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Psychometric Properties of the MICRA Questionnaire in Portuguese Individuals Carrying SDHx Mutations

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Abstract

This study aims to present the translation and cultural adaptation, as well as the psychometric characteristics of the Portuguese version of the Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire in individuals with SDHx mutations. The questionnaire was translated and culturally adapted in accordance with the process recommended by the World Health Organization. As per suggestion of the authors of the original instrument, a joint, universal European and Brazilian Portuguese version of the MICRA was created. Ninety-six (asymptomatic or affected) patients with SDHx mutations nationwide completed the adapted version of the MICRA in Portugal. Analyses consisted of confirmatory factor analysis, reliability estimation (alphas), and correlations with two other distress and quality of life instruments. The Portuguese adaptation of the MICRA was understandable to patients from various socioeconomic backgrounds. All items and factor structure of the original version were retained, yielding a good model fit. The MICRA’s three subscales and total score showed good internal consistency, and the correlations found between the Portuguese version of the MICRA and the other instruments assessing similar constructs further supported its validity. The adapted version of the MICRA showed good psychometric properties with a representative population of SDHx mutation carriers. This instrument can now be used to study the multidimensional impact of taking a genetic test for these mutations. It can also be used in future studies with other Portuguese populations of patients submitted to genetic tests for cancer risk assessment.

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References

  1. Dahia PL (2014) Pheochromocytoma and paraganglioma pathogenesis: learning from genetic heterogeneity. Nat Rev Cancer 14(2):108–119. https://doi.org/10.1038/nrc3648

    Article  CAS  PubMed  Google Scholar 

  2. Lenders, J. W., Duh, Q. Y., Eisenhofer, G., Gimenez-Roqueplo, A. P., Grebe, S. K., Murad, M. H., Naruse M., Pacak K., Young WF Jr, Endocrine Society. (2014). Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab, 99(6), 1915–1942, doi:https://doi.org/10.1210/jc.2014-1498

  3. Jimenez C, Cote G, Arnold A, Gagel RF (2006) Review: should patients with apparently sporadic pheochromocytomas or paragangliomas be screened for hereditary syndromes? J Clin Endocrinol Metab 91(8):2851–2858. https://doi.org/10.1210/jc.2005-2178

    Article  CAS  PubMed  Google Scholar 

  4. Brito JP, Asi N, Bancos I, Gionfriddo MR, Zeballos-Palacios CL, Leppin AL, Undavalli C, Wang Z, Domecq JP, Prustsky G, Elraiyah TA, Prokop LJ, Montori VM, Murad MH (2015) Testing for germline mutations in sporadic pheochromocytoma/paraganglioma: a systematic review. Clin Endocrinol 82(3):338–345. https://doi.org/10.1111/cen.12530

    Article  CAS  Google Scholar 

  5. Cella D, Hughes C, Peterman A, Chang CH, Peshkin BN, Schwartz MD, Wenzel L, Lemke A, Marcus AC, Lerman C (2002) A brief assessment of concerns associated with genetic testing for cancer: the Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire. Health Psychol 21(6):564–572

    Article  PubMed  Google Scholar 

  6. Bjornslett M, Dahl AA, Sorebo O, Dorum A (2015) Psychological distress related to BRCA testing in ovarian cancer patients. Familial Cancer 14(4):495–504. https://doi.org/10.1007/s10689-015-9811-2

    Article  PubMed  Google Scholar 

  7. Lumish HS, Steinfeld H, Koval C, Russo D, Levinson E, Wynn J, Duong J, Chung WK (2017) Impact of panel gene testing for hereditary breast and ovarian cancer on patients. J Genet Couns 26(5):1116–1129. https://doi.org/10.1007/s10897-017-0090-y

    Article  PubMed  PubMed Central  Google Scholar 

  8. Lynch HT, Snyder C, Lynch JF, Karatoprakli P, Trowonou A, Metcalfe K, Narod SA, Gong G (2006) Patient responses to the disclosure of BRCA mutation tests in hereditary breast-ovarian cancer families. Cancer Genet Cytogenet 165(2):91–97. https://doi.org/10.1016/j.cancergencyto.2005.07.011

    Article  PubMed  Google Scholar 

  9. Smit AK, Newson AJ, Best M, Badcock CA, Butow PN, Kirk J, Dunlop K, Fenton G, Cust AE (2018) Distress, uncertainty, and positive experiences associated with receiving information on personal genomic risk of melanoma. Eur J Hum Genet 26:1094–1100. https://doi.org/10.1038/s41431-018-0145-z

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Tercyak KP, Peshkin BN, Brogan BM, DeMarco T, Pennanen MF, Willey SC, Magnant CM, Rogers S, Isaacs C, Schwartz MD (2007) Quality of life after contralateral prophylactic mastectomy in newly diagnosed high-risk breast cancer patients who underwent BRCA1/2 gene testing. J Clin Oncol 25(3):285–291. https://doi.org/10.1200/jco.2006.07.3890

    Article  PubMed  Google Scholar 

  11. Shiloh S, Dagan E, Friedman I, Blank N, Friedman E (2013) A follow-up study on men tested for BRCA1/BRCA2 mutations: impacts and coping processes. Psychooncology 22(2):417–425. https://doi.org/10.1002/pon.2106

    Article  PubMed  Google Scholar 

  12. Aspinwall LG, Taber JM, Leaf SL, Kohlmann W, Leachman SA (2013) Genetic testing for hereditary melanoma and pancreatic cancer: a longitudinal study of psychological outcome. Psychooncology 22(2):276–289. https://doi.org/10.1002/pon.2080

