Measurement of the quality of life in cancer survivors
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A QOL instrument was developed to measure the specific concerns of long term cancer survivors. The QOL-CS is based on previous versions of the QOL instrument developed by researchers at the City of Hope National Medical Centre (Grant, Padilla, and Ferrell). This instrument was revised over a one year pilot by Hassey-Dow and Ferrell. The revised instrument included 41 items representing the four domains of quality of life incorporating physical, psychological, social, and spiritual well being. The present study was conducted as a mail survey to the membership (n=1,200) of the National Coalition for Cancer Survivorship with 686 subjects responding to the survey. This survey included a Demographic tool, QOL-CS and the FACT-G tool developed by Cella. Psychometric analysis, performed on 686 respondents, included measures of reliability and validity. Two measures of reliability included test-retest and internal consistency. The overall QOL-CS tool test-retest reliability was 0.89 with subscales of Physicalr=0.88, Psychologicalr=0.88, Socialr=0.81, and Spiritual,r=0.90. The second measure of reliability was computation of internal consistency using Cronbach's α coefficient as a measure of agreement between items and subscales. Analysis revealed an overallr=0.93. Subscale alphas average ranged fromr=0.71 for spiritual well being,r=0.77 for physical,r=0.81 for social, andr=0.89 for psychological.
Several measures of validity were used to determine the extent to which the instrument measured the concept of QOL in cancer survivors. The first method of content validity was based on a panel of QOL researchers and nurses with expertise in oncology. The second measure used stepwise multiple regression to determine factors most predictive of overall QOL in cancer survivors. Seventeen variables were found to be statistically significant accounting for 91% of the variance in overall QOL. The fourth measure of validity used Pearson's correlations to estimate the relationships between the subscales of QOL-CS and the subscales of the established FACT-G tool. There was moderate to strong correlation between associated subscales including QOL-CS physical to FACT physical (r=0.74), QOL-CS Psych to FACT Emotional (r=0.65), QOL Social to FACT Social (r=0.44). The overall QOL-CS correlation with the FACT-G was 0.78. Additional measures of validity included correlations of indimeasures of validity included correlations of individual items of the QOL-CS tool, factor analysis, and construct validity discriminating known groups of cancer survivors. Findings demonstrated that the QOL-CS and its subscales adequately measured QOL in this growing population of cancer survivors.
- ACS: Facts & Figures, 1995. American Cancer Society, Atlanta, GA.
- Robertson C, Hawkins M, Kingston J. Late deaths and survival after childhood cancer: Implications for cure.Br Med Journal 1994;309: 162–166.
- Ferrell BR, Hassey-Dow K, Leigh S, Ly J, Gulasekaram P. Quality of life in long-term cancer survivors.Oncol Nurs Forum 1995;22(6): 915–922.
- Welch-McCaffrey D, Hoffman J, Leigh S, Loescher L, Meyskens F. Surviving adult cancers part II. Psychosocial implications.Ann Int Med 1989;111(6): 517–524.
- Whedon M, Ferrell BR. Quality of life in adult BMT patients: Beyond the first year.Sem in Oncol Nurs 1994;10: 42–57.
- Leigh S, Logan C, The cancer survivorship movement.Cancer Investigation. 1991;9: 571–579.
- LaTour K.The breast cancer companion. New York: A Knobf Publishers, 1993.
- Bushkin E. Signposts of survivorship.Oncol Nurs Forum 1993;20: 869–875.
- Dow KH. The enduring seasons in survival.Oncol Nurs Forum 1992;17: 511.
- Winningham ML, Nail LM, Burke MB, et al.. Fatigue and the cancer experience: The state of the knowledge.Oncol Nursing Forum 1994,21(1): 23–36.
- Blume E. Sex after chemotherapy.J Nat Cancer Inst 1993;85: 768.
- Kaplan HS. Sexual side effects of chemotherapy.J Sex and Mariital Ther 1992;18: 3.
