Abstract
Purpose
This paper reports relationships between symptoms assessed using a newly developed instrument for assessing patient-reported symptoms, the Modified Ambulatory Care Flow Sheet (MACFS), and other symptom assessment measures.
Methods
Using a cross-sectional design, patients on active treatment for colorectal cancer were recruited in an ambulatory setting of a tertiary care cancer center in western Canada. Participants completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire—Cancer 30, the Rotterdam Symptom Checklist Modified, Linear analog scales for pain and coping, and the MACFS, all at a single time point.
Results
We found moderate to strong correlations between the MACFS scores and scores on the other symptom measures used. The correlations were not as strong when using the MACFS symptom change scores, as when using the MACFS scores for the presence or absence of a particular symptom.
Conclusions
The MACFS reflects the symptom experience of colorectal cancer patients. Further evaluation in more diverse populations and of the relationship between MACFS symptom scores and quality of life will improve our understanding of the MACFS and of the cancer patient treatment experience.
Similar content being viewed by others
References
Doward, L. C., & McKenna, S. P. (2004). Defining patient-reported outcomes. Value in Health, 7(S), S4–S8.
Centers for Disease Control and Prevention. (2000). Measuring healthy days: Population assessment of health-related quality of life. Atlanta: Centers for Disease Control and Prevention.
de Kort, S. J., Willemse, P. H. B., Habraken, J. M., de Haes, H. C. J. M., Willems, D. L., & Richel, D. J. (2006). Quality of life versus prolongation of life in patients treated with chemotherapy in advanced colorectal cancer: A review of randomized controlled clinical trials. European Journal of Cancer, 42(7), 835–845.
Arndt, V., Merx, H., Stegmaier, C., Ziegler, H., & Brenner, H. (2004). Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: A population-based study. Journal of Clinical Oncology, 22(23), 4777–4784.
Efficace, F., Bottomley, A., Vanvoorden, V., & Blazeby, J. M. (2004). Methodological issues in assessing health-related quality of life of colorectal cancer patients in randomised controlled trials. European Journal of Cancer, 40(2), 187–197.
Armstrong, T. (2003). Symptoms experience: A concept analysis. Oncology Nursing Forum, 30(4), 601–606.
Brown, V. (2001). The development and evaluation of an instrument to assess the adverse effects of cytotoxic chemotherapy. No. SPGS 608. Worthing, UK: NHS Executive South East Research Project Grant Scheme.
Dodd, M., Miaskowski, C., & Paul, S. (2001). Symptom clusters and their effect on the functional status of patients with cancer. Oncology Nursing Forum, 28(3), 465–470.
Miaskowski, C., Dodd, M., & Lee, K. (2004). Symptom clusters: The new frontier in symptom management research. Journal of The National Cancer Institute Monographs, 32, 17–21.
Greenghalgh, J., Long, A. F., & Flynn, R. (2005). The use of patient reported outcome measure in routine clinical practice: Lack of impact or lack of theory? Social Science and Medicine, 60(4), 833–843.
Bliven, D., Kaufman, S., & Spertus, J. (2001). Electronic collection of health-related quality of life data: Validity, time benefits and patient preference. Quality of Life Research, 10, 15–22.
Sloan, J. A., Aaronson, N., Cappelleri, J. C., Fairclough, D. L. D. H., Varricchio, C. D. S. N., & The Clinical Significance Consensus Meeting Group. (2002). Assessing the clinical significance of single items relative to summated scores. Report. Mayo Clinic Proceedings, 77(5), 479–487.
Osoba, O., Aaronson, N., Zee, B., Sprangers, M., & Te Velde, A. (1997). Modification of the EORTC QLQ-C30 (version 2.0) based on content validity and reliability testing in large samples of patients with cancer. Quality of Life Research, 6(2), 103–108.
Velikova, G., & Wright, P. (2005). Individual patient monitoring. In P. Fayers & R. Hays (Eds.), Assessing quality of life in clinical trials (pp. 291–306). Oxford: Oxford University Press.
Dell, R. B., Holleran, S., & Ramakrishnan, R. (2002). Sample size determination. ILAR Journal, 43(4), 207–213.
Algina, J., & Olejnik, S. (2003). Sample size tables for correlation analysis with application in partial correlation and multiple regression analysis. Multivariate Behavioral Research, 38(3), 309–323.
