was higher among married, higher educated, white-collared women, those born in northern Italy, living closer to the screening unit and with a female-collaborative doctor. Conclusion: Invitation letters with a fixed appointment correlate with a higher attendance rate. Providing women with more information on procedures, risks and benefits of mammography screening does not modify their participation. © The Author 2011. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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