- Cimprich B. Attentional fatigue in women with breast cancer.Res Nurs Health 1993;16: 83.
- Massie M, Holland J, Straker N. Psychotherapeutic interventions. In: Holland JC, Rowland JH, eds.Handbook of Psychooncology: Psychological Care of the Patient with Cancer. New York: Oxford University Press, 1983: 455.
- Mahon SM. Managing the psychosocial consequences of cancer recurrence: implications for nurses.Oncol Nurs Forum 1991;18: 577–583.
- Northouse L. Mastectomy patients and the fear of cancer recurrence.Cancer Nurs 1981;4(3): 213–220.
- Berry DL. Return-to-work experience of people with cancer.Oncol Nurs Forum 1993;20: 905.
- Hoffman B. Cancer survivors at work: Job problems and illegal discrimination.Oncology Nurs Forum 1989;16: 39–42.
- Kahn D, Steeves R. Spiritual well-being: A review of the research literature.Quality of Life: A Nursing Challenge 1993;2: 60–64, Philadelphia: Meniscus Ltd.
- O'Connor A, Wicker C, Germino B. Understanding the cancer patient's search for meaning.Cancer Nurs 1990;3: 167–175.
- Brown-Saltzman K. Tending the spirit.Oncol Nurs Forum 1994;21: 1001–1006.
- Highfield M. Spiritual health of oncology patients: Nurse and patient perspectives.Cancer Nurs 1992;15: 1–8.
- Ersek M, Ferrell BR. Providing relief from cancer pain by assisting in the search for meaning.J Pallia Care 1994;10(4): 15–22.
- Padilla GV, Grant MM, Ferrell B. Nursing research into quality of life.Quality of Life 1992;1: 341–348.
- Cella D.Functional Assessment of Cancer Therapy Scales, Version 3, Rush-Presbyterian St. Luke's Medical Centre, Rush Cancer Institute, 1994.
- Gill TM, Feinstein AR. A critical appraisal of the quality of quality-of-life measurements.JAMA 1994;272(8): 619–626.
- Ganz PA, Haskell CM, Figlin RA, La Soto N, Siau J. Estimating the quality of life in a clinical trial of patients with metastatic lung cancer using the Karnofsky Performance Status and the Functional Living Index—Cancer.Cancer 1988;61: 849–856.
- Hassey Dow K, Ferrell B. Quality of life perceptions among cured cancer survivors.Oncology Nurs Forum 1994:21 (Suppl).
- Ferrell B, Wisdom C, Wenzl C. Quality of life as an outcome variable in the management of cancer pain.Cancer 1989;63: 2321–2327.
- Ferrell B, Grant M, Padilla G. Experience of pain and perceptions of quality of life: Validation of a conceptual model.Hospice J 1991;7: 9–24.
- Padilla G, Ferrell B, Grant M, Rhiner M. Defining the content domain of quality of life for cancer patients with pain.Cancer Nurs 1990;13: 108–115.
- Ferrell B, Grant M, Schmidt G, et al. The meaning of quality of life for bone marrow transplant survivors. Part I: The impact of bone marrow transplant on quality of life.Cancer Nurs 1992;15: 153–160.
- Ferrell B, Grant M, Schmidt G, et al. The meaning of quality of life for bone marrow transplant survivors. Part II: Improving quality of life for bone marrow transplant survivors.Cancer Nurs 1992;15: 247–253.
- Grant M, Ferrell B, Schmidt G, Fonbuena P, Niland J, Forman S. Measurement of quality of life in bone marrow transplantation survivors.Quality Life Res 1992;1: 375–384.
- Spiker B. Introduction. In: Spiker B, ed.Quality of life assessments in clinical trials. New York: Raven Press, 1990; 3–9.
- Measurement of the quality of life in cancer survivors
Quality of Life Research
Volume 4, Issue 6 , pp 523-531
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