Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.
Harvard Medical School, Boston, MA, USA.
J Cancer Surviv. 2024 Apr;18(2):450-456. doi: 10.1007/s11764-022-01237-5. Epub 2022 Jul 29.
Patient-reported outcomes (PROs) are essential for assessing potential late effects experienced by young adult cancer survivors (YACS), but stigma and social desirability bias may limit their effectiveness for assessing sensitive topics (e.g., suicidal ideation, sexual health). This study compared two methods of item administration to determine the optimal method for obtaining sensitive information in YACS.
Two hundred forty-four YACS (ages 18-40) were randomized to complete measures of suicidal ideation and sexual health (i.e., sensitive items) by paper survey or by telephone automated computer assisted structured interview (TACASI). Participants also provided information on acceptability of administration mode and sensitive items.
The proportion of participants reporting symptoms did not significantly vary between paper and TACASI administration: respectively, 10% vs. 12% reported suicidal ideation and 55% vs. 58% reported sexual health concerns. The majority (≥ 78%) of participants reported feeling comfortable answering sensitive items on paper and TACASI and there were no significant differences in acceptability based on administration mode. Although participants endorsing sensitive symptoms were significantly more likely to feel upset answering sensitive items, the majority (93%) of participants experiencing symptoms still felt they were important to ask.
Despite their potentially sensitive nature, questions about suicidal ideation and sexual health were highly acceptable to YACS across administration modes. Moreover, YACS almost universally endorse the importance of providers asking about these topics.
Findings should bolster provider confidence that screening for suicidal ideation and sexual health concerns can and should be integrated into clinical care for YACS using paper or technology-assisted methods.
患者报告的结局（PROs）对于评估年轻成年癌症幸存者（YACS）所经历的潜在晚期影响至关重要，但耻辱感和社交期望偏差可能会限制其评估敏感话题（例如自杀意念、性健康）的有效性。本研究比较了两种项目管理方法，以确定在 YACS 中获取敏感信息的最佳方法。
244 名 YACS（年龄 18-40 岁）被随机分配通过纸质调查或电话自动计算机辅助结构化访谈（TACASI）完成自杀意念和性健康（即敏感项目）的测量。参与者还提供了对管理模式和敏感项目的可接受性的信息。
报告症状的参与者比例在纸质和 TACASI 管理之间没有显著差异：分别有 10%和 12%报告有自杀意念，55%和 58%报告有性健康问题。大多数（≥78%）参与者报告在纸质和 TACASI 上回答敏感项目感到舒适，并且基于管理模式没有可接受性的显著差异。尽管有敏感症状的参与者在回答敏感问题时更有可能感到不安，但大多数（93%）有症状的参与者仍然认为这些问题很重要。
尽管这些问题具有潜在的敏感性，但关于自杀意念和性健康的问题在管理模式下对 YACS 非常可接受。此外，YACS 几乎普遍认可提供者询问这些问题的重要性。
研究结果应该增强提供者的信心，即使用纸质或技术辅助方法，为 YACS 筛查自杀意念和性健康问题可以并且应该纳入临床护理。
