Cancer appetite and symptom questionnaire (CASQ) for brazilian patients: Cross-cultural adaptation and validation study

Background: Appetite and symptoms, conditions generally reported by the patients with cancer, are somewhat challenging for professionals to measure directly in clinical routine (latent conditions). Therefore, specific instruments are required for this purpose. This study aimed to perform a cultural adaptation of the Cancer Appetite and Symptom Questionnaire (CASQ), into Portuguese and evaluate its psychometric properties on a sample of Brazilian cancer patients. Methods: This is a validation study with Brazilian cancer patients. The face, content, and construct (factorial and convergent) validities of the Cancer Appetite and Symptom Questionnaire, the study tool, were estimated. Further, a confirmatory factor analysis (CFA) was conducted. The ratio of chi-square and degrees of freedom (χ2/df), comparative fit index (CFI), goodness of fit index (GFI) and root mean square error of approximation (RMSEA) were used for fit model assessment. In addition, the reliability of the instrument was estimated using the composite reliability (CR) and Cronbach’s alpha coefficient (α), and the invariance of the model in independent samples was estimated by a multigroup analysis (Δχ2). Results: Participants included 1,140 cancer patients with a mean age of 53.95 (SD = 13.25) years; 61.3% were women. After the CFA of the original CASQ structure, 2 items with inadequate factor weights were removed. Four correlations between errors were included to provide adequate fit to the sample (χ2/df = 8.532, CFI = .94, GFI = .95, and RMSEA = .08). The model exhibited a low convergent validity (AVE = .32). The reliability was adequate (CR = .82 α = .82). The refined model showed strong invariance in two independent samples (Δχ2: λ: p = .855; i: p = .824; Res: p = .390). A weak stability was obtained between patients undergoing chemotherapy and radiotherapy (Δχ2: λ: p = .155; i: p < .001; Res: p < .001), and between patients undergoing chemotherapy combined with radiotherapy and palliative care (Δχ2: λ: p = .058; i: p < .001; Res: p < .001). Conclusion: The Portuguese version of the CASQ had good face and construct validity and reliability. However, the CASQ still presented invariance in independent samples of Brazilian patients with cancer. However, the tool has low convergent validity and weak invariance in samples with different treatments.

School engagement and burnout in a sample of brazilian students

Objective: Some studies have suggested that school engagement can be an ally in the prevention of psychosocial and occupational risks, to which students are exposed daily. The aim of this study is to estimate the impact of emotional, behavioral, and cognitive engagement on burnout syndrome among pharmacy undergraduate students. Methods: A total of 363 students enrolled in the pharmacy undergraduate program in the College of Pharmaceutical Sciences at Sao Paulo State University’s Araraquara Campus (UNESP) participated, 78.0% of whom were female. Mean age was 20.3 (SD = 2.7) years. The Maslach Burnout Inventory for students (MBI-SS) and the University Students School Engagement Inventory (USEI) were used. Confirmatory factor analysis was performed to assess the psychometric properties of the instruments. The data were included in a structural equation model in which burnout was considered the central construct. The impact of school engagement on burnout was based on the statistical significance of causal paths (β) evaluated by z tests (α = 5%). Results: The psychometric properties of the MBI-SS and USEI were adequate and the structural model also presented an adequate fit. Behavioral engagement (β = −0.56) and the emotional engagement (β = −0.71) explained 81.0% of burnout variability in the sample. Cognitive engagement was not found to contribute significantly. This data provides evidence of the impact of school engagement on burnout that can be used by educators and policymakers in charge of educational process. Conclusion: School engagement presented inverse and significant influence on burnout syndrome among pharmacy students.