Horsman, S., Olson, K., & Au, H. J. (2009). Symptom and quality of life assessment in ambulatory oncology: The evaluation of a clinical assessment tool. Paper presented at the meeting of the international society for quality of life research, New Orleans, LA.
Horsman, S., & Au, H. J. (2009). The cancer patient in ambulatory oncology: Routine use of PROs into inform patient, nursing and physician interactions. In M. J. Santana & H. J. Au (Chair) Patient reported outcomes in clinical practice: Evolving science and accumulating experience. Symposium conducted at the meeting of the international society for quality of life research, New Orleans, LA.
Horsman, S., & Au, H. J. (2008). A pilot project to assess clinical application of a PRO in ambulatory oncology. Montevideo: Poster session presented at the meeting of the International Society for Quality of Life Research.
de Haes, J. C. J. M., & Olschewski, M. (1998). Quality of life assessment in a cross-cultural context: Use of the Rotterdam symptom checklist in a multinational randomized trial comparing CMF and Zoladex (Goserlin) treatment in early breast cancer. Annals of Oncology, 9(7), 745–750.
Stein, K. D., Denniston, M., Baker, F., Dent, M., Hann, D. M., Bushhouse, S., et al. (2003). Validation of a modified Rotterdam symptom checklist for use with cancer patients in the United States. Journal of Pain and Symptom Management, 26(5), 975–989.
Backer, J. H., Bakas, T., Bennett, S., & Pierce, P. K. (2000). Coping with stress. Programs of nursing research. In V. Hill Rice (Ed.), Handbook of stress, coping and health. Implications for nursing research theory and practice. Thousand Oaks, CA: Sage Publications.
Aaronson, N., Ahmedzai, S., Bergman, B. et al. (1993). The European organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of National Cancer Institute [serial online], 85, 365–375.
Osoba, D., Rodrigues, G., Myles, J., Zee, B., & Pater, J. (1998). Interpreting the significance of changes in health-related quality of life scores. Journal of Clinical Oncology, 16, 139–144.
Salkind, N. J. (2006). Statistics for people who (think they) hate statistics. Thousand Oaks, CA: Sage Publications.
SPSS for Windows Vista. (2007). Rel. 17.0.1. Chicago: SPSS Inc.
Arndt, V., Merx, H., Stegmaier, C., Ziegler, H., & Brenner, H. (2006). Restrictions in quality of life in colorectal cancer patients over three years after diagnosis: A population based study. European Journal of Cancer, 42(12), 1848–1857.
Gotay, C., & Wilson, M. (1998). Use of quality of life outcome assessments in current cancer clinical trials. Evaluation of Health Professions, 21, 157–178.
MacDonald, S., Linton, S., & Jansson-Fröjmark, M. (2008). Reconstructing the past on the original pain recall assessment form (OPRA). The Journal of Pain, 10(8), 809–817.
Hermansen-Kobulnicky, C., Wiederholt, J., & Chewning, B. (2004). Adverse effect monitoring: Opportunity for patient care and pharmacy practice. Journal of American Pharmaceutical Association, 44, 75–88.
Ballatori, E., & Roila, F. (2003). Impact of nausea and vomiting on quality of life in cancer patients during chemotherapy. Health Qual Life Outcomes, 1, 46.
Stull, D. E., Kline Leidy, N., Parasuraman, B., & Chassany, O. (2009). Optimal review periods for patient-reported outcomes: Challenges and potential solutions. Current Medical Research and Opinions, 25(4), 929–942.
Acknowledgments
The authors acknowledge the contributions of Dr Karen Kelly and Dr Alex Clarke to the study upon which this article is based and the financial support for the first author provided by the Cross Cancer Institute and Alberta Cancer Board Nurse Practitioner internship program.
Author information
Authors and Affiliations
Corresponding author
Appendix
Appendix
Rights and permissions
About this article
Cite this article
Horsman, S., Olson, K., Au, H. et al. Symptom assessment in ambulatory oncology: initial validation of the nurse-developed Modified Ambulatory Care Flow Sheet (MACFS). Qual Life Res 21, 899–908 (2012). https://doi.org/10.1007/s11136-011-9998-0
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11136-011-9998-0