Paul Wesley Scott

Background: Oral anticancer medications are standard care for cancer. Medication adherence influences health outcomes, but valid, reliable measures assessing self-reported medication adherence are limited. Psychometric properties of the PROMIS ^® Medication Adherence Scale (PMAS) were evaluated in patients prescribed oral anticancer medications for multiple myeloma. Methodology: This was a secondary analysis from a longitudinal observational study examining medication adherence, symptoms, quality of life, and financial hardship among individuals prescribed oral anticancer medications for multiple myeloma. PMAS measured self-reported medication adherence. Self-report and medical record data assessed participant characteristics and adherence correlates. Objective medication adherence indices were generated from continuous electronic event monitored data. Internal consistency reliability was estimated using Cronbach’s alpha. Dimensionality was assessed with confirmatory factor analysis. Construct validity was assessed considering adherence correlates. Spearman rank-order correlations summarized associations between PMAS and electronic event monitored data. Results: PMAS items had limited variability, with high adherence over time. Reliability of PMAS scores was adequate (T1 α = 0.82, 95% CI: 0.75, 0.87; T2 α = 0.84, 95% CI: 0.78, 0.89). Confirmatory factor analysis fit was better for sub-scales (Medication Beliefs and Knowledge and Medication Taking Behaviors) than Total scale, particularly for the Medication Beliefs and Knowledge subscale. Adherence correlates were observed as expected between PMAS and age, self-reported cognitive function, symptom severity, and depression. Weak/moderate positive associations were found between PMAS and electronic event monitored data. Conclusions: Reliability, two-factor dimensionality, and construct validity were supported, with some evidence of concurrent criterion validity with electronic event monitored adherence data. Additional validation testing is needed to support findings. Evidence supports the feasibility of longitudinal oral anticancer medication adherence assessment monitoring using PMAS.

Background: PAUSE ( Pause before the encounter ; Assess your values, beliefs, and biases ; Understand the medical condition ; See the person as an individual ; and Encounter with empathy ) is an acronym developed to cultivate emotional intelligence and, through it, address implicit bias among nurses. The purpose of this study is to evaluate the content and face validity of PAUSE as a tool to promote emotional intelligence. Methods: Thirteen experts in nursing, medicine, mental health, emotional intelligence/psychology, and education were surveyed to evaluate the content and face validity of the PAUSE acronym. Experts rated the necessity, relevancy, clarity, and importance of each component of PAUSE. Further, they were asked if they agreed with the wording of each component to achieve the goal of the acronym; if they did not agree with the wording, they were instructed to comment on how to improve the ambiguity, misinterpretation, or incomprehensibility. Findings: All PAUSE components were found to be necessary (content validity index [CVI] = 0.692–1), relevant (CVI = 1 for all components), clear (CVI = 0.846–0.923), and important (impact score = 4.46–5.00). Experts provided feedback to improve the wording of the component descriptions for the Understand and Encounter components of PAUSE. Discussion: PAUSE demonstrates both content and face validity. Future research will pilot PAUSE with nursing students and professionals and evaluate the impact of PAUSE on the emotional intelligence and implicit bias of nurses and, ultimately, patient outcomes. Establishing evidence of PAUSE’s validity, feasibility, and effectiveness in these populations is a necessary next step before broader implementation can be recommended.

Understanding gender variations in self-advocacy can help oncology clinicians support the educational needs of cancer survivors. This study aims to examine the role of gender along with additional other sociodemographic variables in how cancer survivors self-advocate including their engagement in decision-making, communication with healthcare providers, and use of social support. Data from two cross-sectional descriptive studies were combined for analyses. Each study used convenience sampling methods to recruit adults (≥ 18 years old) with a history of invasive cancer who had English literacy from cancer clinics and community advocacy groups. The first study recruited women (n = 317), and the second study recruited men (n = 179). In both studies, participants completed two assessments of self-advocacy: Self-Advocacy in Cancer Survivorship (SACS) Scale and the Patient Self-Advocacy Scale. We built a linear regression model to test the association between gender and self-advocacy total and subscale scores controlling for covariates. N = 496 participants completed study procedures between 2014 and 2022. On both self-advocacy scales, women reported higher self-advocacy scores compared to men, with women’s higher scores on the SACS subscales of connected strength and informed decision-making driving the gender difference in cancer-specific self-advocacy. Self-advocacy behaviors are associated with gender, most notably by way of individuals’ ability to derive strength through social connection. Women tend to have greater engagement in care with larger and more meaningful social networks, while men report less engagement. Educational materials for cancer survivors should leverage gender-associated self-advocacy skills and bolster skills that require support.

Background and Purpose: This study evaluates the Pittsburgh Sleep Quality Index (PSQI) in terms of factor structure and measurement invariance (MI). The sample included postmenopausal breast cancer (BC) survivors ( n = 101) and matched healthy controls ( n = 60). Methods: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed on PSQI’s seven component scores. MI was tested between groups and across time using Bayes factor (BF). Results: Two factors were identified: sleep efficiency and perceived sleep quality. MI is evidenced between groups (BF < 0.007) and over time (BF > 150). Conclusions: PSQI scores with two subscales are comparable between postmenopausal BC survivors and controls over a 1-year period, providing some validation of PSQI for researching sleep quality in this population.

Propensity score methods are widely used for causal inference (Rosenbaum, 2020; Thoemmes & Kim, 2011). However, traditional propensity score estimation methods (e.g., logistic regression) degrade i...