Dataset Information

Development of an evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention for breast cancer patients, following the Medical Research Council Framework.

ABSTRACT:

Purpose

To design and develop a complex, evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention (CSI) for breast cancer patients, following the Medical Research Council (MRC) framework.

Methods

From 2018 September to 2020 November, a complex intervention perspective was adopted. The rationale, methods, and processes employed in carrying out the study were reported. The acceptability and feasibility of intervention program were evaluated as a part of subsequent pilot study. Based on piloting, a refined and optimized definitive intervention was obtained. The development of the intervention is an iterative process involving input from three key stakeholders: experts, medical staff, and patient representatives.

Results

The systematic review revealed CSIs were effective and the selected theory served as a guide and indicated theory-inspired modifications. A representative team of breast cancer patients and oncology nurses collaboratively developed and tailored the intervention content and format with attention to the acceptability and feasibility. Five main strategies, including peripheral, evidential, linguistic, constituent-involving, and sociocultural strategies, were used to achieve and strengthen the cultural appropriateness. After the pilot phase, several refinements were made on the CSI program, such as editorial changes in the booklet or alternative suggestions for difficult strengths-based activities (e.g., outdoor activities). All participants not only expressed satisfaction with the program in process evaluation, but also reported perceived benefits such as enjoyable and sociable experience, better well-being, and increased confidence.

Conclusion

Consideration of the MRC framework, theory guidance, and suggestions from stakeholders during intervention development can optimize uptake and sustainability in the clinical setting. It is recommended that randomized controlled trial be used in future studies to assess the intervention, the process and the mechanisms of the intervention. Our approach may offer implications for the design and implementation of similar initiatives to support cancer patients.

Trial registration

ClinicalTrials.gov Register Identifier: NCT04219267, 07/01/2020, retrospectively registered.

SUBMITTER: Yan T

PROVIDER: S-EPMC9755794 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Development of an evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention for breast cancer patients, following the Medical Research Council Framework.

Yan Tingting T Chan Carmen W H CWH Chow Ka Ming KM Xiao Jinnan J Li Mingzi M

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 20221216 1

<h4>Purpose</h4>To design and develop a complex, evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention (CSI) for breast cancer patients, following the Medical Research Council (MRC) framework.<h4>Methods</h4>From 2018 September to 2020 November, a complex intervention perspective was adopted. The rationale, methods, and processes employed in carrying out the study were reported. The acceptability and feasibility of intervention program were evaluated as ...[more]

PMID: 36525147

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Project description:Character strengths profiles in the specific setting of medical professionals are widely unchartered territory. This paper focused on an overview of character strengths profiles of medical professionals (medical students and physicians) based on literature research and available empirical data illustrating their impact on well-being and work engagement. A literature research was conducted and the majority of peer-reviewed considered articles dealt with theoretical or conceptually driven 'virtues' associated with medical specialties or questions of ethics in patient care (e.g., professionalism, or what makes a good physician). The virtues of compassion, courage, altruism, and benevolence were described most often. Only a limited number of papers addressed character strengths of medical students or physicians according to the VIA-classification. Those articles showed that the VIA-character strengths fairness, honesty, kindness, and teamwork were considered most often by respondents to be particularly important for the medical profession. Available cross-sectional (time span: six years) and longitudinal (time span: three years) data regarding VIA-character strengths profiles of medical professionals were analyzed (N = 584 medical students, 274 physicians). These profiles were quite homogenous among both groups. The character strengths fairness, honesty, judgment, kindness, and love had the highest means in both samples. Noteworthy differences appeared when comparing medical specialties, in particular concerning general surgeons and psychiatrists, with the former reporting clearly higher levels of e.g., honesty (d = 1.02) or prudence (d = 1.19). Long-term results revealed significant positive effects of character strengths on well-being and work engagement (e.g., perseverance on physicians' work engagement) but also significant negative effects (e.g., appreciation of beauty and excellence on students' well-being). Further, hope was significantly associated both positively with physicians' well-being and negatively with students' work engagement, possibly indicating specific issues concerning medical education or hospital working conditions. According to the modern-day physician's pledge, medical professionals should pay attention to their own well-being and health. Therefore, promoting self-awareness and character building among medical professionals could be a beneficial strategy.