    Article  PubMed  Google Scholar 

  13. Graves KD, Vegella P, Poggi EA, Peshkin BN, Tong A, Isaacs C, Finch C, Kelly S, Taylor KL, Luta G, Schwartz MD (2012) Long-term psychosocial outcomes of BRCA1/BRCA2 testing: differences across affected status and risk-reducing surgery choice. Cancer Epidemiol Biomark Prev 21(3):445–455. https://doi.org/10.1158/1055-9965.epi-11-0991

    Article  CAS  Google Scholar 

  14. Graves KD, Wenzel L, Schwartz MD, Luta G, Wileyto P, Narod S, Peshkin BN, Marcus A, Cella D, Emsbo SP, Barnes D, Halbert CH (2010) Randomized controlled trial of a psychosocial telephone counseling intervention in BRCA1 and BRCA2 mutation carriers. Cancer Epidemiol Biomark Prev 19(3):648–654. https://doi.org/10.1158/1055-9965.epi-09-0548

    Article  Google Scholar 

  15. Halbert CH, Stopfer JE, McDonald J, Weathers B, Collier A, Troxel AB, Domchek S (2011) Long-term reactions to genetic testing for BRCA1 and BRCA2 mutations: does time heal women's concerns? J Clin Oncol 29(32):4302–4306. https://doi.org/10.1200/jco.2010.33.1561

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hooker GW, Leventhal KG, DeMarco T, Peshkin BN, Finch C, Wahl E, Joines JR, Brown K, Valdimarsdottir H, Schwartz MD (2011) Longitudinal changes in patient distress following interactive decision aid use among BRCA1/2 carriers: a randomized trial. Med Decis Mak 31(3):412–421. https://doi.org/10.1177/0272989x10381283

    Article  Google Scholar 

  17. O'Neill SC, DeMarco T, Peshkin BN, Rogers S, Rispoli J, Brown K, Valdimarsdottir H, Schwartz MD (2006) Tolerance for uncertainty and perceived risk among women receiving uninformative BRCA1/2 test results. Am J Med Genet C Semin Med Genet 142c(4):251–259. https://doi.org/10.1002/ajmg.c.30104

    Article  PubMed  Google Scholar 

  18. O'Neill SC, Rini C, Goldsmith RE, Valdimarsdottir H, Cohen LH, Schwartz MD (2009) Distress among women receiving uninformative BRCA1/2 results: 12-month outcomes. Psychooncology 18(10):1088–1096. https://doi.org/10.1002/pon.1467

    Article  PubMed  PubMed Central  Google Scholar 

  19. Rini C, O'Neill SC, Valdimarsdottir H, Goldsmith RE, Jandorf L, Brown K, DeMarco TA, Peshkin BN, Schwartz MD (2009) Cognitive and emotional factors predicting decisional conflict among high-risk breast cancer survivors who receive uninformative BRCA1/2 results. Health Psychol 28(5):569–578. https://doi.org/10.1037/a0015205

    Article  PubMed  PubMed Central  Google Scholar 

  20. World-Health-Organization (2016) Process of translation and adaptation of instruments. Accessed, pp 16–09-2016

    Google Scholar 

  21. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370

    Article  CAS  PubMed  Google Scholar 

  22. Snaith, R. P., & Zigmond, A. P. (1994). The Hospital Anxiety and Depression Scale Manual. Windsor: NFER-Nelson

  23. Pais-Ribeiro J, Silva I, Ferreira T, Martins A, Meneses R, Baltar M (2007) Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychol Health Med 12(2):225–235; quiz 235-227. https://doi.org/10.1080/13548500500524088

    Article  CAS  PubMed  Google Scholar 

  24. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483

    Article  PubMed  Google Scholar 

  25. Ferreira PL (2000) Development of the Portuguese version of MOS SF-36. Part II --validation tests. Acta Medica Port 13(3):119–127

    CAS  Google Scholar 

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Acknowledgments

The authors would like to thank Sara Martins and Rebeca Moore for their work with translations, Sara Rocha for all logistic support, and all the clinicians in the involved hospitals, who contributed to this study allowing access to the patients. Special thanks to the study participants for their contribution to this research.

Funding

This project was supported by the research grant Dr. Rocha Alves from the Núcleo Regional do Centro da Liga Portuguesa Contra o Cancro.

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Authors and Affiliations

  1. Medical Psychology Unit, Department of Clinical Neurosciences and Mental Health, School of Medicine, University of Oporto, Oporto, Portugal

    Raquel Gomes Martins & Irene Palmares Carvalho

  2. Department of Endocrinology, Portuguese Oncology Institute of Coimbra, Coimbra, Portugal

    Raquel Gomes Martins

  3. Research Centre, Portuguese Oncology Institute of Oporto, Oporto, Portugal

    Raquel Gomes Martins

  4. Departamento de Neurociências Clínicas e Saúde Mental / Unidade de Psicologia Médica, Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal

    Raquel Gomes Martins

  5. CINTESIS, School of Medicine, University of Oporto, Oporto, Portugal

    Irene Palmares Carvalho

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  1. Raquel Gomes Martins
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Correspondence to Raquel Gomes Martins.

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All procedures were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Martins, R.G., Carvalho, I.P. Psychometric Properties of the MICRA Questionnaire in Portuguese Individuals Carrying SDHx Mutations. J Canc Educ 35, 1026–1033 (2020). https://doi.org/10.1007/s13187-019-01562-x

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  • DOI: https://doi.org/10.1007/s13187-019-01562-x

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