Project description:The Medical Research Councils' framework for complex interventions has been criticized for not including theory-driven approaches to evaluation. Although the framework does include broad guidance on the use of theory, it contains little practical guidance for implementers and there have been calls to develop a more comprehensive approach. A prospective, theory-driven process of intervention design and evaluation is required to develop complex healthcare interventions which are more likely to be effective, sustainable and scalable.We propose a theory-driven approach to the design and evaluation of complex interventions by adapting and integrating a programmatic design and evaluation tool, Theory of Change (ToC), into the MRC framework for complex interventions. We provide a guide to what ToC is, how to construct one, and how to integrate its use into research projects seeking to design, implement and evaluate complex interventions using the MRC framework. We test this approach by using ToC within two randomized controlled trials and one non-randomized evaluation of complex interventions.Our application of ToC in three research projects has shown that ToC can strengthen key stages of the MRC framework. It can aid the development of interventions by providing a framework for enhanced stakeholder engagement and by explicitly designing an intervention that is embedded in the local context. For the feasibility and piloting stage, ToC enables the systematic identification of knowledge gaps to generate research questions that strengthen intervention design. ToC may improve the evaluation of interventions by providing a comprehensive set of indicators to evaluate all stages of the causal pathway through which an intervention achieves impact, combining evaluations of intervention effectiveness with detailed process evaluations into one theoretical framework.Incorporating a ToC approach into the MRC framework holds promise for improving the design and evaluation of complex interventions, thereby increasing the likelihood that the intervention will be ultimately effective, sustainable and scalable. We urge researchers developing and evaluating complex interventions to consider using this approach, to evaluate its usefulness and to build an evidence base to further refine the methodology.Clinical trials.gov: NCT02160249.

Project description:BackgroundThe present study aimed to develop and validate the Character Strengths Test 24 (CST24), a simple scale consisting of 24 character strengths represented by one concept word and one sentence each. Three studies were conducted to examine the validation and utility of the CST24 for future research.MethodsThree internet-based surveys were conducted in Japan to investigate the psychometric properties of the CST24. Study 1 comprised 846 adults and focused on test development, including the evaluation of well-being and strengths scales, as well as retest reliability. Study 2 involved 1137 high school students and 1101 college undergraduates, aiming to investigate the factor structure of the CST24 and reaffirm its validity by utilizing happiness and meaning in life scales. In Study 3, 524 working adults participated to explore the scale's potential for future research. This study incorporated various psychological scales, such as value orientation, moral foundation, and work-related scales, to assess the utility of the CST24.ResultsIn Study 1, the CST24 items exhibited a well-distributed response pattern, demonstrating favorable retest reliability and internal consistency. Significant positive correlations were found between the CST24 items and measures of subjective well-being, meaning in life, positive self-compassion, and knowledge or utilization of strengths. Study 2 confirmed the stability of the factor structure across diverse sample groups, consistent with prior studies utilizing larger-scale measures. Study 3 identified both core and peripheral strengths, highlighting specific strengths that made substantial contributions to well-being, value orientation, moral foundation, sense of mission, and work-related indices through multiple regression analysis.ConclusionThe findings support the reliability and validity of the CST24 as a concise assessment tool for measuring 24 character strengths. Its potential utility for screening and exploratory research warrants attention in future studies, enhancing our understanding of the role of character strengths in various domains.

Dataset Information

Development of an evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention for breast cancer patients, following the Medical Research Council Framework.

Purpose

Methods

Results

Conclusion

Trial registration

Publications

Development of an evidence‑based, theory‑driven, and culturally appropriate character strengths-based intervention for breast cancer patients, following the Medical Research Council Framework.

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